Diagnosing Arthritis

•    What symptoms are you experiencing?
•    How long have you experienced the symptoms?
•    What joints are affected – are they swollen, red, tender or warm to touch?
•    Did the symptoms begin suddenly or come on gradually?
•    Are your symptoms worse after activity or rest?
•    Do the symptoms occur in the morning or evening or do you experience them throughout the day?
•    What, if anything, provides some relief from the pain?

•    Have you been ill recently?
•    What medications-- prescription or over-the-counter -- do you take?
•    Have you ever been diagnosed with a chronic or autoimmune disease?
•    Have you had any injuries to the affected joints?
•    Do you work in a job requiring long hours of standing or sitting, frequent kneeling or repetitive motion?
•    Have you recently lived in an area where fungal infections are common?

Your doctor will ask you about the medical history of your family members, such as does anyone have

•    Arthritis
•    Autoimmune diseases 
•    Chronic conditions 
•    Anxiety or depression

•    Do you smoke or do drugs?
•    How much exercise do you get on a daily basis?
•    What types of food do you eat?
•    How well do you sleep?
•    Do you have a lot of stress in your life?

Your doctor will also conduct a physical exam.  In addition to the usual steps – taking your temperature, feeling for swollen glands, looking in your eyes and down the throat, listening to your heart and checking your blood pressure – your doctor will also look at your affected joints for visible signs of swelling or redness. She may move the joints to see range of motion and check for tender areas in or around the joints. 

If you are experiencing back pain, your doctor will check for an abnormal curve in your spine. He might also ask you to stand and walk to see how you walk to whether pain affects the way you walk.

Depending upon the results of the medical history and physical exam, your doctor may order tests.

X-rays are the most frequent imaging test, but sometimes ultrasound or MRI are used. Your doctor will be looking for inflammation, erosion or other signs of joint distress.

Your doctor may request an electrodiagnostic study or nerve test to determine if the electrical activity in the nerves has been disrupted.

Blood tests are not needed to diagnose all types of arthritis, but they help to confirm or exclude some forms of inflammatory arthritis. Your doctor may also draw joint fluid or do a skin or muscle biopsy to help diagnose certain forms of arthritis.

Making an arthritis diagnosis may take some time.  It may involve a primary care doctor, a rheumatologist, a pain specialist and an orthopaedist. They are more than 100 types of arthritis and related conditions and some conditions have similar symptoms. You may need to take several different tests and be patient during the process.