The Diagnostic Criteria for Rheumatoid Arthritis
The diagnosis of rheumatoid arthritis can't be established with just one test. Instead, rheumatologists rely on a combination of your medical history, a physical exam, laboratory tests, and sometimes imaging tests to pinpoint the disease.
Magnetic resonance imaging (MRI) and ultrasound may help diagnose rheumatoid arthritis in the early stages of the disease. In addition, these imaging tests can help evaluate the amount of damage in the joints and the severity of the disease.
A positive (abnormal) result means that a higher level of rheumatoid factor was found in your blood. This doesn't always mean that rheumatoid factors are causing your symptoms. But the higher your RF test results, the more likely it is that you have a condition linked to rheumatoid factors.
Signs and symptoms of rheumatoid arthritis may include: Tender, warm, swollen joints. Joint stiffness that is usually worse in the mornings and after inactivity. Fatigue, fever and loss of appetite.
How is RA diagnosed? RA is diagnosed by reviewing symptoms, conducting a physical examination, and doing X-rays and lab tests. It's best to diagnose RA early—within 6 months of the onset of symptoms—so that people with the disease can begin treatment to slow or stop disease progression (for example, damage to joints).
Biopsy to test tissue for signs of autoimmune disease. Blood tests to check liver or kidney function. Bone density test (DEXA scan). CT scan, MRI or ultrasound to view organs and structures.
The typical case of rheumatoid arthritis begins insidiously, with the slow development of signs and symptoms over weeks to months. Often the patient first notices stiffness in one or more joints, usually accompanied by pain on movement and by tenderness in the joint.
The normal range of RF is from 0-20 IU/ml. RF above 20 IU/ml is not considered enough to diagnose RA, as there other reasons the RF level may be elevated.
Rheumatoid arthritis (RA)
When a person has RA, the immune system attacks healthy cells in the body for unknown reasons, causing an inflammatory response. RA commonly affects the hips, knees, ankles, or feet. Therefore, it can cause leg pain.
The symptoms of rheumatoid arthritis often develop gradually over several weeks, but some cases can progress quickly over a number of days. The symptoms vary from person to person. They may come and go, or change over time. You may experience flares when your condition deteriorates and your symptoms become worse.
People with rheumatoid arthritis typically have several permanently inflamed joints. The inflammation inside the body can lead to general physical weakness, drowsiness and exhaustion. This feeling of extreme tiredness is also called "fatigue." Some people find this to be the worst symptom of the disease.
For decades, X-rays were used to help detect rheumatoid arthritis (RA) and monitor for worsening bone damage. In the early stages of RA, however, X-rays may appear normal although the disease is active, making the films useful as a baseline but not much help in getting a timely diagnosis and treatment.
Methotrexate is usually the first medicine given for rheumatoid arthritis, often with another DMARD and a short course of steroids (corticosteroids) to relieve any pain. These may be combined with biological treatments.
No single blood test can reliably diagnose RA. Some healthy people test positive for anti-CCPs, while others who have RA have negative test results. Blood tests are just one of several factors, including a medical history, physical exam and X-rays, that help doctors diagnose the disease.
In the study, the median survival rate for healthy adults was approximately 82 years while the median survival rate for people with RA was approximately 77 years.
The most common eye-related symptom of rheumatoid arthritis is dryness. Dry eyes are prone to infection, and if untreated, severe dry eyes can cause damage to the cornea, the clear, dome-shaped surface of the eye that helps your eye focus.
Mild RA is the least severe form of the rheumatoid arthritis. At this stage, people will experience intermittent pain, stiffness, and swelling. However, lack of severity and infrequency of symptoms also make diagnosis at this stage difficult and can delay treatment.
Rheumatoid arthritis can be life changing. You may need long-term treatment to control the symptoms and joint damage. Depending on how much pain and stiffness you feel and how much joint damage you have, simple daily tasks may become difficult or take longer to do.
Symptoms of rheumatoid arthritis include: Pain, swelling, stiffness and tenderness in more than one joint. Stiffness, especially in the morning or after sitting for long periods. Pain and stiffness in the same joints on both sides of your body.
High levels of CRP mean there is inflammation in the body. This can help doctors to diagnose and manage RA. For example, doctors may measure a person's CRP levels during a treatment program to assess how effectively specific methods are reducing inflammation.
Heredity and RA
"RA, like many autoimmune diseases, is quite heritable and unfortunately tends to cluster in families," says Hu. "Many genetic studies have gone into identifying genes that predispose individuals to the risk of RA."