Diagnosis of Osteoarthritis

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Diagnosis is based on:

family history of any joint disorder,
previous injuries,
when the symptoms started,
where the pain is,
whether the pain comes and goes or if it is constant,
what brings it on and makes it worse,
how much disability it causes, and
what other symptoms are associated with it.

X-rays show typical changes in the affected joints. In the case of osteoarthritis of the hip joint, one of the most striking changes to be seen on x-ray is the loss of the normal space between the ball at the head of the hip bone (femur) and the cup into which it fits. This space is easily visible all round the head in a healthy hip joint.

Other x-ray signs include increased density in the bone around the joint and the presence of abnormal bony outgrowths on the edges of the joint or spurs into the joint. These are called osteophytes. There may be cysts in the bones of the joint. Another x-ray feature of osteoarthritis is lipping - the formation of a curled edge at the bearing joint surface of a bone.

In the knee joint, x-ray examination will commonly show cysts under the bearing cartilages and loose pieces of cartilage, known as loose bodies, in the joint. Magnetic resonance imaging (MRI) is very useful for showing up disease of soft tissue in and around the affected joint and is being increasingly used. It provides more detailed information than straight x-rays do.

Other special methods of examination include removing a little of the joint fluid by needle and syringe for examination, and the use of fine optical instruments that are passed into the joint for direct inspection. This technique is called arthroscopy and is widely used for direct inspection and to allow delicate surgery to be performed within the joint.