Recognizing Early Osteoarthritis Symptoms

Differentiating the Types of Monoarthritis

Senior Caucasian woman rubbing her shoulder
Jose Luis Pelaez Inc/Blend Images/Getty Images

Early osteoarthritis symptoms typically involve a single joint. When only one joint is affected, the condition is referred to as monoarthritis. As symptoms first appear, it's important to distinguish if the cause of the joint pain and swelling is osteoarthritis or another type of monoarthritis.

Possible Causes of Monoarthritis

Diseases that deposit crystals in the joint fluid (such as gout), infection, and trauma or injury are the other most common causes of monoarthritis besides osteoarthritis.

Once a patient shows signs of monoarthritis, the doctor uses the patient's medical history, a physical examination, x-rays, and additional tests (i.e., a microorganism culture to determine if there is infection; arthrocentesis to examine the fluids in the joints) to formulate an accurate diagnosis and determine the possibility of osteoarthritis.

Information that the doctor gets from your medical history and physical examination can give strong clues regarding the cause of the monoarthritis. Be prepared with as detailed of a history of your symptoms as you can provide. For example, these are things your doctor may suspect based on what you tell him about when you experienced the joint pain and your medical history:

  • When you suddenly have joint pain, it is likely that it was caused by a fracture, injury or loose tissue moving around inside the joint.
  • When joint pain comes on over several hours, up to 2 days, it is more likely to be caused by infection, inflammatory arthritis, or crystal deposition disease.
  • When joint pain comes on over the span of  several days or weeks, it points to osteoarthritis, an inactive infection, or a tumor.
  • If you have a history of intravenous drug use or immunosuppression (weakened immune system), it increases your risk for septic arthritis. This could be the cause of the joint pain.
  • If you had previous acute attacks of monoarthritis in other joints, it points to crystal deposition disease or inflammatory arthritis.
  • A long course of corticosteroid drugs can increase risk of monoarthritis from infection or avascular necrosis.
  • If you have psoriatic patches or pitting of your nails, it suggests psoriatic arthritis is involved.
  • Bumps around your joints are known as tophi and are signs of gout.
  • Eye inflammation and low back pain point to ankylosing spondylitis.

Diagnostic Tests Determine Type of Monoarthritis

Along with the information gathered from the medical history and physical examination, x-rays are taken to capture an image of the arthritic joint. An arthrocentesis or synovial fluid analysis also is used to distinguish between the types of monoarthritis. The joint fluid is cultured to look for bacterial infection. It also can reveal crystals in the fluid. Depending on the appearance of the joint fluid and the blood counts, it can be categorized as non-inflammatory, inflammatory or hemorrhagic.

Because a bacterial joint infection is considered an emergency, people with a suspected (but not confirmed) infection are often given antibiotics, just in case, until a clear diagnosis can be made

What Goes into the Diagnosis of Osteoarthritis as the Cause of Single Joint Pain

To diagnose osteoarthritis, there must be:

  • insidious (slow) onset of joint pain
  • joint effusion
  • no evidence of infection
  • no evidence of gout-related crystals in the joint fluid
  • no injuries or trauma to surrounding soft tissues
  • synovial fluid analysis consistent with non-inflammatory arthritis

Diagnosing Acute Monoarthritis in Adults: A Practical Approach for the Family Physician. July 1, 2003. American Family Physician.

Specific Types of Monoarthritis. Primer on the Rheumatic Diseases. p.159. Published by the Arthritis Foundation.

Continue Reading