Obtaining a quality diagnosis

The medical management of arthritis and joint degeneration may be handled by a family doctor, an internist, or a rheumatologist. However, when medical management is not effective, an orthopaedic surgeon should be consulted to determine if surgery is an option. In some cases, the orthopaedic surgeon may be the first physician to see a patient and make the diagnosis of arthritis.

The orthopaedic evaluation

While every orthopaedic evaluation is different, there are many commonly used tests that an orthopaedic surgeon may consider in evaluating a patient's condition.

In general, the orthopaedic evaluation usually consists of :

• A thorough medical history
• A physical examination
• X-rays
• Additional tests, as needed

A medical history is taken to assist the orthopaedic surgeon in evaluating your overall health and the possible causes of your joint pain. In addition, it will help him or her determine to what degree your joint pain is interfering with your ability to perform everyday activities.

What the physician sees during the physical examination, helps confirm (or rule out) the possible diagnosis. The physical exam will also enable the orthopaedic surgeon to evaluate other important aspects, including:

• Strength
• Range of motion
• Swelling
• Reflexes
• Skin condition

After the physical examination, X-ray evaluation is usually the next step in making the diagnosis. The X-rays help show how much joint damage or deformity exists. An abnormal X-ray may reveal:

• Narrowing of the joint space
• Cysts in the bone
• Spurs on the edge of the bone
• Areas of bony thickening called sclerosis
• Deformity or incorrect alignment

Occasionally, additional tests may be needed to confirm the diagnosis. Laboratory testing of your blood, urine, or joint fluid can be helpful in identifying specific types of arthritis and in ruling out certain diseases. Magnetic Resonance Imaging (MRI) or a bone scan may be needed to determine the condition of the bone and soft tissues of the affected joint.