Rheumatoid Arthritis Diagnosis & Tests
In diagnosing rheumatoid arthritis (RA), examination must be conducted of immunological factors and damage done to joints and their surrounding areas. Many of the symptoms of RA are shared by other diseases and not all RA patients experience very many of them to begin with, both of which factors contribute to complicating the diagnostic process.
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Moreover, some symptoms develop gradually and subtly, and some RA cases are connected with other medical issues. Some tests used to diagnose RA may show normal results for many months even after patients inform their doctors of joint aches and pains. These dynamics make for some complex cases to diagnose as well as complicated ones to treat.
Fortunately, there are very precise diagnostic techniques available. Also, these tests can discover whether the disease is type I (mild) or type II (aggressive) so that doctors can properly treat each case. All testing methods start from the first step, which is seeing a doctor (a general practitioner or, better yet, a rheumatologist).
Doctor’s check up:
Your doctor will ask you to list your symptoms. He will feel your aching joints for swelling and physical abnormalities and growths. Also, he will likely feel most of the joints in your body as well as pressure points to evaluate your pain and reaction to his gentle and firm touches. For the specific diagnosis of RA, he will look for the following key distinctive symptoms: morning stiffness, subcutaneous nodules, arthritic joint pain on both sides of the body and three joints hurting simultaneously.
Using an ultrasound, bone loss and inflammatory activity can be detected using sound waves.
X-rays are useful in detecting rheumatoid arthritis in more advanced stages, but not in early stages.
Dexa Scan imaging:
The dual energy x-ray absorptiometry (dexa scan) proves to be useful in detecting bone loss and erosion in early stages of in rheumatoid arthritis.
Magnetic resonance imaging (MRI):
MRIs can detect attrition of bones and synovial inflammation in areas that X-rays cannot pick up. This is especially important, as synovitis is considered the best predictor of future joint erosion.
Blood is commonly drawn to test for full blood count, the presence of the following indications of rheumatoid arthritis. It should benoted, however, that none of these tests are clear indications of the presence of the disease. In fact, their presence could be indications of a different disease that also presents inflammation and similar symptoms as rheumatoid arthritis.
- Rheumatoid factor (RF) – RFs are the antibodies that gather in the synovium of arthritic joints. RF is present in about 80% of RA cases.
- Anti-cycilic citrullinated peptide (anti-CCP) – The presence of antibodies to cyclic citrullinated peptides (CCP) can recognize the existence of RA years before any symptoms become present.
- Point of care test (POCT) – The newly developed test designed specifically for RA diagnosis
- C-reactive protein (CRP) – Indicative of inflammation. Patients’ body mass indexes should be considered when using this test result, as CRP levels are increased in obesity.
- Erythrocyte sedimentation rate (ESR, sed rate) – Measures how quickly erythrocytes (red blood cells) fall to the bottom of a glass tube filled with the patient’s own blood. The quicker the erythrocytes fall, the more of an indication there is of the severity of RA. This test is not used to determine the presence of the disease, but rather it is used to determine the presence and severity of inflammation.
- Tests for anemia
- Anti-citrullinated protein antibodies (ACPAs)
- Anti-mutated citrullinated vimentin (anti-MCV)
- Anti-nuclear antibodies
- Renal function
- Liver enzymes
Once you have undergone testing for RA, talk with your doctor about ruling out other diseases in the process of diagnosis. Ask your doctor which testing methods may prove beneficial for follow-up examinations to be done in a few months or years to monitor the progression of RA. Once the correct diagnosis has been made, find out which medications and therapies are right for you.