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How Do They Diagnose Rheumatoid Arthritis

Ra Blood Tests: What Lab Tests Show Rheumatoid Arthritis

How is Rheumatoid Arthritis Diagnosed? | Johns Hopkins Rheumatology

To diagnose rheumatoid arthritis there is no one test that can on its own reach a diagnosis. Instead, there are a number of criteria that must be established in order to reach a rheumatoid arthritis diagnosis.

As part of the criteria for diagnosing rheumatoid arthritis, doctors will order multiple blood tests. These blood tests look for specific indicators that support the possibility that the patient could have rheumatoid arthritis.

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.

What Questions Will My Rheumatologist Ask

One of the first questions the doctor will ask is, âWhat brings you here?â This is your chance to tell them how RA is affecting your life.

Then, get ready to answer a lot of other questions, like:

  • What are your symptoms?
  • Where on your body is the pain?
  • How bad is the pain?
  • Which words best describe your pain?
  • How does the pain make you feel?
  • Does it stop you from doing things you enjoy?
  • Are there symptoms other than joint, muscle, or bone pain that seem to be linked?
  • Does anyone in your family have RA?

Some of the questions may not seem to be about rheumatoid arthritis, but your doctor has a good reason for asking them. Tell them if you want to know why or if you feel uncomfortable.

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Come Prepared With Your Health History

You are more than just your joint pain. Any and all medical conditions that have affected you in the past might be relevant to your current condition. Keep a list with the names and dates of any illnesses and surgeries youve had. Bring a list of what medications you take prescription, over-the-counter, vitamins, alternative/herbal remedies and their doses. Write down anything you can think of that might be relevant in your familys medical history, too. Did anyone in your family have a rheumatic disease or autoimmune condition ? Ask your primary care doctor for a copy of your medical record, as well any relevant images or lab results.

Social And Emotional Support

CBD For Rheumatoid Arthritis  What You Should Know

One of the most important tools for managing a chronic condition like RA is support. It can make a big difference in your treatment to have a doctor and other medical staff you feel comfortable with as part of your care team. Support from friends and family can also help you get through flare-ups and challenging days.

It can also be helpful to connect with other people living with RA. A support group can give you a place to share struggles and triumphs with people in a similar situation. To find an RA support group, check out:

  • MyRAteam.MyRAteam is an online social network and support system for people with RA.
  • Rheumatoid Arthritis Support. Rheumatoid Arthritis Support is an online forum where you can connect with other people with RA.
  • Live Yes! Connect Groups. Offered by the Arthritis Foundation, Live Yes! Connect Groups are online support groups for people with RA.
  • Arthritis Introspective. Arthritis Introspective is focused on young and middle-aged adults living with rheumatoid and other forms of arthritis. You can find an Arthritis Introspective support group in your area using their locator service.

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Reviewing Your Risk Factors

Your doctor may suspect you’re dealing with rheumatoid arthritis if youre a woman because about 75% of people who are diagnosed with RA are female. Some women are diagnosed with RA early, in their 20s or 30s, but a number are diagnosed later, in their 50s or 60s. Men who are diagnosed tend to be older. If you have first-degree family members who have been diagnosed with RA, tell your doctor, because that increases your risk as well.

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.

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Favorite Online Support Network For Ra

The Live Yes! Arthritis Network, from the Arthritis Foundation, provides a network of support with the aim of helping people live their best lives. By exchanging ideas, tips, and experiences with others in provided online forums covering a variety of topics, the network empowers people with RA to gain confidence in dealing with their disease proactively.

Physical And Occupational Therapy For Rheumatoid Arthritis

How is Rheumatoid Arthritis diagnosed?

An occupational therapist can teach you how to modify your home and workplace and better navigate your surroundings to effectively reduce strain on your joints and prevent further aggravation of the inflammation during your day-to-day activities. Additionally, they can teach you how to perform regular tasks in different ways to better protect your joints.

Theyll teach you joint protection techniques, such as how to maintain proper body position and posture, body mechanics for specific daily functions, and how to distribute pressure to minimize stress on individual joints.

Occupational and physical therapists can also teach you about the hand exercises that are best for you.

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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.

Learning When You’re Stiff

RA-related stiffness is usually worst in the morning and lasts about an hour, Dr. Khan says: The fingers are tight. They have a hard time movingthey feel like the Tin Manand then as they get moving, in half an hour to an hour, symptoms get better. Any extended period of sitting or just not moving can cause RA joints to stiffen up, too. Osteoarthritis stiffness typically happens for less time later in the day, after physical activity.

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Joint Stiffness & Loss Of Range Of Motion

Stiffness in the joints occurs when this disease is in an active state of inflammation, or when your immune system is actively attacking healthy tissue. Oftentimes, the greatest amount of stiffness occurs in the mornings, but it can continue throughout the day as well.

Dealing with this type of stiffness, as well as overall joint swelling, can result in the loss of range of motion if rheumatoid arthritis treatment is not sought early or if the disease is too advanced. In more advanced RA, the range of motion can be permanently lost in certain joints.

Working with a qualified physical therapist may help preserve or extend the range of motion for RA patients. Other treatment methods, such as taking nonsteroidal anti-inflammatory drugs, can help as well.

Role Of The Primary Care Doctor

Arthritis Pain Relief

Your primary care doctor will able to make an initial assessment following a physical examination. They can order X-rays, blood tests, or any other diagnostic tests needed to support his initial assessment. Your primary care doctor can also prescribe medications to relieve pain and other arthritis symptoms.

After test results come back and enough time has passed to evaluate how you are doing on the prescribed medications, your doctor may decide that they can handle your case. If not, they may decide to refer you to a specialist in arthritis diseases known as a rheumatologist.

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Does Rheumatoid Arthritis Cause Fatigue

Everyones experience of rheumatoid arthritis is a little different. But many people with RA say that fatigue is among the worst symptoms of the disease.

Living with chronic pain can be exhausting. And fatigue can make it more difficult to manage your pain. Its important to pay attention to your body and take breaks before you get too tired.

What are rheumatoid arthritis flare symptoms?

The symptoms of a rheumatoid arthritis flare arent much different from the symptoms of rheumatoid arthritis. But people with RA have ups and downs. A flare is a time when you have significant symptoms after feeling better for a while. With treatment, youll likely have periods of time when you feel better. Then, stress, changes in weather, certain foods or infections trigger a period of increased disease activity.

Although you cant prevent flares altogether, there are steps you can take to help you manage them. It might help to write your symptoms down every day in a journal, along with whats going on in your life. Share this journal with your rheumatologist, who may help you identify triggers. Then you can work to manage those triggers.

What Does A Rheumatologist Do On Your First Visit

The first visit will include a physical exam in which your rheumatologist will search for joint swelling or nodules that may indicate inflammation, says Dr. Smith. Lab tests, such as X-rays and blood work, may also supply pieces of the puzzle to assist your rheumatologist in arriving at your diagnosis.

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Early Onset Arthritis Age Range

In regards to rheumatoid arthritis, for example, the average arthritis age of diagnosis in adults is between 30 and 50.7 Therefore, the early onset arthritis age is anything less than 30 because people of any age can actually develop this form of arthritis.

It is a common misconception that one is too young to have arthritis. But in fact, about half of arthritis patients are under the age of 65. While osteoarthritis is more closely associated with elderly adults and most people over 60 have at least some degree of osteoarthritis,8 the early onset arthritis age for this this condition is between 20 and 40.9

Causes And Risk Factors Of Rheumatoid Arthritis

5 Warning Signs of Rheumatoid Arthritis

RA develops when white blood cells, which normally protect the body from foreign invaders such as bacteria and viruses, enter the synovium . Inflammation ensues the synovium thickens, causing swelling, redness, warmth, and pain in the synovial joint.

Researchers don’t know exactly what causes the immune system to invade the synovium, but it’s believed that genes and environmental factors play a role in the development of RA.

Rheumatology

But not everyone with these identified gene variants develops RA, and people without them can still develop it. So, it’s likely that environmental factors often trigger the disease, particularly in people with a genetic makeup that makes them more susceptible to it. These factors include:

  • Viruses and bacteria
  • Female hormones
  • Obesity, which also increases progression of disability for people with RA.Obese patients are less likely to achieve RA remission regardless of the treatment they receive.
  • Severely stressful events

Children up to age 16 who experience prolonged swollen or painful joints anywhere in the body are typically diagnosed with juvenile idiopathic arthritis .

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What Medications Treat Rheumatoid Arthritis

Early treatment with certain drugs can improve your long-term outcome. Combinations of drugs may be more effective than, and appear to be as safe as, single-drug therapy.

There are many medications to decrease joint pain, swelling and inflammation, and to prevent or slow down the disease. Medications that treat rheumatoid arthritis include:

Non-steroidal anti-inflammatory drugs

Biologics tend to work rapidly within two to six weeks. Your provider may prescribe them alone or in combination with a DMARD like methotrexate.

What Conditions May Be Confused With Ra

Fibromyalgia

People with this condition often feel pain all over, in all their muscles and joints, and have multiple tender points when examined. They will also often have a degree of early morning stiffness. Poor unrestorative sleep is often present, with associated fatigue and low mood, and often there are associated symptoms of headaches and irritable bowels and bladder. Investigations tend to be normal. It is important to distinguish this condition from rheumatoid arthritis as their management is very different, although sometimes both conditions are present.

Polymyalgia Rheumatica

This condition causes pain and stiffness of the shoulders and thighs and tends to occur in people over 65 years of age. It is more common in females. Sometimes elderly people with RA present with similar symptoms. PMR is treated by a course of steroid tablets where the dosage is gradually reduced over months and can generally be stopped after about 18 months 2 years. In people with RA presenting with PMR type symptoms, the correct diagnosis of RA usually becomes apparent when the patient is unable to reduce the steroid dosage below 10mg.

Post-viral arthritis

Osteoarthritis

Crystal Arthritis

Other types of inflammatory arthritis

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Whats The Age Of Onset For Rheumatoid Arthritis

RA usually starts to develop between the ages of 30 and 60. But anyone can develop rheumatoid arthritis. In children and young adults usually between the ages of 16 and 40 its called young-onset rheumatoid arthritis . In people who develop symptoms after they turn 60, its called later-onset rheumatoid arthritis .

The Diagnostic Criteria For Rheumatoid Arthritis

Comparing Osteoarthritis and Rheumatoid Arthritis #Osteoarthritis ...

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 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.

How Is Arthritis Treated

The main goal of treatment is to reduce the amount of pain youre experiencing and prevent additional damage to the joints. Youll learn what works best for you in terms of controlling pain. Some people find heating pads and ice packs to be soothing. Others use mobility assistance devices, like canes or walkers, to help take pressure off sore joints.

Improving your joint function is also important. Your doctor may prescribe you a combination of treatment methods to achieve the best results.

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Physical Exam And Medical History

The appointment will likely begin with the physician taking a thorough medical history. This will include asking the patient several questions, such as:

  • What joints are affected?
  • How would you describe the pain?
  • Do you have morning stiffness?
  • Have you noticed increased fatigue or weight changes?
  • Have you experienced other symptoms besides joint pain?
  • When did symptoms begin?
  • How have symptoms changed over time?
  • What movements or activities make the patient feel better or worse?

The history will also include a review of the patients:

  • Other medical problems

See Lifestyle Factors and Fatigue Associated with Rheumatoid Arthritis

During the physical exam, a doctor will evaluate the patients general health and then examine the joints, looking for signs of joint inflammation. For example, a doctor may measure a joints range of motion, press the skin over a joint to see if it causes pain, and test joint strength.

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