OA fundamentals series: Diagnosis and clinical assessment of osteoarthritis

Osteoarthritis (OA), the most common form of arthritis, is a heterogenous condition with substantial variability in clinical presentation. Despite its high prevalence, OA is frequently underdiagnosed and inadequately managed. A clinician's diagnosis is an important step to facilitate access to and engagement with treatment. Our aim was to provide practical guidance for clinicians on the diagnosis and holistic assessment of individuals with OA. Narrative review. Clinical assessment, integrating patient symptoms and physical examination findings, is the standard way for diagnosing OA. Radiographs and other investigations rarely alter the diagnosis or management when typical clinical features of OA are present, and normal radiographs do not exclude OA in its early stage. Therefore, imaging and laboratory tests are generally reserved for when clinical assessment raises suspicion of an alternate condition. Comprehensive assessment of individuals with OA should address not only joint symptoms but also the impact of pain and functional limitations on work, leisure and social participation and consider biopsychosocial factors that influence the severity of OA symptoms. Given the substantial global burden of OA, timely diagnosis is essential to guide appropriate therapeutic intervention. OA is primarily a clinical diagnosis, based on focused history and examination, with imaging and laboratory tests serving a supporting role particularly when there is diagnostic uncertainty. For individuals with OA, holistic assessment and periodic reassessment are critical to optimize symptom control and maintain quality of life.