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 to a
    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 point to the type of
arthritis.

Comparing Rheumatoid Arthritis and Osteoarthritis

Complete the medical test information form (PDF) (What is a PDF document?) to help you prepare for this test.

Credits

ByHealthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD – Internal Medicine
Martin J. Gabica, MD – Family Medicine
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer Stanford M. Shoor, MD – Rheumatology

Current as ofOctober 10, 2017