Physical exam and history for osteoarthritis
Exam Overview
A doctor often discovers important information about the possible
causes of symptoms through a discussion about your medical history. During this
discussion, the doctor may ask questions such as the following:
- How long have you had symptoms? (Osteoarthritis
usually develops slowly.)
- Are your joints stiff in the morning? If
so, for how long?
- Have you tried any medicines that have helped the
pain? If yes, how much do they help?
- Do exercises help your pain or
make it worse? Which kinds of exercises have you tried? Have you tried
bicycling or swimming for your hips or knees?
- Has there been a
pattern to your symptoms? (Osteoarthritis symptoms typically begin on one side
of the body and often affect just one set of joints.)
- Do you have a
family history of arthritis?
- Do you have any general symptoms that
seem to affect your whole body, such as fatigue, weight loss, or fever?
(Osteoarthritis usually doesn't cause whole-body symptoms.)
- Has
there been any recent or past injury to the affected joints, especially a major
joint injury or injuries related to repetitive motion? (A recent injury may
mean painful symptoms are related to the injury, not an underlying
disease.)
During the physical exam, the doctor will look at, feel, and move
each joint, evaluating it:
- For swelling, warmth, or
tenderness.
- For range of motion.
- To determine the
pattern of affected joints (such as one knee, both knees, knuckles, wrists, or
shoulders). Often, the pattern of joints affected can help a doctor tell the
difference between osteoarthritis and other types of arthritis such as
rheumatoid arthritis.
- To note any bony
knobs (osteophytic changes) on joints (especially the fingers).
The doctor will also look for any signs of unequal leg lengths,
muscle weakness, or muscle wasting.
During a physical exam, the doctor also will do an evaluation of
the lungs, heart, liver, and kidneys.
Why It Is Done
A medical history and physical exam are a normal and important part
of the evaluation of joint pain and stiffness.
Results
The key to diagnosing osteoarthritis is determining the pattern of
joints
that are affected . For example, if you have symptoms in the set of
knuckle joints between the wrists and finger joints (metacarpal-phalangeal
joints), the balls of the feet (metatarsal-phalangeal joints), wrists, ankles,
or elbows, you probably have a different, inflammatory form of arthritis such
as rheumatoid arthritis.
Normal
A normal joint is not painful, tender, or swollen, has a full
range of motion, and appears structurally normal.
Abnormal
In an abnormal joint, an exam may detect pain or swelling along
with a bony hardness. Other abnormal findings that suggest osteoarthritis
include:
- Bony bumps on the finger joint closest to the
fingernail (Heberden's nodes), bony bumps on the middle joint of
the finger (Bouchard's nodes), or bony bumps at the base of the
thumb.
- Tenderness and/or swelling in weight-bearing joints such as
the hips and knees.
- Pain, limited movement, and/or a creaking noise
or feeling (crepitus) that occurs when the joints are moved.
- Joints
that have been affected by injury or infection. These joints may also show
signs of bone or tissue damage.
What To Think About
Distinguishing between osteoarthritis and other types of arthritis
may be difficult based on individual joint symptoms but a pattern of symptoms
may indicate the type of arthritis.
-
Characteristics of rheumatoid arthritis and
osteoarthritis
Complete the
medical test information form (PDF) (What is a PDF document?)
to help you prepare for this test.
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