The Orthopaedic Evaluation
While every orthopaedic evaluation is different, there are many commonly used tests that an orthopaedic surgeon may consider in evaluating a patient's condition.
In general, the orthopaedic evaluation usually consists of:
- A thorough medical history
- A physical examination
- Additional tests, as needed
Your medical history is taken to assist the orthopaedic surgeon in evaluating your overall health and the possible causes of your joint pain. In addition, it will help your orthopaedic surgeon determine to what degree your joint pain is interfering with your ability to perform everyday activities.
What the physician sees during the physical examination — which includes examination of standing posture, gait analysis (watching how you walk), sitting down, and lying down — helps to confirm (or to rule out) the possible diagnosis. The physical exam will also enable the orthopaedic surgeon to evaluate other important aspects of your hips and knees, including:
- Size and length
- Range of motion
- Skin condition
If you are experiencing pain in your hip joint, your back may be examined because hip pain may actually be the result of problems in the lower spine.
After the physical examination, X-ray evaluation is usually the next step in making the diagnosis. The X-rays help show how much joint damage or deformity exists. An abnormal X-ray may reveal:
- Narrowing of the joint space
- Cysts in the bone
- Spurs on the edge of the bone
- Areas of bony thickening called sclerosis
- Deformity or incorrect alignment
Occasionally, additional tests may be needed to confirm the diagnosis. Laboratory testing of your blood, urine, or joint fluid can be helpful in identifying specific types of arthritis and in ruling out certain diseases. Specialized X-rays of the back can help confirm that hip pain isn't being caused by a back problem. Magnetic Resonance Imaging (MRI) or a bone scan may be needed to determine the condition of the bone and soft tissues of the affected joint.
In order to assist the orthopaedic surgeon in making a diagnosis, it may be helpful to write down your answers to the following questions before the appointment:
- Where and when do I have pain?
- How long have I had this pain?
- Do I have any redness or swelling around my joints?
- What daily tasks are hard to do now?
- Did I ever hurt the joint or overuse it?
- Does anyone in my family have similar problems, such as spurs on the edge of the bone?