How Is Arthritis Diagnosed
If you think you may have arthritis, see your healthcare provider. The provider will ask about your symptoms and learn how joint pain affects your life. Your provider will perform a physical exam, which may include:
- Assessing mobility and range of motion in your joints.
- Checking for areas of tenderness or swelling around your joints.
- Evaluating your overall health to determine if a different condition could be causing your symptoms.
Who Treats Rheumatoid Arthritis
Diagnosing and treating rheumatoid arthritis requires a team effort involving you and several types of health care professionals. These may include:
- Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.
- Primary care providers, such as internists, who specialize in the diagnosis and medical treatment of adults.
- Orthopaedists, who specialize in the treatment of and surgery for bone and joint diseases or injuries.
- Physical therapists, who help to improve joint function.
- Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.
- Dietitians, who teach ways to eat a good diet to improve health and maintain a healthy weight.
- Nurse educators, who specialize in helping people understand their overall condition and set up their treatment plans.
- Mental health professionals, who help people cope with difficulties.
How Doctors Diagnose Arthritis Hand Pain
To determine whats behind your hand pain, your doctor will rely on your medical history, a physical exam, and imaging and blood tests to make a diagnosis and determine what kind of arthritis hand pain you have.
Feeling a patients joints during the exam can help differentiate between OA and inflammatory arthritis, Dr. Byram says. The swelling feels harder in those with OA because extra bone at the joints, called osteophytes, forms over time. The swelling in RA and other inflammatory disease feels softer.
Imaging tests, such as X-rays or an MRI, can reveal joint erosion and osteophytes and loss of cartilage .
If your doctor suspects inflammatory arthritis, they will also order blood tests to detect the presence of certain antibodies, such as rheumatoid factor or anti-CCP, that help identify RA and other types of inflammatory arthritis.
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Are Glucosamine And Chondroitin Supplements Helpful For Treating Osteoarthritis Of The Hand
Supplements are not reviewed or approved by the Food and Drug Administration . They are not required to undergo the same rigorous clinical trial methods that medications must undergo in the U.S. Some clinical trials show benefits with pain relief however, there is no proof that these supplements slow the progression of osteoarthritis. If you plan to try these, always check with your healthcare provider before using supplements. These products may interfere with medications you currently take.
A note from Cleveland Clinic
Dull or burning joint pain, morning stiffness, swollen joints in your hand are all symptoms of arthritis. Many types of arthritis could affect your hands. Many treatment options are available depending on your exact arthritis type. Medications can reduce joint pain and swelling. Researchers are still working on ways to slow the progression of osteoarthritis. See your healthcare provider if you think you have arthritis in your hands. They will perform a complete exam and offer you a complete treatment plan, which includes hand exercises, use of hot and cold packs, other lifestyle tips and traditional treatments including medications, braces/splints, steroid injections and surgery.
Last reviewed by a Cleveland Clinic medical professional on 07/06/2021.
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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Do Certain Types Of Weather Make Arthritis Worse
Some people find that arthritis feels worse during certain types of weather. Humidity and cold are two common triggers of joint pain.
There are a variety of reasons why this might happen. People tend to be less active in rainy seasons and the wintertime. The cold and damp can also stiffen joints and aggravate arthritis. Other theories suggest that barometric pressure, or the pressure of the air around us, may have some effect on arthritis.
If you find that certain types of weather make your arthritis worse, talk to your healthcare provider about ways to manage your symptoms. Dressing warmly, exercising inside or using heat therapy may help relieve your pain.
A note from Cleveland Clinic
Arthritis is a disease that affects the joints. There are many types of arthritis, all of which can cause pain and reduce mobility. Some forms of arthritis result from natural wear and tear. Other types come from autoimmune diseases or inflammatory conditions. There are a variety of treatments for arthritis, ranging from physical or occupational therapy to joint surgery. Your healthcare provider will assess your symptoms and recommend the right treatment plan for your needs. Most people can successfully manage arthritis and still do the activities they care about.
Last reviewed by a Cleveland Clinic medical professional on 04/15/2021.
Why You Have Arthritis
There are over 100 different types ofarthritis that can develop as you get older or following an injury. The many types of arthritis target your joints, causing pain, inflammation, and stiffness and limiting your joints flexibility.
The two most common types of arthritis that affect many adults in the United States include osteoarthritis and rheumatoid arthritis.
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Unusual Symptoms Of Ra
While rheumatoid arthritis most commonly causes joint pain, inflammation, and swelling, systemic symptoms such as fatigue can affect the whole body. Inflammation from rheumatoid arthritis can also target other systems of the body, resulting in a variety of different symptoms. These are known as extra-articiular manifestations.
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.
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How Is Arthritis In The Hand Treated
Treatment options depend on the type of arthritis, stage of arthritis, how many joints are affected, your age, activity level, the hand affected and other existing medical conditions.
Goals of treatment are to:
- Improve mobility and function.
- Increase your quality of life.
- In the case of rheumatoid or psoriatic arthritis, to slow the progression of the disease.
Treatment options include splinting/bracing, medications, injections, non-drug approaches and surgery.
Splits or braces support and protect the affected joint, reduce deformity, provide joint stability, lessen strain, and promote proper joint alignment. Your healthcare provider, occupational therapist or hand therapist will discuss splinting/bracing options, how and when to wear them and how long to wear them .
Steroids reduce inflammation and relieve pain. Steroids are usually used if medications dont control inflammation or if the inflammation is limited to a few joints. Injections are administered directly into the affected joint. Because steroids can weaken tendons and ligaments, injections are repeated only a few times.
Other management strategies
A complete treatment plan for arthritis of the hand includes these additional approaches:
If nonsurgical treatments no longer provide relief and the cartilage at the ends of your bones has worn away, surgery may be an option. There are several approaches:
Will I Need Surgery For Arthritis
Healthcare providers usually only recommend surgery for certain severe cases of arthritis. These are cases that havent improved with conservative treatments. Surgical options include:
- Fusion: Two or more bones are permanently fused together. Fusion immobilizes a joint and reduces pain caused by movement.
- Joint replacement: A damaged, arthritic joint gets replaced with an artificial joint. Joint replacement preserves joint function and movement. Examples include ankle replacement, hip replacement, knee replacement and shoulder replacement.
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Symptoms And Family History
40 percent of people with psoriasis or PsA had a family member with either psoriasis or PsA.
In the study, those with a family history of PsA had a higher risk for developing deformities from PsA, but a lower risk for developing plaque psoriasis, the red, scaly skin patches that are a common symptom of psoriasis.
Researchers are only now beginning to decipher the specific genes associated with PsA. The main challenge is distinguishing genes responsible for psoriasis from those responsible for PsA.
Identifying the genes that lead to PsA may pave the way toward developing gene therapy for treating PsA.
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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Who Gets Arthritis In Their Hands
You are more likely to get arthritis in your hands if:
- Youre older. Osteoarthritis is commonly seen after age 50. Rheumatoid arthritis typically first appears between the age of 35 and 50.
- Youre a woman.
- Youre overweight.
- Youve had previous injuries to your hand. If youve dislocated or broken any joints in your hands or fingers, you are more likely to develop arthritis.
- You’ve inherited genes that cause the development of arthritis.
Blood Tests For Psoriatic Arthritis
Blood tests in themselves will not confirm a PsA diagnosis. These tests are usually given to determine the presence of inflammation and to rule out other conditions.
Read on to learn what types of blood tests may be given to make a PsA diagnosis.
- Erythrocyte sedimentation rate . This gauges your bodys degree of inflammation, though not specifically for PsA. It measures the amount of red blood cells that settle in a vial of blood, which is greater when you have inflammation.
- C-Reactive protein . Your doctor may order this test to check for an elevated C-reactive protein level. This test is not specific for PsA, but it does indicate the presence of inflammation.
- Rheumatoid Factor . Presence of this antibody in your blood indicates rheumatoid arthritis . Its presence means you dont have PsA.
- Anti-Cyclic Citrullinated Peptide test. These antibodies usually indicate RA. However, their presence can occur in other forms of arthritis, and your doctor will probably test for them.
- Human leukocyte antigen B27 . This is a protein found on the surface of white blood cells in some people with PsA.
- Serum uric acid. Your doctor may take a sample of fluid from your joints to check for uric acid crystals. Elevated uric acid in the blood or crystals in bodily fluids indicate gout.
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How Does A Normal Joint Work
A joint is where two bones meet. Most of our joints are designed to allow the bones to move in certain directions and within certain limits.
For example, the knee is the largest joint in the body and one of the most complicated. It must be strong enough to take our weight and must lock into position, so we can stand upright.
It also has to act as a hinge, so we can walk, and needs to twist and turn when we run or play sports.
The end of each bone is covered with cartilage that has a very smooth, slippery surface. The cartilage allows the ends of the bones to move against each other, almost without rubbing.
The joint is held in place by the synovium, which contains thick fluid to protect the bones and joint.
The synovium has a tough outer layer that holds the joint in place and stops the bones moving too far.
Strong cords called tendons anchor the muscles to the bones.
Routine Monitoring And Ongoing Care
Regular medical care is important because your doctor can:
- Monitor how the disease is progressing.
- Determine how well the medications are working.
- Talk to you about any side the effects from the medications.
- Adjust your treatment as needed.
Monitoring typically includes regular visits to the doctor. It also may include blood and urine tests, and xrays. Having rheumatoid arthritis increases your risk of developing osteoporosis, particularly if you take corticosteroids. Osteoporosis is a bone disease that causes the bones to weaken and easily break. Talk to your doctor about your risk for the disease and the potential benefits of calcium and vitamin D supplements or other osteoporosis treatments.
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The Role Of Arthritis Testing
Arthritis testing may be used for diagnosis, guiding treatment, or monitoring of arthritis:
- Diagnosis: Arthritis testing is often used to diagnose the cause of a persons symptoms and rule out other health conditions.
- Treatment planning: In some patients, arthritis testing is used to plan for treatment or determine a patients risk of severe side effects while receiving arthritis treatment.
- Monitoring: While patients are being treated for arthritis, testing may be used to monitor the effectiveness of medications and track the progression of the disease.
Can Imaging Exams Detect Arthritis
Imaging exams can help your healthcare provider get a clear picture of your bones, joints and soft tissues. An X-ray, MRI or ultrasound can reveal:
- Bone fractures or dislocations that may be causing you joint pain.
- Cartilage breakdown around your joints.
- Muscle, ligament or tendon injuries near your joints.
- Soft tissue inflammation.
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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.
What Outcome Can I Expect If I Have Arthritis In My Hands
There is no cure for arthritis. However, you can usually manage mild to moderate symptoms with a combination of medication and non-medication approaches. Surgery may be an option if other treatments fail or the arthritis in your hands is severe. Your healthcare provider will explain what outcome you can expect for your type and severity of arthritis, your age, other existing medical conditions and other factors.
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What Can I Do To Make Living With Arthritis Easier
Changing your routine can make living with arthritis easier. Adjust your activities to lessen joint pain. It may help to work with an occupational therapist . An OT is a healthcare provider who specializes in managing physical challenges like arthritis.
An OT may recommend:
- Adaptive equipment, such as grips for opening jars.
- Techniques for doing hobbies, sports or other activities safely.
- Tips for reducing joint pain during arthritic flare-ups.
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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