Common Conditions that can Mimic Osteoarthritis

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Not everything that hurts is arthritis. Although it is easy to sweep aches and pains under the general "rug" of arthritis, there are common conditions that mimic arthritis. Unless the correct diagnosis is uncovered, pain might become chronic and unrelenting. Often, the treatment of these common painful conditions is very different than the treatment of arthritis pain. Without the right type of treatment, pain will not get better.

One of the most common conditions that mimic osteoarthritis is bursitis and tendonitis. The joints are not just composed of bones coming together. Many soft tissues are also involved in holding a joint together and helping it to function properly. The tendons attach muscles to the bones and provide the action that a joint performs. The bursaes are fluid filled cushions that prevent things from rubbing together. Both of these types of soft tissues can become inflamed and painful when the joint is repetitively working hard. Bursitis is inflammation of the bursae and tendonitis is inflammation of the tendon. Both commonly affect the shoulder. Even though the pain may feel like the shoulder has severe arthritis, an x-ray will prove that the joint space is well preserved with no other signs of major arthritis. And further examination of the shoulder will show that the tendons and bursa are inflamed. Treatment of this non-arthritic pain consists of methods to reduce inflammation in soft tissue like massage, ice, and strengthening to rebalance the joint.

Another joint that fools people into thinking that it is afflicted with arthritis pain is the hip. First of all, what people think to be "hip" pain is often not. The hip joint is deep in the groin. So, pain off to the side or in the behind is often not coming from the hip joint itself. Often times, this pain is coming from problems in the back. Disc degeneration and "sciatica" cause pain in the buttocks and off to the side near the greater trochanter. Obviously, the treatment of back conditions is going to be much different than the treatment of hip arthritis and visa versa. So it is important not to confuse hip arthritis with common back problems. Again, a simple hip x-ray and thorough examination will be the best way to tell the difference.

Aching hands can be confusing too because they are complicated structures with so many joints, tendons, and nerves. One of the most common painful conditions of the hand is carpal tunnel syndrome. Because carpal tunnel syndrome causes aching pain, especially at night, it can be confused with hand arthritis. However, arthritis does not cause numbness and tingling like carpal tunnel syndrome does. Although hand splints can help both conditions, the hand splint for carpal tunnel syndrome is different than the hand splint for arthritis of the thumb. The surgery for carpal tunnel syndrome is much different than the surgery for thumb arthritis too. So getting the correct diagnosis is critical for successful treatment plans.

Another complicated structure is the ankle joint. Thus, what may be considered ankle arthritis may actually be hidden fracture of the ankle like a talar dome fracture. Anyone with persistent pain after a history of recent trauma to the ankle might be walking around with a hidden fracture. Special x-rays, bone scans and CT scans will be the best way to find these hidden fractures. Yes, arthritis may eventually result from the injury but it is not necessarily the primary, initial cause of pain in the ankle. With a non-weightbearing cast, a fracture will heal unlike ankle arthritis that will not heal with casting. Furthermore, proper early treatment of such a fracture may help to prevent arthritis pain in the future. (1)

As one can see, not everything that hurts is arthritis especially when the shoulder, hip, hand and ankle are concerned.Soft tissues, discs, nerves and bones can all be sources of pain. The key to making the correct diagnosis is to start with a thorough examination by a doctor. This will start you on the right treatment pathway. The assumption that your pain is "just arthritis pain" may cause you to live with more pain than necessary.

Reference:

(1) Foot Fractures Misdiagnosed as Ankle Sprains, Judd, Daniel; Kim, David; American Family Physician, 2002, Sept. 66(5) 785-795

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