Could It Be Osteoarthritis?

Certain Signs Suggest Pain Could Be Related to Osteoarthritis

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When you first experience pain in or near a joint, your first thought often is that you injured yourself. You may think you twisted the joint or overextended it. Usually, people reach for over-the-counter pain relievers and try conservative treatments, such as ice or heat. At some point, though, you realize that what is going on with the affected joint is more than simple injury. You begin to wonder about chronic conditions -- and that's when osteoarthritis creeps into the discussion. Could it be osteoarthritis?

General Signs that You May Have Osteoarthritis

  • Pain at the affected joint
  • Tenderness or pain when pressure is applied to the joint (except the hip, which is too deep)
  • Bony enlargement and effusion at the joint (without redness or heat)
  • Crepitus over a joint with passive or active movement.
  • Limited range of motion that signifies the source of the pain.
  • Malalignment of the affected joint. Using the knee as an example, medial (inner) compartment knee osteoarthritis correlates with varus malalignment (bowlegged) while lateral (the outside) compartment is associated with valgus (knock-kneed) deformity
  • Muscles around affected joints may begin to show signs of atrophy (muscle wasting or loss of muscle mass leading to muscle weakness).

Signs of Osteoarthritis at Specific Joints

There are general signs that apply to any joint affected by osteoarthritis. However, specific joints tend to have their own characteristics. For example:

  • Hand osteoarthritis is associated with Heberden's nodes and Bouchard's nodes. There can also be deformity of certain finger joints.
  • Knee osteoarthritis, specifically the patellofemoral joint, characteristically responds worse to stairs than walking on flat ground. There is also the aforementioned varus-valgus malalignment. Baker's cysts are common, as is tenderness of the pes anserine bursa (inner side of knee).
  • Hip osteoarthritis is typically associated with groin pain and sometimes buttocks pain. Flexion contractures (tightening of muscles) can occur; Trendelenburg sign is possibly present.
  • With osteoarthritis of the cervical spine, there is localized spine pain, muscle spasm, limited motion, radiating pain, possibly some sensory loss and bladder dysfunction.
  • With involvement of the lumbar spine, there is local pain, muscle spasm, limited extension, buttock pain that is worse in the evening, radiating pain and a pattern of pain associated with spinal stenosis.

Bottom Line

With symptomatic osteoarthritis, pain is usually the first sign of a joint problem. Use of the joint makes the pain worse, and resting relieves it. Morning stiffness may also occur with osteoarthritis, but it typically lasts less than 30 minutes. It is important to see your doctor for an evaluation and assessment of the signs and symptoms you are experiencing. You need to have an accurate diagnosis so you can start appropriate treatment and know for sure what you are dealing with.

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Article Sources
  • Osteoarthritis - Diagnosis and Medical/Surgical Management. Fourth Edition. Moskowitz RW et al. 2007. Chapter 7 Osteoarthritis: Clinical Presentations.
  • Primer on the Rheumatic Diseases. Thirteenth Edition. Klippel JH et al. Chapter 11 Clinical Features. Published by Arthritis Foundation.