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Harvard Commentaries
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Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Diagnosis


April 03, 2009

Arthritis
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Basics
Diagnosis
Diagnosis
htmArthritisDiagnosis
In most cases, arthritis is diagnosed after an individual contacts his or her health care professional because chronic pain has begun to interfere with daily life.
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2009-04-03
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2011-01-03

Reviewed by the Faculty of Harvard Medical School

Diagnosing Arthritis

In most cases, arthritis is diagnosed after an individual contacts his or her health care professional because pain is significant and has begun to interfere with daily life. If you have that kind of pain, your physician will ask you to describe the feeling because the severity and quality of the pain is helpful in figuring out the cause. Is it a throbbing, achy, burning or stabbing sensation? Is it constant or occasionally intense? Do certain activities make the pain worse? Is it worse in the morning or at night? In some cases, your doctor may ask you to record your daily experiences in a pain diary.

Your health care professional will review your current symptoms as well as your past medical history, family history and medication use. A thorough medical examination will follow. The doctor may order blood and urine tests, and, in select cases, X-rays and possibly imaging procedures such as a computed tomography (CT) or magnetic resonance imaging (MRI) may be recommended.

Once arthritis has been detected, a treatment plan can be developed to suit you and your lifestyle. With early diagnosis, most arthritic conditions can be managed sufficiently to minimize both the pain and the disruption to your daily life. In many instances, early diagnosis and treatment can also work to curtail the actual damage that the condition can cause.

The pain associated with arthritis stems from a number of sources. When, for example, the tissue that lines the joints (synovial membrane), tendons or ligaments swells, you may feel aches and discomfort right at the joint. Muscle strain and fatigue frequently follows as well, adding to the intensity and duration of pain. If there is joint damage over time, even the most ordinary activities — getting out of bed in the morning, taking a bath, holding a pencil — can cause pain.

At the same time, the level of pain and discomfort that people find tolerable varies from person to person, from situation to situation. Each person's threshold for pain is different. In addition, it is not uncommon for an individual who lives with chronic pain, or the possibility of intense, intermittent pain, to experience anxiety and reactive depression as a result. Emotional stress and distress can intensify the sensation of pain.

Recognizing the typical types of pain, the location and the accompanying features helps clarify whether arthritis is present. Once the diagnosis is established, the type of arthritis may help direct treatment and provide an idea of what to expect. It should be noted, however, that the specific type of arthritis cannot always be diagnosed early in the course of illness. In addition, many types of arthritis are treated similarly, so a specific diagnosis is not always as helpful as it might seem.

In many types of arthritis, the course of the disease is unpredictable. Most chronic diseases involve, by their very nature, periods when the symptoms are active and troublesome (flares) and periods when symptoms are negligible (remissions). This unpredictable and variable course can complicate both diagnosis and treatment.

 

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