clinically diagnosed as knee pain, patient >50 year, stiffness more than 30 minutes per day , crepitus, presence of osteophytes on Xray
Rheumatoid arthritis patient clinically present as morning stiffness and joint pain. Mostly patient >50 yr, stiffness more than 30 minutes , crepitus, presence of osteophytes on Xray can be seen. Clinically it can diagnosed in the laboratory by combination and work up of the patient for the test mentioned here Raised rheumatoid factor > 20 U/ mL, Raised anti-CCP factor (anti Cyclic Citrullinated Peptide Antibody >20 U/ mL ), CRP (C-Reactive Protein >1 g/L ) increased ESR (Erythrocyte level : Children 0 and 10 mm/hr. Women under age 50 yr (0 and 20 mm/hr )Men under age 50 should have an ESR between( 0 and 15 mm/hr.) Women over age 50 should have an ESR between (0 and 30 mm/hr).Men over age 50 should have an ESR between ( 0 and 20 mm/hr)
To summarize the gold standard for different type of arthritis is dependent on clinical examination, radiological and laboratory test. Hence Plain Xray with Radiological features in anterolateral and lateral position plus 3D radiological imaging, and laboratory investigations mentioned above wherever possible of the joint is a must to diagnose different type. Clinician can look out for Joint space narrowing which is irregular or asymptomatic. Subchondral sclerosis increased density in subchondral bone and Bony proliferation with osteophytes. Cysts in subchondral marrow adjacent to or remote from joint which are affected needs to be examined. Soft tissue changes calcifications and soft tissue swelling need to be noted.
In some cases, MRI (Magnetic Resonance imaging) may also be helpful in secondary causes like meniscal tear, previous injury or intraarticular joint body since in one go you can see the status of all joints, cartilage, bone and synovial tissue.