What Is The Normal Range For Rheumatoid Factor
Though there is some variation depending on the lab, a normal level of rheumatoid factor is typically considered to be less than 15 or 20 IU/mL.
A number above that is considered to be abnormal, and means you are positive for rheumatoid factor. Generally speaking, the higher the rheumatoid factor, the more severe your disease may be.
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.
Other Conditions Associated With Seronegative Patients
A seronegative result along with what are thought to be rheumatoid arthritis symptoms could potentially indicate other conditions altogether. Often times when inflammation is present or consistent it means that the seronegative patient may have osteoarthritis instead of rheumatoid arthritis. This is a common confusion.
Spondyloarthritis conditions are sometimes associated with seronegative rheumatoid arthritis because they are inflammatory. These are conditions like ankylosing spondylitis, reactive arthritis, as well as psoriatic arthritis.
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The 2010 Acr/eular Classification Criteria Guidelines
Sometimes people who have been diagnosed with RA take part in studies or clinical trials perhaps to try a promising drug or study ways to improve quality of life.
To identify RA patients with typical features of RA who are suitable for these important studies, scientists use a set of guidelines created by the American College of Rheumatology and the European League Against Rheumatism. These are called the 2010 ACR/EULAR classification criteria.
For classification purposes to be considered for enrollment into studies, patients must first have at least one inflamed joint that cant be explained by another condition. Then theyre evaluated for classification based on the following:
- Joint involvement. Which joints are swollen? How many are affected? Are they large or small?
- Serology test results. What are the results of RF and/or ACPA tests?
- Acute-phase reactant test results. Are the results of CRP and/or ESR tests normal or abnormal?
- Duration of symptoms. Have symptoms been around more or less than six weeks?
Others who may be eligible for studies include long-time RA patients whose past symptoms fulfill the criteria, those with joint damage very characteristic of RA, and those with new RA who are receiving treatment.
What Causes Rheumatoid Arthritis
The exact cause of rheumatoid arthritis is unknown. Researchers think its caused by a combination of genetics, hormones and environmental factors.
Normally, your immune system protects your body from disease. With rheumatoid arthritis, something triggers your immune system to attack your joints. An infection, smoking or physical or emotional stress may be triggering.
Is rheumatoid arthritis genetic?
Scientists have studied many genes as potential risk factors for RA. Certain genetic variations and non-genetic factors contribute to your risk of developing rheumatoid arthritis. Non-genetic factors include sex and exposure to irritants and pollutants.
People born with variations in the human leukocyte antigen genes are more likely to develop rheumatoid arthritis. HLA genes help your immune system tell the difference between proteins your body makes and proteins from invaders like viruses and bacteria.
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What Is The Difference
Rheumatoid arthritis vs. osteoarthritis
Rheumatoid arthritis and osteoarthritis are both common causes of pain and stiffness in joints. But they have different causes. In osteoarthritis, inflammation and injury break down your cartilage over time. In rheumatoid arthritis, your immune system attacks the lining of your joints.
Rheumatoid arthritis vs. gout
Rheumatoid arthritis and gout are both painful types of arthritis. Gout symptoms include intense pain, redness, stiffness, swelling and warmth in your big toe or other joints. In gout, uric acid crystals cause inflammation. In rheumatoid arthritis, its your immune system that causes joint damage.
How Rheumatoid Factor Affects Prognosis
Determining a prognosis for rheumatoid arthritis patients can be a complicated process. The disease affects different people in different ways. A prognosis can depend largely on the type and severity of symptoms the patient displays, as well as their medical history.
Many doctors and researchers feel that a positive rheumatoid factor test result may predict a more severe pattern of symptoms and overall disease course. Extra-articular symptoms like rheumatoid nodules may be more likely to form in patients who have positive rheumatoid factor blood test results. Other aggressive symptoms, though rare, could be more likely to occur in rheumatoid factor positive patients. These may include symptoms due to an autoimmune effect on the lung and heart.
Rheumatoid factor-positive patients may also have a higher disease activity score, meaning frequent flare-ups and fewer remission periods.
Keep in mind this isnt always the case. If rheumatoid factor is tested and symptoms are detected early, a diagnosis can be quickly reached. Early diagnosis means treatment can begin sooner, hence preventing further progression of joint damage, swelling and pain.
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How Is Ra Treated
RA can be effectively treated and managed with medication and self-management strategies. Treatment for RA usually includes the use of medications that slow disease and prevent joint deformity, called disease-modifying antirheumatic drugs biological response modifiers are medications that are an effective second-line treatment. In addition to medications, people can manage their RA with self-management strategies proven to reduce pain and disability, allowing them to pursue the activities important to them. People with RA can relieve pain and improve joint function by learning to use five simple and effective arthritis management strategies.
Living With Rheumatoid Arthritis
Research shows that people who take part in their own care report less pain and make fewer doctor visits. They also enjoy a better quality of life.
Self-care can help you play a role in managing your RA and improving your health. You can:
- Learn about rheumatoid arthritis and its treatments.
- Use exercises and relaxation techniques to reduce your pain and help you stay active.
- Communicate well with your health care team so you can have more control over your disease.
- Reach out for support to help cope with the physical emotional, and mental effects of rheumatoid arthritis.
Participating in your care can help build confidence in your ability to perform day-to-day activities, allowing you to lead a full, active, and independent life.
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Telling The Difference Between Ra And Other Conditions
RA is often confused with other conditions that can cause joint pain, including:
- Inflammatory bowel disease and Crohns disease
- Palindromic rheumatism
- Reactive arthritis resulting from bacterial infection
Many of these conditions cause overlapping symptoms, including joint pain and stiffness.
RA is also potentially confused with osteoarthritis, which causes pain and stiffness in the joints, but is caused by wear and tear, not inflammation from an immune response.
In order to distinguish RA from other autoimmune conditions, your doctor will likely perform a variety of diagnostic tests, including imaging of your joints, blood tests, and comprehensive physical exams. Your doctor may also recommend that you see a rheumatologist .
If you have persistent swelling, pain, or stiffness in your joints, its important to find a medical professional to diagnose your condition as soon as possible. Dignity Health provides comprehensive care for rheumatoid arthritis as part of our orthopedic services. Consult with a trained specialist at Dignity Health through our Find a Doctor tool.
The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.
Testing For Rheumatoid Factor Can Help Diagnose Ra Although It Is Just One Part Of A Larger Picture
Rheumatoid arthritis is a chronic inflammatory condition that causes painful swelling of the joints. If it isnt treated, over time the disease can permanently damage your joints and cause many other health issues. Thats why its important to diagnose and begin taking care of RA as soon as possible. Early intervention can prevent long-term disability and other life-altering complications.
If your doctor suspects you have RA, to begin the diagnostic process, they will take your personal and family medical history, perform a physical exam, and order a number of lab tests. One of those tests will be for an autoantibody called rheumatoid factor .
Many people with RA will test positive for rheumatoid factor in their blood. When you test positive for rheumatoid factor and/or another autoantibody called anti-cyclic citrullinated protein you are considered to have seropositive rheumatoid arthritis.
Some people with RA will have negative rheumatoid factor and negative anti-CCP. These patients are considered to have seronegative rheumatoid arthritis. For these patients, confirming an RA diagnosis will depend on other criteria. Whats more, once you are diagnosed, it may mean a different disease course as well as some complicated feelings about your condition.
Heres what you need to know about rheumatoid arthritis with negative rheumatoid factor.
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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.
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?
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Diagnosing Rheumatoid Arthritis With The Rheumatoid Factor Test
Patients who test positive for rheumatoid factor arent necessarily diagnosed with rheumatoid arthritis right away. There must also be a clear history of consistent rheumatoid arthritis symptoms.
If your doctor suspects symptoms of rheumatoid arthritis, other criteria must first be taken into consideration before reaching a diagnosis. The presence of rheumatoid factor alone does not typically lead to an immediate rheumatoid arthritis diagnosis. Doctors look at physical symptoms, medical history and may conduct other blood tests, like anti-CCP, as well as imaging scans to help identify the condition.
Depending on the final diagnosis, in some cases the presence of rheumatoid factor in a patients blood may help determine the type of treatment that will be provided to that patient, such as disease-modifying antirheumatic drugs .
A positive rheumatoid factor test along with a rheumatoid arthritis diagnosis can potentially help the doctor determine a prognosis and an appropriate course of treatment. This may depend on a variety of factors.
Symptoms Of Seronegative Rheumatoid Arthritis
Seronegative rheumatoid arthritis patients must possess a distinct set of symptoms in order to be diagnosed. This is because the lack of antibodies in the blood makes it more difficult to reach a rheumatoid arthritis diagnosis.
Some of the most important symptoms in diagnosing seronegative rheumatoid arthritis include:
- Joint pain, stiffness specifically in the hands but also in knees, elbows, hips, feet and ankles
- Joint swelling and redness
- Morning stiffness lasting longer than 30 minutes
Though this is not an exhaustive list, the majority of these will support a rheumatoid arthritis diagnosis. If we compare these symptoms to seropositive rheumatoid arthritis symptoms, there are many similarities. However, many patients see these symptoms evolve and change over time.
It is thought that seropositive patients experience a more severe disease course than seronegative patients. But studies have also shown that in some patient cases, the progression is comparable and sometimes is there is little difference. This is where it becomes complicated in trying to classify rheumatoid arthritis into sub-types and to reach a solid diagnosis.
There are some symptoms that are thought to be rheumatoid arthritis in seronegative patients, but later turn out to be other conditions. These cases mainly involve differences in the types of joints and areas affected as well as the levels of inflammation.
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What Are The Goals Of Treating Rheumatoid Arthritis
The most important goal of treating rheumatoid arthritis is to reduce joint pain and swelling. Doing so should help maintain or improve joint function. The long-term goal of treatment is to slow or stop joint damage. Controlling joint inflammation reduces your pain and improves your quality of life.
Other Diagnostic Methods Used To Confirm Rheumatoid Arthritis
Blood tests arent the only method that can be used to diagnose rheumatoid arthritis. You might also have a variety of other tests done to help confirm rheumatoid arthritis. These include:
- Physical assessment. A physical assessment can help determine how much your symptoms are impacting your daily life. You might be asked how well you can do daily tasks such as showering, eating, and dressing. A physical therapist might also assess your grip, walk, and balance.
- Joint scan. A joint scan looks for inflammation and damage in your joints. It can help confirm a rheumatoid arthritis diagnosis.
- Imaging tests. X-rays and MRIs create detailed pictures of your bones, muscles, and joints that can help diagnose rheumatoid arthritis.
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Making A Diagnosis Of Rheumatoid Arthritis
Diagnosis of RA is not straight forward as there is no individual test for RA. A diagnosis tends to be made by a consultant rheumatologist on the basis of tests, examination and ruling out other possible causes for symptoms.
Sometimes it is clear from symptoms and initial blood tests that someone has rheumatoid arthritis, but not always. Specialist criteria have been developed jointly by American and European experts to try to help make a diagnosis of rheumatoid arthritis in people presenting with new-onset swollen, painful joints with no obvious cause . These should be used with care though as people with osteoarthritis or a crystal arthritis could meet the criteria and end up being incorrectly diagnosed with rheumatoid arthritis, which could have significant consequences for treatment. They have also been developed to classify, not diagnose, rheumatoid arthritis and so should not be used to decide who gets referred.
As already mentioned above, there are a number of other conditions that can cause very similar symptoms to rheumatoid arthritis and your GP will have to consider these when assessing each case.
Rheumatoid Factor And Anti
One blood test measures levels of rheumatoid factors in the blood. Rheumatoid factors are proteins that the immune system produces when it attacks health tissue.
About half of all people with rheumatoid arthritis have high levels of rheumatoid factors in their blood when the disease starts, but about 1 in 20 people without rheumatoid arthritis also test positive.
A related blood test known as anti-cyclic citrullinated peptide test is also available. Anti-CCPs are antibodies also produced by the immune system.
People who test positive for anti-CCP are very likely to develop rheumatoid arthritis, but not everybody with rheumatoid arthritis has this antibody.
Those who test positive for both rheumatoid factor and anti-CCP may be more likely to have severe rheumatoid arthritis requiring higher levels of treatment.
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Exercise And Wise Use Of Joints
Another key to coping with pain is to follow an exercise program designed by your doctor or physical therapist.
Your exercise program should include special range-of-motion exercises to help keep your joints movable. It should also include general fitness exercise such as swimming or walking. These help keep your heart, lungs, bones and muscles strong. Exercise also helps relieve stiffness and gives you an improved sense of well-being. Here are some tips to help you exercise properly:
- If you have a flare, do only gentle range-of-motion exercises.
- Start with just a few exercises and slowly add more.
- Listen to your body. If it hurts too much or if you begin to have too much pain, stop the exercise. Ask your doctor or therapist to help you learn the difference between normal exercise discomfort and too much exercise pain.
Using joints wisely and saving energy
Using your joints wisely means doing everyday tasks in ways that reduce the stress on painful joints. Saving your energy means listening to your body for signals that it needs to rest. It also means learning to pace yourself so you dont become too tired. Here are a few guidelines for using your joints wisely and for saving your energy: