How is arthrosis diagnosed?
The diagnosis of osteoarthritis is usually made by the physician from the clinical picture. If the patient comes to the doctor and complains of pain in the frequently affected joints:
- Finger joints (finger arthrosis)
- Foot toe joints (toe joint arthrosis)
- Hip joints (hip arthrosis)
- Shoulder joints (shoulder joint arthrosis)
- Knee joints (knee joint arthrosis)
the suspicion of arthrosis of the corresponding joint must be raised. The doctor (usually a specialist in orthopaedics) will usually have an X-ray taken after the patient has been questioned and the physical examination.
The physical diagnosis/examination of the patient consists of an inspection of the corresponding joints. This includes checking whether the joint is swollen or deformed and whether the skin is reddened. This is followed by the physical examination which consists of palpation of the joint.
Furthermore, the doctor moves the patient’s joint and looks for pain indicated by the patient, as well as for blockages and movement restrictions. The diagnosis “arthrosis” can be made on the basis of several factors. These include physical examination by the doctor, imaging procedures (e.g. X-ray, CT and MRI) and examination of the patient’s blood.
Arthroscopy is also used to diagnose arthrosis. When making a diagnosis, it must always be asked whether the disease is already known in the family. If this is the case, the probability that the patient concerned suffers from arthrosis increases.
One of the most important aspects is to ask the doctor about the type of pain. With arthrosis, the pain often occurs after a long rest, i.e. in the morning (morning stiffness). In addition, the doctor should exclude overloading as a cause of pain and swelling of joints by asking specific questions.
In the x-rays of a joint that has arthrosis, typical changes can be seen. These include a narrowing of the joint space and a thickening of the bone beneath the cartilage. In addition, the bone has formed offshoots (so-called “osteophytes”) and cysts can be seen in the bone itself.
Often, bone malpositions can also be detected, which can either be the consequence or the cause of the arthrosis. As an alternative to an x-ray, an ultrasound can also be performed to diagnose the joint. In its accuracy and differentiation, however, it is subject to X-ray imaging, since apart from the joint space narrowing, none of the above-mentioned signs are usually seen in ultrasound.
MRI, which is becoming increasingly important in the diagnosis of osteoarthritis, is much more obvious. However, it is usually not used for initial diagnosis. Rather, it is used for a more detailed examination if X-rays do not provide a clear indication of arthrosis. The MRI can also show nerve and muscle involvement, which can cause corresponding pain.