Osteoarthritis: Diagnosis [Clinical Review Discussion]

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)