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? (
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.)
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 to a
During the physical exam, the doctor will look at, feel,
and move each joint, evaluating it:
For swelling, warmth, or
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
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
Why It Is Done
A medical history and physical exam
are a normal and important part of the evaluation of joint pain and
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.
A normal joint is not painful, tender, or swollen, has a
full range of motion, and appears structurally normal.
In an abnormal joint, an exam may detect pain or
swelling along with a bony hardness. Other abnormal findings that suggest
Bony bumps on the finger joint closest to the
Heberden's nodes), bony bumps on the middle joint of
the finger (
Bouchard's nodes), or bony bumps at the base of the
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.
that have been affected by injury or infection. These joints may also show
signs of bone or tissue damage.
What To Think About
osteoarthritis and other types of arthritis may be difficult based on
individual joint symptoms. But a pattern of symptoms may point to the type of
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