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[[File:Osteoarthritis differential diagnosis.gif|thumb|Osteoarthritis differential diagnosis]]
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{{Osteoarthritis}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Osteoarthritis]]
{{CMG}}
{{CMG}} {{AE}}[[User:DrMars|Mohammadmain Rezazadehsaatlou]] [2], [[User:Irfan Dotani|Irfan Dotani]] [3]


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==Overview==
==Overview==
OA must be differentiated from other diseases that cause joint impairment and  other related signs and symptoms such as [[Rheumatoid arthritis]], [[Gout]], Joint [[tuberculosis]].
==Differentiating Osteoarthritis from other Diseases==
==Differentiating Osteoarthritis from other Diseases==
Diseases which can have similar symptoms are
Diseases which can have similar symptoms are <ref name="pmid25817486">{{cite journal |vauthors=Pereira D, Ramos E, Branco J |title=Osteoarthritis |journal=Acta Med Port |volume=28 |issue=1 |pages=99–106 |date=2015 |pmid=25817486 |doi= |url=}}</ref><ref name="pmid21467838">{{cite journal |vauthors=Sakalauskienė G, Jauniškienė D |title=Osteoarthritis: etiology, epidemiology, impact on the individual and society and the main principles of management |journal=Medicina (Kaunas) |volume=46 |issue=11 |pages=790–7 |date=2010 |pmid=21467838 |doi= |url=}}</ref><ref name="pmid25748615">{{cite journal |vauthors=Glyn-Jones S, Palmer AJ, Agricola R, Price AJ, Vincent TL, Weinans H, Carr AJ |title=Osteoarthritis |journal=Lancet |volume=386 |issue=9991 |pages=376–87 |date=July 2015 |pmid=25748615 |doi=10.1016/S0140-6736(14)60802-3 |url=}}</ref><ref name="pmid25100783">{{cite journal |vauthors=Chu CR, Millis MB, Olson SA |title=Osteoarthritis: From Palliation to Prevention: AOA Critical Issues |journal=J Bone Joint Surg Am |volume=96 |issue=15 |pages=e130 |date=August 2014 |pmid=25100783 |pmc=4116563 |doi=10.2106/JBJS.M.01209 |url=}}</ref>:
*[[Rheumatoid arthritis]]
*[[Rheumatoid arthritis]]
*[[Gout]]
*[[Gout]]
*Joint [[tuberculosis]]
*Joint [[tuberculosis]]
Diagnoses of arthritis are largely clinical, but laboratory tests such as ANA, erythrocyte sedimentation rate, C-reactive protein can help differentiate osteoarthritis from an inflammatory cause of arthritis.
{| class="wikitable"
!Disease
!Differentiating signs and symptoms
!Diagnostic findings
|-
|[[Fibromyalgia]]
|
* Symptoms have been present at a similar level for at least 3 months.
* Chronic [[musculoskeletal pain]] with multiple tender points
* [[Stiffness]], [[numbness]], and [[fatigue]]
* [[Headaches]]
* [[Sleep disorder]]
|
*All lab tests are normal
|-
|[[Rheumatoid arthritis]]
|
* Multiple [[joint swelling]]
* Morning [[stiffness]]
* [[Rheumatoid nodules]]
|
* [[Rheumatoid factor|RF]] or [[Anti-citrullinated protein antibody|anti-cyclic citrullinated protein (CCP) antibody]] is positive.
* Markers of systemic inflammation ([[ESR]], [[CRP]]) are typically elevated.
|-
|[[SLE]]
|
* [[Maculopapular rash]]
* Multi-system involvement
|
*Positive anti-Smith [[antibodies]]
|-
|[[Chronic fatigue syndrome]]
|Fatigue plus 4 of the following symptoms:
*Short-term [[memory loss]]
*[[Sore throat]]
*Tender [[lymph nodes]] in the neck or armpit
*[[Muscle pain]]
*[[Joint pain]] without [[swelling]] or [[Redness of the skin|redness]]
*[[Headaches]]
*[[Insomnia]]
*[[Malaise]]
|
*Diagnosis of exclusions
*Symptoms must present for more than 6 months
|-
|[[Spondyloarthritis]]
|
* [[Axial skeleton|Axial skeletal]] pain and [[stiffness]]
* Restricted spinal motion
|
* Elevated [[ESR]] or [[CRP]]
* Negative [[RF]]
* [[Bamboo spine]] on [[x-ray]]
|-
|[[Polymyalgia rheumatica]]
|
* Older at onset
* Generalized [[stiffness]]
|
* An elevated [[erythrocyte sedimentation rate]] ([[ESR]]) OR [[C-reactive protein]] (CRP)
* Response to [[corticosteroids]]
|-
|[[Osteoarthritis]]
|
* Localized [[joint pain]]
* Restricted to affect joints
* Older at onset
|
* [[X-ray]] of the involved joints demonstrate degenerative changes
|-
|[[Hypothyroidism]]
|
*Systemic symptoms such as [[weight gain]], [[constipation]], [[dry skin]]
*[[Myalgia|Muscular aching]] and prominent [[fatigue]] that improves on replacement of [[thyroid hormone]].
|
*[[TSH]] is elevated and free [[T4]] is low.
|-
|Myopathaies ([[polymyositis]] and [[dermatomyositis]])
|
*Pelvic and shoulder girdle [[muscle weakness]]
*[[Rash]]
|
*[[Muscle biopsy]] confirms the diagnosis
*Elevated [[CPK|CPK enzyme]]
|-
|[[Neuropathy]]
|
*[[Numbness]] and [[tingling]]
*[[Paresthesia]]
|
*Abnormal [[EMG]]
|}


==References==
==References==

Latest revision as of 21:07, 20 February 2019

Osteoarthritis differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou [2], Irfan Dotani [3]

Overview

OA must be differentiated from other diseases that cause joint impairment and other related signs and symptoms such as Rheumatoid arthritis, Gout, Joint tuberculosis.

Differentiating Osteoarthritis from other Diseases

Diseases which can have similar symptoms are [1][2][3][4]:

Diagnoses of arthritis are largely clinical, but laboratory tests such as ANA, erythrocyte sedimentation rate, C-reactive protein can help differentiate osteoarthritis from an inflammatory cause of arthritis.

Disease Differentiating signs and symptoms Diagnostic findings
Fibromyalgia
  • All lab tests are normal
Rheumatoid arthritis
  • Markers of systemic inflammation (ESR, CRP) are typically elevated.
SLE
Chronic fatigue syndrome Fatigue plus 4 of the following symptoms:
  • Diagnosis of exclusions
  • Symptoms must present for more than 6 months
Spondyloarthritis
Polymyalgia rheumatica
Osteoarthritis
  • Localized joint pain
  • Restricted to affect joints
  • Older at onset
  • X-ray of the involved joints demonstrate degenerative changes
Hypothyroidism
  • TSH is elevated and free T4 is low.
Myopathaies (polymyositis and dermatomyositis)
Neuropathy

References

  1. ↑ Pereira D, Ramos E, Branco J (2015). "Osteoarthritis". Acta Med Port. 28 (1): 99–106. PMID 25817486.
  2. ↑ Sakalauskienė G, Jauniškienė D (2010). "Osteoarthritis: etiology, epidemiology, impact on the individual and society and the main principles of management". Medicina (Kaunas). 46 (11): 790–7. PMID 21467838.
  3. ↑ Glyn-Jones S, Palmer AJ, Agricola R, Price AJ, Vincent TL, Weinans H, Carr AJ (July 2015). "Osteoarthritis". Lancet. 386 (9991): 376–87. doi:10.1016/S0140-6736(14)60802-3. PMID 25748615.
  4. ↑ Chu CR, Millis MB, Olson SA (August 2014). "Osteoarthritis: From Palliation to Prevention: AOA Critical Issues". J Bone Joint Surg Am. 96 (15): e130. doi:10.2106/JBJS.M.01209. PMC 4116563. PMID 25100783.

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