When taking vital signs (i.e., blood pressure, weight, temperature), the patient's gait and arm and hand movement should be observed by the nursing staff or physician assistants; if pain is the chief complaint, the affected joint should be examined. After a brief examination, the nurse, nurse practitioner, or physician assistant should ask the length of time the pain has affected the patient and if there have been any limitations in his or her work or home life. The practitioner should record abnormal symptoms on the intake sheet for review by the physician. As part of the physical examination, the physician will evaluate swelling, limitations on the range of motion, pain on movement, and crepitus (i.e., cracking or grinding sound heard during joint movement). Osteoarthritis is often similar in presentation to rheumatoid arthritis, but lacks the presence of inflammation (until its very late stages) found in rheumatoid arthritis.
There is no laboratory test specific to the diagnosis of OA. Laboratory tests are important, however, in ruling out other diseases that may be responsible for the symptoms the patient is presenting. Treatment is usually based on the results of diagnostic imaging, which is conducted by a radiologic technician or radiologist. The features of the disease are a loss of joint space, the presence of subchondral cysts, and evidence of new bone formation (i.e., bone spurs). The patient's symptoms, however, do not always correlate with x-ray findings. Magnetic resonance imaging (MRI) and computed tomography (CT), or computed axial tomography (CAT) scans can be used to more precisely determine the location and extent of cartilage damage.
Osteoarthritis is a progressive disorder without a permanent cure. In some patients, the rate of progression can be slowed by weight loss, appropriate exercise, surgical treatment, and the use of alternative therapies.
Michele R. Webb, The Gale Group Inc., Gale, Detroit,