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Osteoarthritis: Diagnosis
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Lead Author(s):Â
Dwain M. Daniel, D.C.
How this evidence was rated:
Strength of Recommendation Taxonomy (SORT)
Strength of Recommendation Taxonomy (SORT)
Legend:A = consistent, good quality patient oriented evidence;
B = inconsistent or limited quality patient oriented evidence;
C = consensus, disease oriented evidence, usual practice, expert opinion or case series;
D = all or the preponderance of existing evidence is negative.
For more information on the Strength of Recommendation Taxonomy (SORT), please click here.
Published on
February 28, 2007
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Diagnosis
of osteoarthritis (OA) is primarily based on history, examination and
radiographic examination. Interestingly, no clear consensus has been
developed that specifically defines the diagnostic criteria for OA (1).
One question that has yet to be answered is whether radiographic
changes without pain or disability are properly diagnosed as OA (2).
The criteria established by the American Board of Rheumatology for
diagnosis follows (keep in mind different criteria are used for
different joints and the guideline presented here is for a general
diagnosis):
A. Clinical (3 of 6 factors)
1. Age over 50 years
2. Stiffness developing in less than 30 minutes of immobility
3. Crepitus
4. Bony tenderness
5. Bony enlargement
6. No palpable warmth
B. Radiographic
1. Osteophyte formation
2. Decreased joint space
C. Laboratory
1. Erythrocyte sedimentation rate
2. Rheumatoid factor
3. Synovial fluid signs (clear, viscous or WBC count of <2,000/mm3)
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References
1.Â
Reijman M, Hazes JM, Koes BW, Verhagen AP, Bierma-Zeinstra SM. Validity, reliability, and applicability of seven definitions of hip osteoarthritis used in epidemiological studies: a systematic appraisal. Ann Rheum Dis 2004; 63(3):226-232.
2.Â
Hinton R, Moody RL, Davis AW, Thomas SF. Osteoarthritis: diagnosis and therapeutic considerations. Am Fam Physician 2002; 65(5):841-848.