Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
X-rays: Approximately one-third of people with osteoarthritis on X-rays have symptoms such as pain or swelling. X-rays can show narrowing of the space between the joint (articular surface), osteophytes, cyst formation, and hardening of the underlying bone. Scoring systems have been used by doctors to assess the extent of the bony changes on X-rays. Separate scoring systems for the different joints have been studied and found to be predictive of disease status. An important finding from these studies was that the presence of osteoarthritis of the hands was a predictive sign of deterioration of the knee joint. In other words, people with finger joint osteoarthritis were more at risk to show a rapid progression of their knee.
MRI: This study is a complex, noninvasive imaging technique that is unlike X-rays. X-rays provide information mainly on bones. However, MRI is capable of visualizing all structures within the joint. MRI technology is sophisticated and requires an expert to interpret the study.
CT scan: This study may be used to image a joint. CT scanning mainly provides information on the bony structures of the joint but in greater detail than plain X-rays.
Joint fluid analysis: Fluid may be extracted from the knee with a needle and syringe when the diagnosis is uncertain or if an infection is suspected.
Blood tests: No currently accepted blood test or marker for this disease exists. Blood tests may be drawn in cases in which infection is suspected.