The diagnosis of arthritis is made based on history of patient’s complaints (symptoms), past history and family history of such complaints, a detailed physical examination and investigations.
Patients with complaints of pain, swelling, stiffness, deformity and disability of more than 4-6 weeks’ duration should undergo a thorough clinical examination by a specialist along with X-rays of the affected joint. Based on the findings examination and X-rays, further laboratory tests may be necessary to ascertain the cause and extent of involvement of the joint.
X-rays
Routinely X-rays are taken in two projections (AP & Lateral view). In certain situations it may be necessary to take special views. X-rays give a broad idea about the status of the bony structure and alignment of the joint. In early stages of the disease X-rays may be completely normal.
Laboratory tests
The blood tests that are commonly ordered are CBC (complete blood count), ESR (sedimentation rate), CRP (C- reactive protein), RA (Rheumatoid arthritis) factor and Serum uric acid. In some cases it may be necessary to do further tests like the HLA-B27, ANA factor and Anti-CCP antibody. In cases where infective or inflammatory arthritis (like gout) is being considered it may be necessary to aspirate (withdraw fluid from the joint) and subject it to laboratory tests (Synovial fluid analysis).
MRI scans
Occasionally it may be necessary to do MRI scanning of the joint. MRI scans give a much better definition of the soft tissues (cartilage, ligaments etc) in and around the joint. They are more useful in early stages of the arthritis to detect tears or damage in the cartilage or ligaments.