Rheumatoid Arthritis Diagnosis

In rheumatoid arthritis diagnosis, the first step is the meeting between the doctor and the patient. The doctor reviews the history of symptoms, check the joints for inflammation and abnormality, the skin for rheumatoid nodules, and other body parts for inflammation. Certain blood and x-ray tests are often obtained.

The rheumatoid arthritis diagnosis will be based on the pattern of symptoms, the distribution of the inflamed joints, and the blood and x-ray findings. Several visits may be required before the doctor can be sure of the diagnosis. A doctor with special training in arthritis and related diseases is called a rheumatologist.

The distribution of joint inflammation is vital to the doctor in making a rheumatoid arthritis diagnosis. In rheumatoid arthritis, the small joints of the hands, wrists, feet, and knees are typically inflamed in a symmetrical distribution. The rheumatoid arthritis diagnosis becomes more difficult when only one or two joints are inflamed.

The doctor may then perform other tests to exclude arthritis due to infection or gout. The detection of rheumatoid nodules, most often around the elbows and fingers, can suggest the diagnosis.

Rheumatoid Arthritis Diagnosis For Unexplained Joint Inflammation

Abnormal blood antibodies can be found in rheumatoid arthritis patients. A blood antibody called "rheumatoid factor" can be found in 80% of patients. Citrulline antibody is present in most rheumatoid arthritis patients. It is used in the rheumatoid arthritis diagnosis when evaluating patients with unexplained joint inflammation.

A test for citrulline antibodies is most useful in looking for the cause of previously undiagnosed inflammatory arthritis in the absence of traditional blood test for rheumatoid arthritis, rheumatoid factor.

Citrulline antibodies have been felt to represent the earlier stages of rheumatoid arthritis in this setting. Another antibody called "the antinuclear antibody" (ANA) is also frequently found in rheumatoid arthritis patients.

Rheumatoid Arthritis Diagnosis With Arthrocentesis

The doctor may elect to perform an office procedure called arthrocentesis. In this procedure, a sterile needle and syringe are used to drain joint fluid out of the joint for laboratory study.

Analysis of the joint fluid, in the laboratory, can help to exclude other causes of arthritis, such as infection and gout. Arthrocentesis can also be helpful in relieving joint swelling and pain. Rarely, cortisone medications are injected into the joint during the arthrocentesis in order to rapidly relieve joint inflammation and further reduce symptoms.

Joint X-Ray

Joint x-rays may be normal or only show swelling of soft tissues early in the disease. As the disease progresses, x-rays can show bony erosions typical of rheumatoid arthritis in the joints.

Joint x-rays can also be useful in monitoring the progression of disease and joint damage over time. A radioactive test procedure, bone scanning, can demonstrate the inflamed joints.

Blood Tests

A blood test which used to measure how fast red blood cells fall to the bottom of a test tube is called the sedimentation rate (sed rate). The sed rate is used as a crude measure of the inflammation of the joints. The sed rate is generally faster during disease flares, and slower during remissions.

C-reactive protein is another blood test that is used to measure the degree of inflammation present in the body. The rheumatoid factor, sed rate, ANA, and C-reactive protein tests can also be irregular in other systemic autoimmune conditions.

Therefore, abnormalities in these blood tests alone are not sufficient for a firm rheumatoid arthritis diagnosis.