Fast Five Quiz: Knee Osteoarthritis Presentation and Diagnosis

James Monroe Laborde, MD, MS


May 18, 2022

According to the American College of Rheumatology Clinical Classification Criteria, a clinical diagnosis of knee pain owing to OA can be established if three of the following history and physical examination findings are present: age > 50 years, morning stiffness lasting < 30 minutes, crepitus on active movement, bony tenderness, bony enlargement, and no palpable warmth of the synovium.

Symptoms of knee OA may precede radiographic changes suggestive of OA by years. Although radiographic examination is not routinely used to diagnose OA, imaging may confirm uncertain OA or an alternative diagnosis.

Laboratory findings are typically within normal reference range and may be used in addition to history and physical examination findings for the diagnosis of knee OA: erythrocyte sedimentation rate < 400mm/hour and rheumatoid factor < 1:40. Although cartilage and bone-derived biomarkers have been identified in subtypes of OA, no biomarkers have proved reliable for the diagnosis of knee OA.

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