Medical Tests & Diagnosis Methods/Tools
Different diagnostic methods to detect arthritis include:
I. Physical Examination: In physical
examination, the doctor looks out for following points:
Swelling: Inflammation of the
synovial membrane causes mild joint swelling. Marked swelling
indicates excessive joint fluid which is a sign of inflammation
or bleeding into the joint.
enlargement is not the same as swelling. Bony enlargement without
joint swelling is hard to touch and is not usually tender. This
is a specific characteristic of osteoarthritis and may occur without
joint pain subsequently leading to rheumatoid arthritis.
The mobility of joints is assessed in two ways:
- Active Range Motion: The patient voluntarily
moves the joints.
- Passive Range Motion: The doctor moves the
patients joints and compares it with active motion.
By comparing the two movements it can be determined
if the cause is due to muscle weakness, bursitis or tendonitis.
The doctor listens and feels for crepitus, a crunching or grating
sensation that is caused by rubbing together of rough surfaces inside
Spine Flexibility: Spine flexibility
is tested by asking the patient to bend forward and touch the
toes without moving the pelvis, bend backward, lean from one side
to the other and twist upper body from side to side (32).
II. Blood Tests: Blood tests involve
complete blood cell count, anemia and tests for infection. Blood tests
- Antibody tests: This test helps in detecting
various antibodies suggesting the presence of arthritis. In
patients suspected to be suffering from rheumatoid arthritis,
the test for rheumatoid factor is called for and the presence
of 70-80% of this antibody confirms the same. Similarly, anticitrullinated
cyclic protein (anti-CCP) test and a test for antinuclear
antibodies (ANAs) are also done to detect rheumatoid arthritis
and lupus (SLE) respectively.
- Rate of Erythrocyte sedimentation and
C-reactive protein level in the blood: Elevated levels
of C-reactive protein and higher rate of Erythrocyte sedimentation
indicate severe inflammation (as in rheumatoid arthritis).
However, people suffering from osteoarthritis indicate normal
- Serum Uric Acid Test: Uric
acid level in blood is elevated in gout.
III. X-rays: Joint abnormalities due
to arthritis are detected with the help of x-rays. In rheumatoid arthritis
and gout the erosion is easily detectable.
IV. Magnetic Resonance Imaging (MRI):
This test helps in assessing soft tissues, cartilage, tendons and
joint inflammation. An MRI helps in diagnosing rheumatoid arthritis.
V. Scintigraphy: This radiographic
diagnostic method is adopted for detecting the bone abnormalities
by injecting radioisotope (a radioactive dye) into a vein.
VII. Computed Tomography (CT): This
radiographic technique is used to scan and evaluate the joints for
hidden fractures, torn cartilage and other structural abnormalities.
VIII. Arthrocentesis: In this method,
a small sample of synovial fluid is taken for examination. An excess
synovial fluid indicates bacterial infection in the joint, crystal
deposits, injury, bleeding into the joint or synovial inflammation.
An increase in White Blood Cell (WBC) count in the synovial fluid
indicates infection or severe inflammation (33).
Article by Kona Vishnu, MS
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