Osteoarthritis differential diagnosis

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Osteoarthritis differential diagnosis
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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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