Diagnosis and Differential

Diagnosis of Osteoarthritis
1. Anamnesis
Pain in the joints (most often)
Pain increases when there is
movement and decreases when resting
Stiffness in the joints in the morning
Stiffness after inactivity, generally will
arise slowly
Crepitus
Swelling of joints (can be asymmetric)
The presence of signs of inflammation
Changes in gait

2. Physical Examinations
1. Barriers Motion
2. Crepitus
3. Swelling of joints which often
asymmetric
4. Signs of inflammation
5. Changes in shape (deformity)
permanent joints
6. Changes in gait

Radiological examination
The degree of knee OA (kellgren and lawrence):
0 = no OA picture
1 = doubt, the picture of a normal joint, there is a
minimal osteophytes
2 = OA minimal with osteophytes in 2 places,
there are no sclerosis and subchondral cysts,
joint gap either.
3 = moderate OA, moderate osteophytes, bone
deformity end, and there is a narrowing of the joint
gap
4 = severe OA, large osteophytes

Criteria diagnosis of OA
A patient is clinically referred positive with OA, when it
meets 3 of 6 criteria according to the American
College of Rheumatology (ACR) in Altman et al (1986),
as follows:
Age> 50 years
Stiffness in the morning <30 minutes
Crepitus
Tenderness in the bone
Enlargement of bone
On palpation around the joints do not feel warm.
These criteria had a sensitivity of 95% and a specificity
of 69%