Osteoarthritis diagnostic criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2],Irfan Dotani [3].


There is no specific signs and symptoms of osteoarthritis (OA) diagnosis. Although, osteoarthritis may be diagnosed based on several elements such as patients age, past medical history, and available symptoms. Osteoarthritis of the major joints is diagnosed using a combination of patients past medical history, physical examination, and variety of lab tests including imaging studies such as X-ray[1].

Diagnostic Criteria

Classification Criteria for Osteoarthritis of the Hip


Traditional format
Hip pain

+ at least two of the following: ESR of less than 20 mm/hour

Femoral or acetabular osteophytes on radiographs

Joint space narrowing on radiographs (superior, axial, medial)

Classification format
Hip pain plus femoral or acetabular osteophytes on radiographs


Hip pain plus joint space narrowing on radiographs and an ESR of less than 20 mm/hour

ESR = erythrocyte sedimentation rate.

Altman, R, et al.: Arthritis Rheum 34:505, 1991

Classification Criteria for Idiopathic Osteoarthritis of the Knee


Traditional format
Knee pain plus osteophytes on radiographs and at least one of the following:

Patient age older than 50 years

Morning stiffness lasting 30 minutes or less

Crepitus on motion

Classification format
Knee pain and osteophytes on radiographs


Knee pain plus the patient age of 40 years or older, morning stiffness lasting 30 minutes or less and crepitus on motion

Altman, R, et al.: Arthritis Rheum 34:505, 1991

Classification Criteria for Osteoarthritis of the Hand


Hand pain, aching or stiffness


Hard tissue enlargement of two or more of 10 selected joints*


Fewer than three swollen metacarpophalangeal joints


Hard tissue enlargement of two or more distal interphalangeal joints


Deformity of two or more of 10 selected joints*

* —The 10 selected joints are the second and third distal interphalangeal joints, the second and third proximal interphalangeal joints and the first carpometacarpal joints (of both hands).

Altman, R, et al.: Arthritis Rheum 34:505, 1991


  1. Thakur M, Dickenson AH, Baron R (June 2014). "Osteoarthritis pain: nociceptive or neuropathic?". Nat Rev Rheumatol. 10 (6): 374–80. doi:10.1038/nrrheum.2014.47. PMID 24686507.
  2. Segal NA, Nevitt MC, Lynch JA, Niu J, Torner JC, Guermazi A (July 2015). "Diagnostic performance of 3D standing CT imaging for detection of knee osteoarthritis features". Phys Sportsmed. 43 (3): 213–20. doi:10.1080/00913847.2015.1074854. PMC 4818011. PMID 26313455.
  3. Ipach I, Rondak IC, Sachsenmaier S, Buck E, Syha R, Mittag F (May 2014). "Radiographic signs for detection of femoroacetabular impingement and hip dysplasia should be carefully used in patients with osteoarthritis of the hip". BMC Musculoskelet Disord. 15: 150. doi:10.1186/1471-2474-15-150. PMC 4029939. PMID 24886025.
  4. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M (August 1986). "Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association". Arthritis Rheum. 29 (8): 1039–49. PMID 3741515.
  5. Altman RD (1987). "Criteria for the classification of osteoarthritis of the knee and hip". Scand. J. Rheumatol. Suppl. 65: 31–9. PMID 3317807.
  6. Altman R, Alarcón G, Appelrouth D, Bloch D, Borenstein D, Brandt K, Brown C, Cooke TD, Daniel W, Gray R (November 1990). "The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand". Arthritis Rheum. 33 (11): 1601–10. PMID 2242058.
  7. Altman RD (March 2010). "Early management of osteoarthritis". Am J Manag Care. 16 Suppl Management: S41–7. PMID 20297876.
  8. Altman RD, Bloch DA, Bole GG, Brandt KD, Cooke DV, Greenwald RA, Hochberg MC, Howell DS, Kaplan D, Koopman WJ (May 1987). "Development of clinical criteria for osteoarthritis". J. Rheumatol. 14 Spec No: 3–6. PMID 3625674.

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