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:
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X-ray. X-rays may show joint changes and bone damage found in some types of arthritis. Other imaging tests may also be done.
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Ultrasound. Ultrasound uses sound waves to see the quality of synovial tissue, tendons, ligaments, and bones.
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Magnetic resonance imaging . MRI images are more detailed than X-rays. They may show damage to joints, including muscles, ligaments, and cartilage.
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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.
References
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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 Are The Different Types Of Arthritis
Arthritis is a broad term that describes more than 100 different joint conditions. The most common types of arthritis include:
- Osteoarthritis, or wear and tear arthritis, which develops when joint cartilage breaks down from repeated stress. Its the most common form of arthritis.
- Ankylosing spondylitis, or arthritis of the spine .
- Juvenile arthritis , a disorder where the immune system attacks the tissue around joints. JA typically affects children 16 or younger.
- Gout, a disease that causes hard crystals of uric acid to form in your joints.
- Psoriatic arthritis, joint inflammation that develops in people with psoriasis .
- Rheumatoid arthritis, a disease that causes the immune system to attack synovial membranes in your joints.
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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.
Who Should Get Testing
Patients who experience inflammation, pain, or loss of mobility in joints should discuss testing for rheumatoid arthritis with their doctor, especially if symptoms occur in multiple joints or in matching joints on both sides of the body, such as both wrists. Other symptoms of rheumatoid arthritis include:
- Stiffness in the morning for 30 minutes or longer
- Dry eyes and mouth
- Firm lumps beneath the skin
These symptoms are often due to something other than RA when they last less than six weeks. The longer a patient experiences symptoms, the more likely the symptoms are to be due to RA.
Diagnosing rheumatoid arthritis in its early stages can be challenging, as patients may experience few symptoms, but early diagnosis is important because early treatment may prevent joints from worsening or at least slow the process. When symptoms are present, they often differ from person to person and mimic the symptoms of other diseases. Testing is an important part of the process of determining whether symptoms are due to RA or another condition.
After receiving a diagnosis of RA, its important for patients to continue rheumatoid arthritis testing. Testing can assist doctors in assessing the severity of RA, as well as monitoring the efficacy of treatment, tracking disease progression, and detecting potentially serious side effects of treatment drugs.
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Blood Fluid And Tissue Tests For Arthritis
Checking blood, tissues and various body fluids help doctors diagnose and monitor arthritis.
Blood and other lab tests play a critical role in diagnosing and monitoring arthritis. When your doctor needs to confirm an arthritis diagnosis, monitor disease progress, check medication effectiveness or determine if medications are causing potentially dangerous but not evident side effects, lab tests are ordered.
Most tests require drawing and testing the blood, but some may involve testing urine, joint fluid or even small pieces of skin or muscle.
Diagnosing and Monitoring Disease Activity
If your doctor suspects you have inflammatory arthritis, these are the most common tests used to diagnose as well as monitor the disease:
Blood Tests
Other Lab Tests
- Skin biopsy A small piece of skin is removed by a doctor. Its usually done under local anesthetic. The sample is tested in a lab and the results help determine the presence of lupus, vasculitis and psoriatic arthritis.
- Muscle biopsy A doctor takes the tissue sample from a muscle with a biopsy needle. The sample is reviewed for signs of damage to muscle fibers to help confirm a diagnosis of polymyositis or vasculitis.
- Joint fluid tests A doctor removes a small amount of fluid from a joint to determine the presence of uric acid and diagnose gout.
Monitoring Medication Response and Side Effects
Checking for Comorbidities
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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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Ra And Your Eyes: What You Need To Know
Rheumatoid arthritis is known for joint pain, but it can also affect other parts of the body, including your eyes. Learn which rheumatoid arthritis symptoms and eye issues are most common, and how to manage them.
Most people think of rheumatoid arthritis as a joint disease, but like other autoimmune disorders, it can impact different areas of the body as well. One of the more common complications for people with rheumatoid arthritis is eye problems, which can lead to corneal damage and ultimately impact vision if left untreated.
Some common eye conditions, like the ones described below, may affect people with rheumatoid arthritis . But there are steps to take to safeguard eye health and avoid permanent damage.
Dry Eyes
RA can be associated with extra-articular manifestations, and dry eyes are one of the most common problems, says Ana-Maria Orbai, MD, instructor of medicine in the division of rheumatology at the Johns Hopkins University School of Medicine in Baltimore. A person with dry eyes might experience itching, a sand-like sensation in the eyes, and redness. They may also notice a lack of moisture or tears in the eyes, as well as blurred vision.
If you decide to go the over-the-counter route, avoid eye-drop products that have preservatives or vasoconstrictive agents, such as some from Visine and Clear Eyes, which often promise to relieve redness or take the red out, Orbai explains.
Talk With Others Who Understand
On myRAteam, the social network for people with rheumatoid arthritis and their loved ones, more than 147,000 members come together to ask questions, give advice, and share their stories with others who understand life with rheumatoid arthritis.
Are you living with rheumatoid arthritis and considering biologic treatment? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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Can Psoriatic Arthritis Attack Other Organs Of The Body
Apart from the skin, nails and joints, increased cardiovascular morbidity is considered part of psoriatic disease, as is the association with inflammatory bowel disease. An itchy, red eye due to conjunctivitis is more common in people with psoriatic arthritis and some people occasionally develop a painful, red eye caused by inflammation around the pupil of the eye, which is called iritis or uveitis. Anaemia may also be found but this is the result of long-term inflammation and is not a specific feature of psoriatic arthritis.
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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
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Are People With Rheumatoid Arthritis At Greater Risk For Covid
Yes, but this is an ongoing area of research. Its believed that autoimmune and inflammatory rheumatic disease patients are at higher risk for being hospitalized due to COVID-19 and having worse outcomes compared to the general population, according to the ACR.
However, this is likely affected by factors such as age, other comorbidities such as heart or lung disease, which is common in RA, and taking steroid medications, rather than simply having RA alone.
The medical community does consider patients living with rheumatoid arthritis to be at a greater risk for COVID-19, based on their inflammatory response from their condition, says Dr. Cadet. The medications used to treat the disease can also suppress the immune system.
In other words, when your body is preoccupied by fighting its own cells, it doesnt attack invaders as well as it should. Medications that affect immune system function can also affect the bodys ability to fight off viruses like the coronavirus.
For more information, check out this summary of research on inflammatory arthritis and rheumatic disease patients and their risk for COVID-19 complications.
Liver Enzyme Tests Sgot Sgpt Bilirubin Alkalin
These tests measure the amount of liver damage. Certain medications used in the treatment of arthritis can damage the liver. Aspirin, for example, has been known in rare instances to damage the liver especially in children or in people who have had previous liver damage. Other NSAIDs can cause liver inflammation . Methotrexate can cause liver damage especially in people who drink alcohol.
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What Causes Arthritis
The cause of many types of arthritis is unknown. Researchers are looking into the role of genetics and lifestyle in the development of arthritis.
There are several things that may raise your risk for arthritis, including:
Age. Over time, your joints tend to get worn down. That’s why the risk of developing arthritis, especially osteoarthritis, goes up with age.
Sex. Most types of arthritis are more common among women, except for gout.
Genes. Certain types of arthritis run in families. Conditions like rheumatoid arthritis, lupus, and ankylosing spondylitis, for example, are linked to certain genes.
Excess weight. Being overweight puts extra stress on weight-bearing joints, increasing wear and tear and the risk of arthritis, especially osteoarthritis.
Injuries. They can cause joint damage that can bring on some types of the condition.
Infection. Bacteria, viruses, or fungi can infect joints and trigger inflammation.
Work. Some jobs that use repetitive movements or heavy lifting can stress the joints or cause an injury, which can lead to arthritis, particularly osteoarthritis. For example, if you need to do a lot of knee bends and squats at work, you might be more likely to get osteoarthritis.
How To Get Tested
Rheumatoid factor testing is ordered by a doctor. A patients doctor may suggest a rheumatoid factor test alone, but usually this test is used along with other tests to evaluate a patient for an autoimmune disorder. RF testing requires a blood sample that is normally drawn in a doctors office, hospital, or laboratory.
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Getting Tested For Arthritis
Arthritis testing is ordered by a doctor or specialist if indicated by a patients signs or symptoms. For testing that requires a sample of a patients blood, the sample can be drawn in a doctors office or other medical setting.
A sample of synovial fluid is obtained through a procedure called a joint aspiration or arthrocentesis. During a joint aspiration, a doctor applies local anesthesia to the affected joint before using a needle to withdraw a sample of synovial fluid for analysis. An ultrasound may be performed during a joint aspiration to help the doctor obtain the sample.
Urine samples and oral swabs may be collected by a doctor or by the patient using a doctors instructions. In some cases, a 24-hour urine sample may be required, which involves the collection of all a patients urine over a 24-hour period.