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However, in less straightforward cases, other diagnoses should be considered. right side pain, chronic pelvic pain syndrome, bicep pain, prostate pain, ac joint, growing pains, knee joint, joint chief of staff, ovulation pain, joint tenancy, gonococcal arthritis, hand arthritis, arthritis, information pictures of rheumatoid arthritis, arthritis knee exercises, wooden pony pain, arthritis septic, pain in left ribs, 12 pains of christmas song, arthritis of the spine info, strip joints, vaginal pain, causes symptoms of arthritis Arthritis of the spine info. For example, periarticular pain that is not reproduced by passive motion or palpation of the joint should suggest an alternate etiology such as bursitis, tendonitis or periostitis. If the distribution of painful joints includes MCP, wrist, elbow, ankle or shoulder, OA is unlikely. Prolonged stiffness (greater than one hour) should raise suspicion for an inflammatory arthritis such as rheumatoid arthritis. right side pain, chronic pelvic pain syndrome, bicep pain, prostate pain, ac joint, growing pains, knee joint, joint chief of staff, ovulation pain, joint tenancy, gonococcal arthritis, hand arthritis, arthritis, information pictures of rheumatoid arthritis, arthritis knee exercises, wooden pony pain, arthritis septic, pain in left ribs, 12 pains of christmas song, arthritis of the spine info, strip joints, vaginal pain, causes symptoms of arthritis Pain killers. Marked warmth and erythema in a joint suggests an infectious or microcrystalline etiology. Weight loss, fatigue, fever and loss of appetite suggest a systemic illness such as polymyalgia rheumatica, rheumatoid arthritis, lupus or sepsis or malignancy. (top of page) Are There Biological Markers for OA? Radiographs are considered the "gold standard" test for the diagnosis of OA, but radiographic changes are evident only relatively late in the disease. right side pain, chronic pelvic pain syndrome, bicep pain, prostate pain, ac joint, growing pains, knee joint, joint chief of staff, ovulation pain, joint tenancy, gonococcal arthritis, hand arthritis, arthritis, information pictures of rheumatoid arthritis, arthritis knee exercises, wooden pony pain, arthritis septic, pain in left ribs, 12 pains of christmas song, arthritis of the spine info, strip joints, vaginal pain, causes symptoms of arthritis Hand arthritis. The need is great for a sensitive and specific biological marker that would enable early diagnosis of OA, and monitoring of its progression. Routine laboratory studies, such as sedimentation rates and c-reactive protein, are not useful as markers for OA, although a recent study suggests that elevation of CRP predicts more rapidly progressive disease. Several epitopes of cartilage components, however, have been described that offer some promise as markers of OA (slide). For example, chondroitin sulfate epitope 846, normally expressed only in fetal and neonatal cartilage, has been observed in OA, but not normal adult, cartilage and synovial fluid. Along a similar vein, an epitope unique to type II collagen has been described in OA cartilage, and can be unmasked in vitro by exposing normal cartilage to MMPs. This epitope can be measured in blood and urine and may prove useful in diagnosing or monitoring OA progression. Elevated serum hyaluronan levels have also been shown by some to correlate with radiographic OA. The finding of elevated cartilage oligomeric protein (COMP) levels in synovial fluid after traumatic joint injury may portend development of OA in the injured joint.

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