Question 5 Of : Prognosis
Early Detection And Diagnosis
As with most diseases, early detection and diagnosis are crucial for being able to treat symptoms, manage pain, and slow progression. An early diagnosis of RA can help you and your team of physicians and specialists put together an individualized treatment plan so that you can continue living a high quality of life.
Early on, you will want to discuss your case with a rheumatologist or RA specialist who can provide you with the treatment you need to delay the diseases progression. Generally, early diagnosis treatment is aggressive and targeted to properly manage the disease and prevent it from progressing.
If your RA was diagnosed in the early stage when symptoms first appeared, your chances of achieving longer periods of remission typically increase drastically. Thats not to say you wont experience flare-ups. Early diagnosis simply helps manage the disease and cannot guarantee the complete elimination of symptoms.
Why Diagnosing Ra Is Difficult For Rheumatologists
There are many other stories of RA misdiagnoses, including delays in reaching the correct diagnosis for patient Jeff Krakow and the Canadian snowboarder Spencer OBrien. Why is it so hard for doctors to get it right?
Scott J. Zashin, MD, a rheumatologist based in Dallas, explains how RA can seem difficult to diagnose. When patients present with signs and symptoms of an inflammatory arthritis and have a positive rheumatoid factor or anti-CCP antibody, the diagnosis is very clear. The more difficult diagnosis occurs when the patient may not have clear-cut swelling or RA markers are negative,” he says.
A new diagnostic antibody test, the 14-3-3 ETA, reported on in June 2017 in the Annals of the Rheumatic Diseases, may help in some cases, but it is still being researched and is not commercially available everywhere. “Because it is a more expensive test,” says Zashin, “I reserve it for patients in whom the diagnosis is not confirmed. And, he adds, In some patients, the joint symptoms are felt to be due to a viral cause. But when the symptoms persist after three or four months, a more chronic type of arthritis like RA must be considered.
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Question 2 Of : Causes
What Are The Mortality Rates Among Canadians With Or Without Rheumatoid Arthritis
Between 20072008 and 20162017, age-standardized all-cause mortality rates decreased among females with diagnosed rheumatoid arthritis and among males with diagnosed rheumatoid arthritis . Mortality rates were consistently higher among males compared to females.
Over the surveillance period, the age-standardized all-cause mortality rate ratios were relatively stable ranging from 1.7 to 1.6 in females and from 1.5 to 1.7 in males. While rate ratios were similar among females and males, they showed an increase in mortality risk among those with diagnosed rheumatoid arthritis.
Figure 4: Age-standardizedFootnote e all-cause mortality rates and rate ratios among Canadians aged 16 years and older with and without diagnosed rheumatoid arthritis , Canada,Footnote f from 20072008 to 20162017
- Footnote e
| 1.7 |
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How Is Seronegative Rheumatoid Arthritis Diagnosed
Some patients still have RA but do not test positive for either anti-CCPs or RF they have seronegative RA.
Annals of the Rheumatic Diseases
Your doctor may also conduct a synovial biopsy, which involves removing a small piece of the tissue lining one of your joints.
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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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How Were You Diagnosed With Rheumatoid Arthritis
Often it takes persistence to get an RA diagnosis so you can start working on getting effective treatment.
Michelle Ottey of Philadelphia, PA, shares her path to diagnosis.
When something’s wrong with your body, you just want a name because there’s power in that, because then there’s something you can do.
The first symptom I ever had was in my right index finger. I was sitting in a coffee shop drinking a hot apple cider, which I have not had since that day, and my finger just swelled up. Within a week, both of my hands were swelled up, inflexible.
I went to my primary and said, I think I need to go to a rheumatologist. I think that this might be RA. I’m having these symptoms. It seems to match that. Because I was in my late 20s, they kind of dissuaded me to do that and said, well, I don’t know if that’s really the deal, but I pushed and got to a rheumatologist and it took a couple of months to really get a diagnosis because I was exhibiting symptoms from a myriad of autoimmune diseases. I had factors for lupus. I had symptoms for Behcet’s. I was having all these different symptoms. and I didn’t fit a profile for RA.
When I finally got the diagnosis at the first rheumatology practice I was at, even having the name, at first it was a relief, but then that sort of went away because none of the treatments that I was trying were helping. So, it was a lot of fear and just uncertainty.
Highlights From The Canadian Chronic Disease Surveillance System
Rheumatoid arthritis is the most common chronic inflammatory joint disease and is a leading cause of disability worldwide.Footnote 1 People with rheumatoid arthritis are at a higher risk of mortality than the general population due to the associated comorbidities that present with this disease.Footnote 2Footnote 3 There is no cure for rheumatoid arthritis, however, early diagnosis and treatment can reduce associated joint pain and symptoms, helping individuals to live active lives.
The Public Health Agency of Canada , in collaboration with all Canadian provinces and territories, conducts national surveillance of rheumatoid arthritis to support public health action. This fact sheet presents an overview of diagnosed rheumatoid arthritis data from the Canadian Chronic Disease Surveillance System . For further information, refer to What’s in the Data?
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Getting A Diagnosis Before Getting Tested
I myself was initially misdiagnosed. I was a teenager when my first symptom of RA developed.
Following a tennis match, my knee became very swollen and painful. My family doctor in Cleveland, Ohio, drained the knee and gave me a cortisone shot. But it recurred four times over eight weeks. My doctor repeated his treatment routine, diagnosed it as a sports injury and told me to take aspirin. He never sent the knee joint fluid to be examined. He discarded it. Over time and not too long a time my symptoms spread to my hip. My family doctor referred me to an orthopedic doctor who also thought it was a sports injury. I requested a referral to a rheumatologist about one or two years after my initial symptoms, and after further testing, I was diagnosed with RA at age 19.
Measures To Reduce Bone Loss
Inflammatory conditions such as rheumatoid arthritis can cause bone loss, which can lead to osteoporosis. The use of prednisone further increases the risk of bone loss, especially in postmenopausal women.
You can do the following to help minimize the bone loss associated with steroid therapy:
- Use the lowest possible dose of glucocorticoids for the shortest possible time, when possible, to minimize bone loss.
- Get an adequate amount of calcium and vitamin D, either in the diet or by taking supplements.
- Use medications that can reduce bone loss, including that which is caused by glucocorticoids.
- Control rheumatoid arthritis itself with appropriate medications prescribed by your doctor.
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Theyll Praise Your Proactivity
When RA is caught and controlled early enough, you may never experience complications like joint damage or changes. Thats why its so important to see your doctor at the first signs of RAjoint pain, warmth and swelling around the wrists and knuckles, and morning stiffness that lasts for more than 15 minutes, Dr. Cohen says. You did the right thing by taking action.
The Role Of Rheumatoid Arthritis Testing
Rheumatoid arthritis testing is used to diagnose RA, evaluate the severity of a patients disease, monitor treatment, and detect potential side effects of treatment drugs:
- Diagnosis: Diagnostic testing helps determine the cause of a patients symptoms. If a doctor is concerned that a patients symptoms may be related to rheumatoid arthritis, testing can assist in diagnosing RA and ruling out other health conditions.
- Evaluating severity: The results of several laboratory tests can inform doctors about the severity of a patients RA, the amount of joint damage, and the prognosis or expected course of the disease.
- Treatment monitoring: Monitoring patients diagnosed with RA involves regular medical care, including doctors visits, laboratory testing, and imaging tests. Combining these strategies can assist doctors in tracking the progression of RA and understanding if treatment is effective.
- Detecting side effects: Testing may also be used to detect side effects caused by treatment drugs, as well as other health conditions that are more common in patients with rheumatoid arthritis, including osteoporosis, heart disease, and diabetes.
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Welcome To The Newly Diagnosed With Rheumatoid Arthritis Page
The very first thing that I want you to read is, Bless your heart. Im sorry. Being newly diagnosed with Rheumatoid Arthritis is challenging. Whether you are in tremendous pain, wondering whether you will get better or youre shocked at the news and afraid of what may be to come being newly diagnosed with RA is hard.
Two things will be key to you in fighting RA. The first is information. Rheumatoid Arthritis is a complicated disease, and there is so much to learn that you may wonder what to read first. It is made harder because the magazines, books in the library, and even many websites may have conflicting or out of date information. There are also many myths about RA that are passed around. One way to verify information is to check recent research on reliable sites at hospitals such as Mayo Clinic or Hospital for Special Surgery, or scientific journals like Arthritis Research and Therapy or the National Library of Medicines MedlinePlus. The best thing that you can do is continue to ask questions.
The second thing that will help is company. When someone offers you a juice cure and tells you that he has a little touch of RA in his knee, it helps to have someone who knows how you feel. When you cannot convince a family member that your chemo treatments are really necessary, nothing helps like having a friend with RA. I have also learned the hard way that it may take another person with RA to really know how severely Rheumatoid Arthritis pain can hurt.
What Is It Like To Live With Rheumatoid Arthritis
Remissions and flares of Rheumatoid Arthritis
One thing newly diagnosed RA patients often ask me is Will it ever get better? The other thing newly diagnosed patients ask me is Will it get worse? The answer to both questions is Probably.
Rheumatoid Arthritis is a disease that usually progresses. That means that it continues to advance. However, most RA patients experience periods when the disease is less active. Frequently, this is described as a pattern of flares and remissions.
It is impossible to predict when or to what degree RA will progress or remit. Some patients experience a mild course of the disease or even a remission that lasts for a period of years. Other patients live with uncontrolled flare that does not ever abate. Most patients experience varying degrees of flare and remission, with a gradual progression toward greater damage and disability. No two patients seem to have exactly the same disease course.
Read more about this topic:
Rheumatoid Arthritis symptoms
- fatigue or weakness that is similar to the flu
- joint pain in any joint
- muscle weakness
Disability or deformity
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When To Seek Treatment
The following are general guidelines of when to seek treatment for your RA progression:
When you first suspect symptoms Regularly during the first few years of diagnosis If you suspect you are experiencing progressive rheumatoid arthritis If you feel your condition is worsening in any way or new symptoms appear
Ask A Laboratory Scientist
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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 Signs And Symptoms Of Ra
With RA, there are times when symptoms get worse, known as flares, and times when symptoms get better, known as remission.
Signs and symptoms of RA include:
- Pain or aching in more than one joint
- Stiffness in more than one joint
- Tenderness and swelling in more than one joint
- The same symptoms on both sides of the body
- Weight loss
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