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The presence of an osteophyte is the most specific radiographic marker for OA (ACR Guidelines-Clinical Classification criteria for OA of the knee) although it is indicative of relatively advanced disease. arthritis information, information on rhematoid arthritis, joint pain diagnosis, gold shots for rheumatoid arthritis, pain quotes, cervical neck pain, arthritis support, right abdominal pain, early symptoms of arthritis, rolling a joint, hyaluronate for osteoarthritis, magnet therapy for arthritis, pain upper arm muscle, rheumatoid arthritis foundation, treatment osteo arthritis, rheumatoid arthritis and white matter changes, shark cartilage arthritis, tai chi for arthritis, arthritis dogs, acupuncture arthritis, arthritis creams, ac joint, ovarian pain Rheumatoid arthritis foundation. (top of page) Differential Diagnosis If a patient has the typical symptoms and radiographic features described above, the diagnosis of OA is relative straightforward and is unlikely to be confused with other entities. However, in less straightforward cases, other diagnoses should be considered. For example, periarticular pain that is not reproduced by passive motion or palpation of the joint should suggest an alternate etiology such as bursitis, tendonitis or periostitis. arthritis information, information on rhematoid arthritis, joint pain diagnosis, gold shots for rheumatoid arthritis, pain quotes, cervical neck pain, arthritis support, right abdominal pain, early symptoms of arthritis, rolling a joint, hyaluronate for osteoarthritis, magnet therapy for arthritis, pain upper arm muscle, rheumatoid arthritis foundation, treatment osteo arthritis, rheumatoid arthritis and white matter changes, shark cartilage arthritis, tai chi for arthritis, arthritis dogs, acupuncture arthritis, arthritis creams, ac joint, ovarian pain Scrotal pain. If the distribution of painful joints includes MCP, wrist, elbow, ankle or shoulder, OA is unlikely. Prolonged stiffness (greater than one hour) should raise suspicion for an inflammatory arthritis such as rheumatoid arthritis. Marked warmth and erythema in a joint suggests an infectious or microcrystalline etiology. arthritis information, information on rhematoid arthritis, joint pain diagnosis, gold shots for rheumatoid arthritis, pain quotes, cervical neck pain, arthritis support, right abdominal pain, early symptoms of arthritis, rolling a joint, hyaluronate for osteoarthritis, magnet therapy for arthritis, pain upper arm muscle, rheumatoid arthritis foundation, treatment osteo arthritis, rheumatoid arthritis and white matter changes, shark cartilage arthritis, tai chi for arthritis, arthritis dogs, acupuncture arthritis, arthritis creams, ac joint, ovarian pain Right abdominal pain. Weight loss, fatigue, fever and loss of appetite suggest a systemic illness such as polymyalgia rheumatica, rheumatoid arthritis, lupus or sepsis or malignancy. (top of page) Are There Biological Markers for OA? Radiographs are considered the "gold standard" test for the diagnosis of OA, but radiographic changes are evident only relatively late in the disease. The need is great for a sensitive and specific biological marker that would enable early diagnosis of OA, and monitoring of its progression. Routine laboratory studies, such as sedimentation rates and c-reactive protein, are not useful as markers for OA, although a recent study suggests that elevation of CRP predicts more rapidly progressive disease. Several epitopes of cartilage components, however, have been described that offer some promise as markers of OA (slide). For example, chondroitin sulfate epitope 846, normally expressed only in fetal and neonatal cartilage, has been observed in OA, but not normal adult, cartilage and synovial fluid.
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