What Imaging Techniques May Be Used To Diagnose Arthritis
Imaging techniques may give your healthcare provider a clearer picture of what is happening to your joint. Imaging techniques may include the following:
X-ray. X-rays may show joint changes and bone damage found in some types of arthritis. Other imaging tests may also be done.
Ultrasound. Ultrasound uses sound waves to see the quality of synovial tissue, tendons, ligaments, and bones.
Magnetic resonance imaging . MRI images are more detailed than X-rays. They may show damage to joints, including muscles, ligaments, and cartilage.
Arthroscopy. This procedure uses a thin tube containing a light and camera to look inside the joint. The arthroscope is inserted into the joint through a small incision. Images of the inside of the joint are projected onto a screen. It is used to evaluate any degenerative and/or arthritic changes in the joint to detect bone diseases and tumors to determine the cause of bone pain and inflammation, and to treat certain conditions.
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Ra Diagnosis: What Criteria Are Used To Diagnose Rheumatoid Arthritis
If a patient is showing early signs and symptoms of RA, a doctor can refer the patient to a rheumatologist a physician who specializes in arthritis and other diseases of the joints, muscles and bones. The rheumatologist will work with the patient and the patients primary care physician to reach a RA diagnosis and provide treatment.
Because there is no exact known cause of RA, doctors look at a number of different factors before reaching a diagnosis. To reach a diagnosis, physicians follow a set procedure looking for multiple criteria, rather than one individual test. This includes examining physical symptoms, looking at family and personal medical history, and performing blood and other diagnostic tests .
Some cases may be easier to diagnose than others, especially in the early stages of developing symptoms when symptoms may be less clear. Doctors work hard to ensure theyve looked at all possibilities and that their examination and testing results are consistent with most cases of RA.
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What Is Involved In Reviewing Your Medical History And Your Current Symptoms
When reviewing your medical history, your healthcare provider may ask the following questions:
Have you had any illnesses or injuries that may explain the pain?
Is there a family history of arthritis or other rheumatic diseases?
What medication are you currently taking?
Your healthcare provider may also ask:
What symptoms are you having? For example, pain, stiffness, difficulty with movement, or swelling.
About your pain:
What makes it worse?
Understanding Your Ra Blood Tests
Blood tests are frequently used to help in the diagnosis of rheumatoid arthritis but also to assess any potential problems with the various drugs that are used to treat RA.
Blood tests are frequently used to help in the diagnosis of rheumatoid arthritis but also to assess any potential problems with the various drugs that are used to treat RA. Routine blood tests that are frequently undertaken include a full blood count, urea and electrolytes and a variety of liver function tests. This article covers the blood tests used for diagnosis and general monitoring of RA.
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Ra Medical Imaging Tests
Rheumatologists often use medical imaging tests to look for joint damage that can indicate RA. These may include X-rays, which are most helpful in more advanced RA, or MRIs, which can detect the signs of the disease in its earliest stages.
It is important to note that while all of these tests can help your rheumatologist make a diagnosis, no single test can confirm RA on its own. Your doctor will use some combination of these tests, along with a thorough physical exam and evaluation of your symptoms and medical history to ensure an accurate diagnosis.
What To Think About
- Some DMARDs can take up to 6 months to work.
- In some people, a certain DMARD may not work at all. So a different DMARD will be used.
- If you’re taking DMARDs, it’s a good idea to have a rheumatologist manage your care.
- Many DMARDs have serious side effects. You will need regular blood and urine tests to check the drug’s effects on blood-producing cells , the kidneys, and the liver.
- If you have other conditions such as high blood pressure or high cholesterol, your doctor may recommend that you take medicine to control them.
- Be safe with medicines. Read and follow all instructions on the label.
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Types Of Rheumatoid Arthritis Tests
In order to diagnose rheumatoid arthritis, a doctor begins by discussing a patients symptoms, understanding their medical history, and conducting a physical examination.
Laboratory tests are performed to help diagnose rheumatoid arthritis, to distinguish it from other forms of arthritis and conditions with similar symptoms, and to evaluate the severity of the disease. Laboratory tests used to diagnose and evaluate rheumatoid arthritis, as well as to rule out other conditions, include:
|TESTS RELATED TO DIAGNOSING RHEUMATOID ARTHRITIS|
|Blood sample||How quickly red blood cells settle in a test tube, which can indicate inflammation in the body|
|Synovial fluid sample||Physical, chemical, and microscopic aspects of synovial fluid|
Laboratory tests used to monitor rheumatoid arthritis and detect treatment side effects include regular testing of c-reactive protein and erythrocyte sedimentation rate, as well as hemoglobin, albumin, and platelet count. Additional tests used to detect side effects of treatment depend on the type of treatment or medication a patient is receiving.
Genetic testing may be used in planning treatment for rheumatoid arthritis. In order to understand if a patients body is able to metabolize a type of medication called thiopurine prodrugs, doctors may test patients for variants in the thiopurine methyltransferase and nudix hydrolase 15 genes. Testing for drug metabolism is important to determine a safe dosage of these medications.
Blood Test For Rheumatoid Arthritis
- As in the lupus test, there is no clear cut preparation for the rheumatoid arthritis blood test. Stay clear of alcohol or related products.
- It is good to inform the doctor of all the supplements, medication, or anything that helps in managing your condition. The doctor may tell you to avoid taking food before the test.
- There are several rheumatoid arthritis blood tests that the doctor can order. That will depend on the clinical symptoms and the doctors suspicion.
- The doctor will prepare you as in the lupus procedure. When the blood samples are back from the laboratory, the doctor will interpret the negative or positive results.
- The anti-CCP blood test looks for an antibody with the same name. If it is more than 20 units per milliliter, you are at risk. Antinuclear antibody test usually checks for other autoimmune diseases.
- Other blood tests include C-reactive protein, erythrocyte sedimentation rate, HLA tissue typing, and rheumatoid factor. Two further blood tests check on the uric concentration.
- If there is a higher concentration of uric acid, you may have gout rather than rheumatoid arthritis.
- Rheumatoid arthritis blood tests can sometimes fall short of giving a conclusive diagnosis. This will cause the doctor to use some imaging diagnosis to check the joint condition. It is the doctor to decide which other methods to take.
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More Common Than Expected
In the UK alone, arthritis affects around 10 million people. Thats nearly one in six. And it isnt just the elderly. While its more common in older people, arthritis can affect people of any age even children. As for different types, it can be broken down to osteoarthritis and rheumatoid arthritis.
These two main types of the condition both cause swollen joints, but act in different ways. Osteoarthritis occurs when joint cartilage is damaged, resulting in stress on tendons and ligaments and consequently swelling. Rheumatoid arthritis, on the other hand, is the result of the bodys immune system incorrectly targeting joints.
Treatment Of Seronegative Rheumatoid Arthritis
Just like seropositive rheumatoid arthritis, seronegative rheumatoid arthritis cannot be reversed.
Treatment of this disorder is focused on alleviating pain and discomfort associated with inflammation around the body. Treatment can also slow the progression of this disease, or stop the progression altogether.
Its important to listen to your body and be aware of the signs and symptoms of RA, because the earlier we can detect this disorder, the greater our chances are of slowing its progression. Seronegative RA causes serious damage to the joints and bones because the body attacks the synovial tissues that cushion the bones. When the synovial tissue and supporting cartilage deteriorate, the bones no longer have the padding they need, and they start to rub against each other, which deteriorates the bones over time.
The symptoms of seronegative rheumatoid arthritis can be treated with NSAIDs medications, like ibuprofen. NSAIDs are nonsteroidal anti-inflammatory drugs that reduce inflammation and alleviate pain associated with joint swelling. These medications can increase range of motion, as they reduce the swelling that causes stiffness and inhibits movement.
Other medications, specifically disease-modifying antirheumatic drugs , can be taken to slow joint damage caused by seronegative RA. Sulfasalazine is a common DMARD used to slow the progression of seronegative RA and psoriatic arthritis.
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What To Expect During The Tests
You usually do not need to do anything before a blood test for RA, fasting is not required. Tell your healthcare provider if you are taking any prescription or over-the-counter medications that may affect your tests.
Wear a garment that allows access to your elbow area for the blood draw. Bring your identification. The healthcare professional drawing the blood will ensure your identification and label the blood draw sample tubes.
A tourniquet will be placed on your arm, the vein area sanitized, and a needle will be used to collect the blood into one or more vials.
After drawing the blood, the site will be bandaged. You should not have any side effects and usually do not need to take any precautions after the test.
These tests are sent to the lab rather than being done in the clinic as a rapid test. Your results will not be available immediately but will be reported to your healthcare provider in hours to a day or more.
My Experience With Seronegative Ra
Five years ago I was such a case of seronegative arthritis. Over a period of four years I had two ankle surgeries and a bad case of inflammation in both eyes called uveitis. Then I started to have pain and swelling in my fingers coupled with general fatigue. I went to my primary care physician and after taking a history and conducting a physical exam, he immediately sent me to a rheumatologist. All of the blood tests came back negative. Yet, I had bone erosion in my fingers as shown by x-rays and the doctor put me on disease modifying drugs. After symptoms continued unabated, I quickly progressed to using biological treatments.
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The Diagnostic Criteria For Rheumatoid Arthritis
The diagnosis of rheumatoid arthritis cant 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.
They also try to rule out the possibility of other conditions that may resemble RA, such as lupus, psoriatic arthritis, gout, or osteoarthritis. This is called a differential diagnosis.
To begin the diagnostic process, a rheumatologist will take your medical history, which includes asking questions about your current symptoms particularly pain, swelling, and stiffness and their location, duration, and severity.
Theyll also ask about your familys medical history as it pertains to RA and other autoimmune conditions. Conditions like RA can be more common in families with RA or other immune system-related health problems. For example, research recently published in the journal Arthritis Care & Research found that people who have a first-degree relative with RA are more than twice as likely as the general population to develop RA. A family history of lupus, scleroderma, thyroid disease, or inflammatory bowel disease also substantially increased the risk of RA.
Your rheumatologist will also perform a physical examination, testing each of your joints for things like swelling, tenderness, and limited range of motion. The location of affected joints is important to diagnosis.
Common Blood Diagnostic Tests For Rheumatoid Arthritis
Your physician will leverage numerous blood tests â â usually combined with imaging tests â â to help diagnose you with RA. Most of these blood tests are done with a simple blood test and results are available within a few days.
The tests to diagnose RA are grouped into the following general categories:
- Autoantibody tests which can measure if your immune system is making specific factors that can be seen with RA
- Inflammation tests that can help with the diagnosis of RA, as well as in the monitoring of success of therapy
- Additional tests to evaluate your general health
Anyone with RA normally has high levels of C-reactive protein or elevated erythrocyte sedimentation rate , both of which are signs of inflammatory activity in the body.
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Rest When You’re Tired
The disease itself causes fatigue. And the strain of dealing with pain and limited activities also can make you tired. The amount of rest you need depends on how bad your symptoms are.
- With severe symptoms, you may need long periods of rest. You might need to rest a joint by lying down for 15 minutes several times a day to relax. Try to find a balance between daily activities that you must do or want to do and the amount of rest you need to do those activities.
- Plan your day carefully, including rest periods. Pace your activities so that you don’t get overtired.
Tests That Help Diagnose Ra
To help confirm or disprove RA, your rheumatologist will also have lab tests done. The lab tests would point to likelihood of rheumatoid arthritis, as well as potentially rule out other possibilities on the differential diagnosis, says Dr. Neogi. These tests may include:
Erythrocyte sedimentation rate and C-reactive protein blood tests detect and measure inflammation in your body. If inflammation levels are elevated, it helps build the case for an RA diagnosis. If inflammation levels are normal, says Dr. Neogi, That might dissuade us from thinking about an inflammatory arthritis like rheumatoid arthritis, but would not rule it out. Since inflammation is present in many diseases, these tests do not confirm whether you have RA by themselves.
Rheumatoid factor and anti-cyclic citrullinated peptide antibody blood tests look for proteins associated with RA. Testing positive for one increases your chances of RA diagnosis, while testing positive for both raises your odds even more. However, up to 50 percent of RA patients dont have RF or anti-CCP antibodies. They are diagnosed based on other factors. In these cases, the RA is considered to be seronegative.
The possibility of some autoimmune disorders, such as lupus and Sjögrens syndrome, can be eliminated with the help of an antinuclear antibody blood test, while a synovial fluid analysis, which examines the fluid that lubricates your joints, can help count out gout by looking for crystals under the microscope.
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Is This Topic For You
There are many types of arthritis . This topic is about rheumatoid arthritis. If you are looking for information about how juvenile idiopathic arthritis affects young children, see the topic Juvenile Idiopathic Arthritis. If you are looking for information on the most common form of arthritis in older adults, see the topic Osteoarthritis.
Diagnosing Ra In Outlier Patients
Some cases of RA may be different or more difficult to diagnose then others, and certain routine tests and exams might not be as helpful. These include patients with a very recent onset of disease, people whose RA is inactive, and those with seronegative RA.
In these situations, making an RA diagnosis may take more time, or more weight may be given to certain factors, but RA can still be accurately established.
In people with inactive RA, for example, a rheumatologist may rely less on CRP and ESR tests and more on RF and anti-CCP tests, as well as evidence of characteristic joint erosions on imaging, if the disease has been present for long enough to develop erosions.
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Rheumatoid Arthritis Blood Tests
The rheumatoid arthritis blood tests that doctors perform to help diagnose the disease include:
- Rheumatoid factor
- C-Reactive Protein
- Antinuclear Antibody
None of these tests can singularly conclude that a patient has rheumatoid arthritis. Rather, doctors look at the combined results from all, alongside a number of other criteria including physical symptoms and genetics, in order to reach a rheumatoid arthritis diagnosis.
Medicines To Relieve Symptoms
- Non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen. NSAIDs are used to control pain and may help reduce inflammation. They don’t control the disease or stop it from getting worse. NSAIDs may be combined with DMARDs.
- Corticosteroids such as prednisone. These medicines are used to reduce disease activity and joint inflammation. But using only corticosteroids for an extended time is not considered the best treatment. Corticosteroids are often used to control symptoms and flares of joint inflammation until DMARDs reach their full effectiveness.
- Analgesics . These don’t reduce inflammation but may help with pain control. They include:
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