The first step in the diagnosis of RA is a meeting between the doctor and the patient. The doctor reviews the history of symptoms, examines the joints for inflammation and deformity, the skin for rheumatoid nodules, and other parts of the body for inflammation. Your GP may arrange for the following to aid in the diagnosis: -
- Joint x-rays - to see if your joints show any damage caused by the inflammation of RA.
- Magnetic resonance imaging (MRI) - is more sensitive than X-rays and may show signs of joint damage earlier than other tests.
- Blood tests : -
- Sedimentation Rate (sed-rate) - is a measure of how fast red blood cells fall to the bottom of a test tube. During disease flares it is faster and slower during remissions. This can then be used to measure the amount of inflammation in the joints.
- C-reactive Protein (CRP) – used to measure the degree of inflammation present in the body.
- Blood Antibody Study : -
- Citrullinated peptide (anti-CCP) - is a new blood test, which measures certain specific antibodies and can be found in most patients with rheumatoid arthritis.
- Rheumatoid Factor (RF) - can be found in 75% of patients exhibiting symptoms.
- Antinuclear Antibody (ANA) - is also frequently found in patients with rheumatoid arthritis.
- Complete Blood Count (CBC) - may show low hematocrit (anemia) or abnormal platelet counts.
- Synovial fluid analysis (arthrocentesis) – may be extracted from inflamed joints using a sterile needle and syringe. Analysis of the joint fluid, in the laboratory, can help to exclude other causes of arthritis, such as infection and gout.
Several visits may be necessary before the doctor can be certain of the diagnosis. He/She will determine if four or more of the following signs are positive, it is very likely that you have RA and your GP will refer you to a rheumatologist.
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Morning stiffness that lasts for more than an hour for more than six weeks
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Inflammation and swelling of three or more joints, for more than six weeks
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Swelling and inflammation of your hand joints, for more than six weeks;
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Symptoms in the same joints on both sides of your body (symmetrical arthritis), for more than six weeks
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You have rheumatoid nodules
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Positive test for rheumatoid factor in your blood
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X-rays show changes in your joints.
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