You are here: Home > News & Resources > Loyola's Printed Publications > Loyola Living December 2001 Issue > Diagnosing Arthritis Takes Detective Work

Diagnosing Arthritis Takes Detective Work

Early Treatment Can Make a Difference

Many patients come to Aileen Lorenzo-Pangan, M.D., thinking they have one type of arthritis when they really have another. To most people, joint pain is joint pain, but actually there are many types of arthritis. It is important to get a correct diagnosis as early as possible since, in the case of rheumatoid arthritis, early treatment can make a big difference in the outcome, according to Lorenzo-Pangan, who is a rheumatologist at Loyola’s Primary Care Center at Darien.

More than 100 different rheumatic diseases can cause joint pain, stiffness and swelling. Osteo-arthritis is the most common type; this joint deterioration is caused by wear and tear of use and affects nearly everyone as they age.

One of the more severe types of joint disease is rheumatoid arthritis, an autoimmune disorder in which the body’s immune system attacks the joints. Only about 1 percent of the general population will get rheumatoid arthritis, but if left untreated, the disease can lead to permanent disability. Fortunately, there are new medications available that, if taken early enough, can slow or even stop joint deterioration that goes along with rheumatoid arthritis.

There is no one test that determines which type of arthritis a person has, Lorenzo-Pangan explained. By performing a thorough physical exam and gathering information from various tests, she often can arrive at a diagnosis. 

In the exam room, the physician can observe clues that help distinguish between diseases. For example, rheumatoid arthritis usually affects joints on both sides of the body, whereas osteoarthritis may be felt in only one hip or knee. Also, the finger joint nearest the fingernail can be involved with osteoarthritis but is not affected by rheumatoid arthritis.

A handful of tests yield more clues. Rheumatoid factor, a type of antibody, is found in the blood of about 75 percent of people who have rheumatoid arthritis, although it is sometimes found in people without the disease. A low blood count, or anemia, can be seen with rheumatoid arthritis. Another blood test, called ESR or sed rate, measures inflammation, which may not be evident in the physical exam.  

The type of arthritis determines which type of treatment is warranted. Osteoarthritis may respond to an anti-inflammatory drug like acetaminophen or ibuprofen. For rheumatoid arthritis, a rheumatologist can tailor and combine specialized medications to fit each person’s specific profile. For all types of arthritis, lifestyle changes can improve function and reduce pain. Regular exercise and weight reduction can decrease the day-to-day stress on joints and reduce pain.

Anyone concerned about the possibility of arthritis should first consult a primary care physician who can then decide if referral to a rheumatologist is necessary.  ‚

-->Go back to issue index-->