X-ray can confirm arthritis diagnosis
Dear Dr. Roach: How do I know if I have arthritis? My left leg makes a slight cracking noise in my knee when I walk down the stairs, but no pain. However, when I go for a long drive, I limp when getting out of the car, which kind of goes away and does not hurt my knee. Long walks also bother me. When I went to a specialist, he said I needed therapy. I went to some sessions, but it did not help! When I told my doctor, he said, “Oh, that’s just arthritis.” (Note: This is the leg that was broken when a drunk driver hit me at age 22. I’m now in my mid-60s.)
Anon.
Answer: I don’t know for sure whether you have arthritis. Many people in their 60s do have some arthritis, usually osteoarthritis, the most common type. The noises joints make when they bend, especially under pressure, might or might not indicate arthritis. The fact that you are stiff after being immobile in a car for a while does suggest osteoarthritis. Severe injury to a joint can cause osteoarthritis: When we see osteoarthritis in just one joint (the one with a history of trauma), that’s likely the underlying reason. Osteoarthritis does not necessarily run in families.
So, even with the diagnosis being fairly likely, I personally get an X-ray done at least once on my patients who I think have osteoarthritis. There are many lesscommon conditions that can mimic osteoarthritis, which may have different treatments. Joint diseases due to deposition of crystals into the joint, like gout and especially pseudogout, can sometimes look like ordinary osteoarthritis, even though they usually have distinct flares. A chunk of cartilage that hardens in the joint can look like osteoarthritis. Psoriasis has a particular arthritis, normally in smaller joints, that can be mistaken for osteoarthritis. This is very dangerous because psoriatic arthritis can be very destructive to a joint. I do think it makes sense to know what exactly you are treating before treating it, and X-rays are very, very good at making the diagnosis.
Exercise and physical therapy are first-line treatments for osteoarthritis, but may take a while to start working. Many medications are also used.