Diagnosing arthritis

Seeing your GP

During your appointment, your GP should examine you for signs of swelling and a reduced range of joint movement. It's not always easy for the doctor to be sure whether arthritis is present, because no single test can confirm the disease. Doctors usually have to piece together their diagnosis from the separate items of information they obtain from their examination, tests, and most importantly what you tell them.

If there's a possibility of arthritis, you'll be referred for two types of test:

• X-rays - these can reveal any damage to the joints caused by arthritis and are most useful when confirming osteoarthritis. In the early stages of rheumatoid arthritis, an x-ray might reveal no changes or damage.
• Blood tests - there are many types, all measuring the levels of different blood cells and chemicals. They can indicate anaemia and how much inflammation there is in the body.

If your doctor works at a large health centre, you may have these tests done there. But it's more likely that you'll be referred to a hospital.

Types of arthritis

After osteoarthritis and rheumatoid arthritis, these are the most common type of arthritis in the UK. You may be tested for:

• Ankylosing spondylitis - inflammation occurs in the spine and pelvis, causing the joints to stiffen and sometimes become immobile. The neck, shoulders, knees and eyes can also be involved. It affects more men than women.
• Systemic lupus erythematosus (SLE) - an uncommon disease, sometimes known as lupus, which affects nine times as many women as men. It causes inflammation of the joints and skin and frequently other organs such as the kidneys and lungs. It is potentially very serious but can usually be controlled with medication.
• Gout - caused by uric acid crystals forming in the joints - particularly the big toe, ankles, hands and wrists. It can be very painful, but is easily controlled by medication and a change in diet.
• Polymyalgia rheumatica - an inflammatory condition affecting the muscles and soft tissues in the shoulder and upper arm, buttocks and thighs. It causes tiredness, stiffness, loss of weight and occasionally circulation problems.
• Reactive arthritis - a temporary inflammation of one or more joints as a reaction to an infection elsewhere in the body - for example, in the bowel. There may be a delay before the arthritis occurs, which then usually clears up by itself.

Other doctors you may see

At the same time as sending you for tests, your GP may refer you to an arthritis specialist at a hospital - usually a consultant rheumatologist. Or you may be referred after your test results have come through. This doesn't mean your condition is serious, but you'll have the opinion of an expert in the field.

You should receive an outpatient appointment at your local hospital. You'll be seen by a consultant or one of their team, and will have more tests, possibly an MRI scan.

You don't have to see a rheumatologist, but if you'd like to, ask your GP. They shouldn't refuse, but if they do you are entitled to a second opinion.

After diagnosis

Once your doctors are sure you have arthritis, you'll agree with them a suitable treatment plan. This may involve returning to your health centre or hospital at regular intervals for check-ups and treatment.

It's possible that you'll be referred to other health professionals with a special understanding of one aspect of your condition: nurses, orthopaedic surgeons, counsellors, physiotherapists, occupational therapists and social workers. These people should work together as a team to provide you with a package of care tailored to your needs. It's up to you and your doctors to discuss your best options.