Step 4: How osteoarthritis is diagnosed
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Allergen: A substance that triggers an allergic reaction.

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Allergic Rhinitis: An allergy affecting the mucus membrane of the nose. Seasonal allergic rhinitis is often called "hay fever."

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Allergist: A doctor that diagnoses, treats, and manages allergy-related conditions.

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Ana-Kit: A device used to inject epinephrine during an anaphylaxis attack.

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Anaphylaxis: A life-threatening allergic reaction that involves the entire body. Anaphylaxis may result in shock or death, and thus requires immediate medical attention

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Animal dander: The small scales or pieces of skin, often containing proteins secreted by oil glands, which are shed by an animal. These proteins are the major causes of allergies to pets.

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Antibiotics: A class of medications used to treat bacterial infections. Certain antibiotics, such as penicillin, may cause an allergic reaction in some people.

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Antibody: A protein in the immune system that recognizes and attacks foreign substances in the body.

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Anticonvulsant: A medication used to prevent or treat seizures. Certain anticonvulsants may cause an allergic reaction in some people.

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Antihistamines: A class of medications used to block the action of histamines in the body and prevent the symptoms of an allergic reaction.

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Asthma: An inflammatory disorder of the airways, causing periodic attacks of wheezing, coughing, chest tightness, and shortness of breath.

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Atopic dermatitis: A chronic skin rash, also known as "eczema," that often appears in the first few years of life.

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Basophil: An immune system cell that attaches to antibodies and circulates through out the blood.

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Beta-blockers: A class of blood pressure medications that ease the heart's pumping action and widen the blood vessels. Beta-blockers counteract the effects of epinephrine used for emergency treatment of anaphylactic shock and should not be used during immunotherapy.

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Bronchial tubes: The lower sections of the airway that lead into the lungs.

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Challenge test: A test used to confirm an allergy to specific substance. A doctor will administer small but increasing amounts of a suspected allergen until an allergic response is noticed. Due to the risk of anaphylaxis, this should only be performed under a controlled setting.

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Conjunctivitis: Inflammation of the conjunctiva, or the mucous membrane surrounding the eye. Also known as pinkeye.

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Contact dermatitis: An allergic reaction resulting from skin contact to an allergen.

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Corticosteroid: An anti-inflammatory medication used to treat the itching and swelling associated with some allergic reactions.

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Cromolym sodium: An anti-inflammatory nasal spray used to treat and sometimes prevent allergic rhinitis.

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Decongestants: A class of medications used for nasal congestion. Decongestants are available in oral doses, nasal sprays, or eye drops (for conjunctivitis).

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Dust mites: A microscopic organism that lives in dust.

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Eczema: See Atopic dermatitis.

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Eosinophil: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Epinepherine: A medication used for immediate treatment of anaphylaxis by raising blood pressure and heart rate back to normal levels. Epinepherine is also known as adrenaline.

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EpiPen: A device used to inject epinephrine during an anaphylaxis attack.

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Heparin: A chemical released by basophils and mast cells that causes nearby tissues to become swollen and inflamed.

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Histamine: A chemical released by basophils and mast cells that causes nearby tissues to become swollen and inflamed.

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Hives: See urticaria.

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Hypertension: High blood pressure. When blood pushes against artery walls harder than normal.

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Immunoglobulin E: A type of antibody responsible for most allergic reactions.

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Immunotherapy: A series of shots that help build up the immune system's tolerance to an allergen.

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Insulin: A hormone that regulates blood sugar levels. Diabetics who take insulin derived from animals may have allergic reactions.

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Intradermal test: A test where an allergen is injected just underneath the skin. Intradermal tests are generally used when results from a skin prick test are unclear.

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Late Phase: The period 4 - 24 hours after exposure to an allergen where tissue damage may occur.

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Leukotrienes: Inflammatory substances that are released by mast cells during an allergic response or asthma attack.

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Lymphocyte: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Mast cell: An immune system cell which attaches to antibodies and is located in the tissue that lines the nose, bronchial tubes, gastrointestinal tract, and the skin

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Neocromil sodium: An inhaled medication used to treat inflammation involved with asthma.

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Neutrophil: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Otitis media: A middle ear infection. Otitis media with effusion occurs when fluid builds up within the ear.

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Radioallergosorbant Test (RAST): A blood test that measures the amount of IgE antibody produced when the sample is mixed with a specific allergen.

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Rhinitis: An inflammation of the nasal passageways, particularly with discharge.

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Sinusitis: An inflammation or infection of one or more sinuses. The sinuses are hollow air spaces located around the nose and eyes.

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Skin prick test: A test where a needle is used to scratch the skin with a small amount of allergen. A response can usually be seen within 15 - 20 minutes.

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Urticaria: Raised areas of the skin that are often red, warm, and itchy. Urticaria is also known as hives.

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Urushiol: An oil found on poison ivy, oak, and sumac.

Older people often don't realize that they have osteoarthritis if they are free of pain and other symptoms. However, x-rays often reveal some osteoarthritis of the spine or fingers in elderly individuals.

Your doctor can diagnose osteoarthritis with:

  • A physical examination and discussion of your symptoms
  • X-rays and possibly other imaging studies
  • Fluid aspiration and blood analysis

Physical examination

If you have joint pain or other joint symptoms, you can talk to your primary care provider, who will be very familiar with diagnosing arthritis. You can also see a rheumatologist (a specialist in joint disorders). The doctor will ask you about any illnesses, injuries, or operations you have had in the past. You should tell the doctor about any allergies or other conditions you have right now.

The doctor will inspect your joints, checking for swelling, redness, heat, tenderness, and rashes. The doctor will want to identify which joints are affected, and how, in order to distinguish osteoarthritis from other forms of arthritis.

The muscles that surround painful, underused joints may be weak. The symptoms in your hands may be especially important in making the diagnosis. Osteoarthritis tends to involve the base of the thumb and the middle and end joints of the fingers.

Osteoarthritis is associated with the aging process and can affect any joint. The cartilage of the affected joint is gradually worn down, eventually causing bone to rub against bone. Bony spurs develop on the unprotected bones causing pain and inflammation.

X-rays and imaging studies

X-rays can confirm that you have arthritis, but will not necessarily indicate the type of arthritis. Your doctor will look for specific structural changes in the joints that suggest osteoarthritis, such as:

  • Narrowing of the joint space. This occurs due to loss of cartilage (for example, joint space narrowing of the inside half of the knee).
  • Bony spurs. These are outgrowths of new bone that develop at the margin of the joint. It is nature's way of protecting the joint.
  • One-sided distribution (for example, one knee, one hip) of joint irregularities.
  • Cysts. These may be seen in the bone just beneath the joint surfaces.

By contrast, imaging studies in people with rheumatoid arthritis more often shows:

  • Loss of calcium from the bone (localized bony decalcification)
  • Erosion-producing defects or holes in the bones in a joint
  • Changes in many joints on both sides of the body

Laboratory tests

If there is a question about the exact nature of joint swelling, the physician may perform a joint aspiration. During this procedure:

  • A needle is gently inserted into the joint to withdraw a small amount of synovial fluid from the joint.
  • The fluid then is tested for chemistry, viscosity (thickness), blood cell counts, overall appearance, and microorganisms (if an infection is suspected).
  • The fluid from an osteoarthritis joint is usually clear, whereas in rheumatoid arthritis, it is cloudy due to the presence of many white blood cells.
  • The fluid then is tested for crystals to exclude diagnoses such as gout.
  • Sometimes the fluid from an osteoarthritis joint contains crystals such as calcium pyrophosphate, which may cause mild irritation and increase swelling.

Blood tests may be ordered to identify infection, measure blood cell counts, and pinpoint telltale diagnostic findings such as rheumatoid factor (RF), which are more common in people with inflammatory types of arthritis, such as rheumatoid arthritis.

Blood and urine tests may be ordered to rule out conditions such as gout. The blood from people with gout contains a high level of uric acid, which is associated with the buildup of arthritis-causing crystals in the joint fluid.

Did you know...?

  • Osteoarthritis is one of the oldest discovered health problems, having been found in dinosaur joints and Egyptian mummies.
  • Osteoarthritis occurs in both men and women and usually develops after age 45.
  • Over 50% of people over 65 have some degree of osteoarthritis.

 

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Review Date: 11/22/2006

Reviewed By: Alan Greene, M.D., F.A.A.P., Stanford University School of Medicine; Chief Medical Officer, A.D.A.M., Inc.


The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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