How Do You Test for Osteoarthritis? Here’s How It’s Diagnosed
Key takeaways:
Osteoarthritis is diagnosed using a combination of self-reported symptoms, physical exam findings, and X-ray images.
Expensive imaging tests like CT scans and MRIs are rarely needed to diagnose osteoarthritis.
Talk to your primary care provider if you have ongoing or worsening joint pain, stiffness, or swelling.
Table of contents
No one likes joint pain, especially when it gets in the way of things we want to do. But pain in the joints (the spaces between two bones) can have many different causes. That’s because there are lots of different structures in and around a joint, like cartilage, tendons, and ligaments.
When pain is coming from the joint itself, it’s called arthritis. There are many different types of arthritis, and osteoarthritis is the most common kind. Osteoarthritis is also known as “degenerative arthritis” because it’s caused by wear and tear over time. Symptoms include joint pain, stiffness, and sometimes swelling.
With so many causes of joint pain, and so many causes of arthritis, it can be hard to figure out what’s behind your discomfort. Here’s how healthcare professionals figure out that osteoarthritis is the issue.
Quiz: Do I have arthritis?
Who should be tested for osteoarthritis?
Anyone with ongoing or worsening pain in a joint (or joints) can ask their primary care provider about testing for osteoarthritis. It may sound “old school,” but clinicians rarely need to run special tests to diagnose this disease. Certain symptoms and risk factors can provide excellent clues that osteoarthritis might be the problem. The following make osteoarthritis more likely:
An age over 50
Gradual onset of pain, with worsening over time
Pain in specific locations
Fluid or swelling in the joints (typically mild, but sometimes severe)
Worsening of joint pain with activity
Joint stiffness, especially after periods of rest
Prior injuries at the site of pain
The location of joint pain matters because osteoarthritis is more likely to affect certain joints over others. If you’re having worsening pain in these areas, you may need to be tested for osteoarthritis:
Neck
Shoulders
Lower back
Hands
Ends of the fingers
Groin area (hips)
Knees
Big toes
Being active with knee arthritis. Keep moving with these low impact exercises.
Confused by the different types of arthritis? Learn more about the differences between osteoarthritis and rheumatoid arthritis, the most common types of arthritis.
No, it’s not an old wives’ tale. Weather changes really can make your joints hurt.
What are the tests for osteoarthritis?
Your symptoms will likely prompt your primary care provider to examine the joint and get X-rays. They will then use a combination of all these findings to diagnose osteoarthritis.
Physical exam signs
Examining the joints is just as important as listening to your symptoms and story. A physical exam will allow your clinician to look for any the following:
Tenderness (pain caused by pressure)
Swelling
Deformities, such as bony nodules or crooked-looking fingers
A crackling feeling with movement
Changes in alignment or range of motion
Blood tests
There are no blood tests to diagnose osteoarthritis.
X-rays and other imaging tests
When your history and physical exam fit the diagnosis of osteoarthritis, X-rays help confirm it. Osteoarthritis causes specific changes in joints that can be seen on X-ray images. In the early stages of osteoarthritis, X-rays might not show anything at all. But changes start small and increase over time. They include:
A decrease in joint space (space between the bones)
Changes in the ends of the bones
Changes in alignment of the joint (when severe)
Interestingly, the severity of pain doesn’t always match the severity of changes seen with X-ray. For example, your pain may feel much more severe than the X-ray findings suggest it should be. In this case, your primary care provider — or rheumatologist, a joint specialist — may consider other factors that could be contributing to your pain.
More expensive imaging tests like CT scans and MRIs aren’t needed to diagnose osteoarthritis. However, these tests can look at structures that X-rays can’t, like cartilage, tendons, and ligaments. So they may be useful when the cause of your pain is unclear, or to rule out other conditions.
What to expect if you are diagnosed with osteoarthritis
There’s no cure for osteoarthritis, but there are several treatment options that can help your symptoms. The treatment of osteoarthritis often depends on the joint(s) affected. For example, knee osteoarthritis symptoms often respond well to strengthening exercises, weight loss, and activity modifications. But it might make more sense to start with medication or a steroid injection for smaller joints in the hands and wrists.
For joint pain and swelling, you can take medications like nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. Topical creams, gels, and patches can help with symptoms, too. In some cases, an injection into the joint may be appropriate.
If your osteoarthritis is severe, and other treatments no longer help, surgery may be an option. Depending on the joint, a surgeon may offer arthroscopic (minimally invasive) surgery or a joint replacement.
The bottom line
Healthcare professionals diagnose osteoarthritis using a combination of clues from your symptom story, physical exam, and X-ray findings. If the signs and symptoms described here sound like yours, talk to your primary care provider.
Why trust our experts?
References
Abramoff, B., et al. (2020). Osteoarthritis: Pathology, diagnosis, and treatment options. Medical Clinics of North America.
Carotti, M., et al. (2017). Relationship between magnetic resonance imaging findings, radiological grading, psychological distress and pain in patients with symptomatic knee osteoarthritis. La Radiologia Medica.
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Osteoarthritis. National Institutes of Health.
Sen, R., et al. (2023). Osteoarthritis. StatPearls.
