Friday, April 26, 2024

How To Find Out If I Have Rheumatoid Arthritis

Lab And Blood Tests For Ra

Innovations in Rheumatoid Arthritis Treatment | Brigham and Women’s Hospital

Here are some of the things you can expect to happen at your appointment if the doctor thinks you have RA.

Personal and family medical history: Your doctor will ask about your past and your relativesâ. If someone in your family tree has RA, you may be more likely to have the disease.

Physical exam: The doctor will check your joints for swelling, tenderness, and range of motion. RA tends to strike several joints.

Antibody blood tests: Doctors look for certain proteins that show up in your blood when you have RA. These proteins mistakenly target healthy cells and kick off the inflammation process. So a high or positive test result means inflammation is in your body.

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Empower Yourself With Information

You might not have known much about RA before your diagnosis, but now you probably want to learn more. Your health care provider is a great resource for information, but you may also want to do your own research. Remember to be cautious of what you read online, especially if someone is offering a quick fix or selling a cure. You can always reach out to your health care provider or patient liaison if you have questions about something youve read.

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.

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When To See A Doctor

RA can become worse the longer its left untreated. Its important to visit your doctor if youve been living with some of these symptoms for more than a few weeks, especially if youve been noticing joint stiffness that takes a while to loosen up in the mornings.

Even if its not RA, persistent fatigue and a general sense of illness can be the precursor to many inflammation-related issues, so the sooner youre seen by a physician, the better.

Theres no single test that can reveal an RA diagnosis. Instead, youll most likely be diagnosed through blood tests, joint and organ examinations, and X-ray or ultrasound images.

If a positive rheumatoid arthritis diagnosis is found, youll probably be referred to a rheumatologist, a doctor whos had extra training around the treatment of diseases that affect the muscles, bones, joints, ligaments, and tendons.

What Are The Risk Factors For Ra

Rheumatoid Arthritis

Researchers have studied a number of genetic and environmental factors to determine if they change persons risk of developing RA.

Characteristics that increase risk

  • Age. RA can begin at any age, but the likelihood increases with age. The onset of RA is highest among adults in their sixties.
  • Sex. New cases of RA are typically two-to-three times higher in women than men.
  • Genetics/inherited traits. People born with specific genes are more likely to develop RA. These genes, called HLA class II genotypes, can also make your arthritis worse. The risk of RA may be highest when people with these genes are exposed to environmental factors like smoking or when a person is obese.
  • Smoking. Multiple studies show that cigarette smoking increases a persons risk of developing RA and can make the disease worse.
  • History of live births. Women who have never given birth may be at greater risk of developing RA.
  • Early Life Exposures. Some early life exposures may increase risk of developing RA in adulthood. For example, one study found that children whose mothers smoked had double the risk of developing RA as adults. Children of lower income parents are at increased risk of developing RA as adults.
  • Obesity. Being obese can increase the risk of developing RA. Studies examining the role of obesity also found that the more overweight a person was, the higher his or her risk of developing RA became.

Characteristics that can decrease risk

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What Are The Symptoms Of Rheumatoid Arthritis

The symptoms of rheumatoid arthritis include the following:

  • Stiffness, especially in the morning or after sitting for long periods
  • Fatigue

Rheumatoid arthritis affects each person differently. In most people, joint symptoms may develop gradually over several years. In other people, rheumatoid arthritis may proceed rapidly. A few people may have rheumatoid arthritis for a limited period of time and then go into remission .

Cartilage normally acts as a shock absorber between the joints. Uncontrolled inflammation causes the destruction and wearing down of the cartilage, which leads to joint deformities. Eventually, the bone itself erodes, potentially leading to fusion of the joint . This process is aided by specific cells and substances of the immune system, which are produced in the joints but also circulate and cause symptoms throughout the body.

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What Are The Symptoms

The main symptoms of rheumatoid arthritis are pain, stiffness, and swelling in the joints of the hands, wrists, elbows, feet, ankles, knees, or neck. The disease usually affects both sides of the body at the same time. In rare but severe cases, it may affect the eyes, lungs, heart, nerves, or blood vessels.

Sometimes the disease can cause bumps called nodules to form over the elbows, knuckles, spine, and lower leg bones.

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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.

What Should Be Done If Rheumatoid Arthritis Is Suspected

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Any person who is suspected of having RA should be referred to a specialist rheumatologist. Early referral is important so that disease modifying anti-rheumatic drugs may be prescribed as soon as possible so as to slow or halt the disease process. Delay in referral or receiving a definitive diagnosis and treatment can result in significant costs to the individual, particularly those who are employed. This is because joint damage occurs most rapidly in the early stages of the disease, and often the treatment drugs can take several months to work.

Many areas now offer Early Arthritis Clinics where a rapid assessment is performed by specialists/specialist nurses in order to limit any delays. An ultrasound of the affected joints may be performed during this assessment.

If your symptoms are particularly severe when you first see your GP, then they may refer you urgently but also ring to speak to one of the local rheumatologists to ask for assistance in how to best help you in the meantime. Sometimes people are started on treatments other than those mentioned above, e.g. steroid tablets or a steroid injection, prior to being seen, in order to improve their condition. This though can affect what the specialists see and find at the first appointment, which can potentially delay their making a diagnosis or there may be increased uncertainty of the diagnosis.

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Keep A List Of Questions

Keep a list of questions about RA handy whether theyre about symptoms, such as joint damage, or treatments, like medication side effects. You can use the list to create a dialogue with your health care provider. Jot down your questions as you think of them. Bring your list to your appointments, so you can remember your questions when speaking with your rheumatologist.

Youre Newly Diagnosed With Rheumatoid Arthritis: Now What

  • Feeling stressed is common after being diagnosed with rheumatoid arthritis , but you can find support by connecting with your health care team and talking to others with the condition.
  • Empowering yourself with information can help you better understand your diagnosis, so its a good idea to learn all you can about living with RA.
  • Resources for RA go beyond what youll find in your doctors office. You can also seek assistance from friends, family, health education classes, chaplaincy services, or nurse navigators.

Everyone responds differently to information about their health. After learning that you have rheumatoid arthritis, you might be stunned, scared, or even relieved to have answers that explain symptoms like painful joints and limited mobility. No matter what youre feeling, youre not alone. On myRAteam, there are thousands of others who have been in your shoes.

I was diagnosed at the end of last month and Im difficulty adjusting to my new normal, shared one myRAteam member.

I know it can be scary and difficult, responded another team member, but I will say find out as much as you can about this disease, ask questions, and above all, surround yourself with people who understand and care.

Are you living with RA?What helped you through your initial diagnosis period?Clickin the comments below.

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Stiffness In The Joints

In addition to pain, this disease causes stiffness in the affected joints. You may have difficulty getting out of bed or walking in the morning because of stiff and painful ankles, knees, or feet. This stiffness is usually worse in the mornings and can last for 45 minutes or more.

RA can also trigger swelling in the affected joints. Long-term inflammation can cause you to feel physically exhausted.

When Should I See A Specialist For Rheumatoid Arthritis

8 Early Signs Of Arthritis

In general, patients with RA will benefit from seeing a specialist as early as possible. Most often the specialists treating this disease are trained in rheumatology. Their knowledge of medications to treat this disease can help patients make informed decisions consistent with their values and goals. These specialists can also help provide a balanced perspective on the benefits of treating the disease well vs. any potential side effects.

Patients diagnosed with RA are encouraged to become the captain of their multidisciplinary team of health providers. These include the primary care physician, the rheumatologist, the physical therapist, social worker, education programs and other members of the health care system will bring about a coordinated treatment program that is both safe and effective. The primary care physician or internist commonly works in partnership with a rheumatologist. Referral to a specialist in rheumatology most commonly occurs in the following situations:

  • when the diagnosis is in question
  • at the start of therapy, in order to provide expert input into the optimal medication and physical therapy regimen
  • during the course of the illness to define response to or alteration in the treatment regimen
  • in the setting of possible medication side effects
  • progressive disease despite therapy
  • a single joint that is leading to significant functional limitation
  • the presence of fever, marked fatigue, or weight loss
  • prior to orthopedic surgery

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Ask A Laboratory Scientist

This form enables patients to ask specific questions about lab tests. Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, American Society for Clinical Laboratory Science. Please allow 2-3 business days for an email response from one of the volunteers on the Consumer Information Response Team.

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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When To Seek Medical Advice

You should see your GP if you think you have symptoms of rheumatoid arthritis, so your GP can try to identify the underlying cause.

Diagnosing rheumatoid arthritis quickly is important because early treatment can help stop the condition getting worse and reduce the risk of further problems such as joint damage.

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Problems With Old Assessments

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After diagnosis, the level and progression of RA need to be monitored and tracked. Prior to RASS, doctors combined results from a physical examination with factors reported by the patient, such as pain level, and inflammatory blood markers, to estimate RA severity.

Doctors also used the Health Assessment Questionnaire , in which patients rated their own level of pain. Of course, everyone has a different threshold for pain, which can make these assessment models inaccurate. These assessment methods were also complicated by a close relationship between pain and depression.

Depression can be a significant component of RA. But there are challenges with using it to measure disease severity, including:

  • some patients may be more depressed than others
  • some patients may feel particularly depressed at the time of examination
  • some patients may not acknowledge they are depressed

While depression can be an element of RA, measuring it is not helpful for disease activity assessment. The RASS is completed by your doctor and based on the visible signs of the disease. Its not based on your individual emotional assessment.

Its important to know what type of RA you have to get an accurate assessment of disease activity. There are three types of RA:

  • rheumatoid factor positive

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Assessing Your Physical Ability

If you have been diagnosed with rheumatoid arthritis, your specialist will do an assessment to see how well you’re coping with everyday tasks.

You may be asked to fill in a questionnaire on how well you can do things like dress, walk and eat, and how good your grip strength is.

This assessment may be repeated after your treatment, to see if you have made any improvements.

Further information

Diagnosis And Tests For Rheumatoid Arthritis

There is no definitive test for rheumatoid arthritis and other conditions can cause similar symptoms. Your GP will ask about your symptoms, check the movement of your joints and perform a physical examination.

If they think you have rheumatoid arthritis, theyll recommend a blood test and refer you to a rheumatologist .

A blood test will check for several different proteins that can indicate rheumatoid arthritis. Your blood test may measure:

  • Anti-cyclic citrullinated peptide antibodies that attack healthy tissue in your body
  • C-reactive protein levels a measure of inflammation
  • Erythrocyte sedimentation rate a measure of inflammation
  • Rheumatoid factors proteins produced by your immune system when it mistakenly attacks healthy tissue
  • Your full blood count this can:
    • Check if you have anaemia, which is common in people with rheumatoid arthritis
    • Help rule out other conditions
    • Indicate your general health

To identify the type of arthritis you have and monitor how the disease progresses over time, your rheumatologist may also take images of your joints, such as:

If you receive a diagnosis of rheumatoid arthritis, your rheumatologist may assess how you cope with everyday tasks.

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How Ra Affects Feet

Rheumatoid arthritis is an autoimmune condition. When you have RA, your immune system tries to destroy the lining of your joints, called synovium. It also attacks the fluid in your joints, called synovial fluid. It does this because it mistakes these parts of your body for disease-causing invaders.

RA causes damage and inflammation that makes your joints swell and feel warm. The small joints, like those in the feet, are the most common targets of these attacks.

Eventually, long-term inflammation thickens the synovium. This causes cartilage and bone to wear away. In the feet and toes, the joints may become deformed. This leads to poor range of motion and considerable pain. Walking, standing, and even wearing shoes can become difficult.

Proper treatment may help reduce the damage and inflammation to your foot joints. It may also prevent or delay deformities and other problems.

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