History and physical examination

All arthritides feature pain. Patterns of pain differ among the arthritides and the location. Osteoarthritis is classically worse at night or following rest. Rheumatoid arthritis is generally worse in the morning; in the early stages, patients often do not have symptoms following their morning shower. In elderly people and children, pain may not be the main feature, and the patient simply moves less (elderly) or refuses to use the affected limb (children).
Elements of the history of the pain (onset, number of joints and which involved, duration, aggravating and relieving factors) all guide diagnosis. Physical examination typically confirms diagnosis. Radiographs are often used to follow progression or assess severity in a more quantitative manner.
Blood tests and X-rays of the affected joints often are performed to make the diagnosis.
Screening blood tests may be indicated if certain arthritides are suspected. This may include: rheumatoid factor, antinuclear factor (ANF), extractable nuclear antigen and specific antibodies.
Many people associate cracking joints with arthritis; however, these have never been associated with one another. A joint is an area where two or more bones meet. This area is surrounded by joint fluid to protect the bones from rubbing against each other. When a joint is cracking, the fluid is pushed out and the "cracking" sound is the result of a high pressure of fluid. Rheumatoid arthritis is what happens when there is a loss of fluid in the joints causing damage to the lining of the joint itself. There is no evidence to support that cracking your knuckles causes such damage.[1]