Ra Blood Tests: What Lab Tests Show Rheumatoid Arthritis
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.
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 If Your Bloodwork Is Normal
Often patients with PsA will have normal CRP and ESR levels. Similarly, while anti-CCP is typically an RA indicator, anti-CCP can be both negative or positive in PsA.
While bloodwork is certainly part of the diagnostic process, patient history and a physical examination are the most important factors to correctly diagnose PsA.4,9
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Why You Need A Blood Test For Rheumatoid Arthritis
ByAlan King Jr | Submitted On June 24, 2009
There is a wealth of information available out there about rheumatoid arthritis and you can start you search online or go through medical books. You can find all sorts of helpful information about how this ailment is treated and even find alternative treatments. You can even go as far as diagnosing yourself to check if you are showing the symptoms of RA. But its always safe to check for accuracy and validity which is why getting a blood test for rheumatoid arthritis is necessary.
Getting Tested
There are different kinds of blood tests for RA and the results can give you information that can be very useful for diagnostic evaluation and especially recommendations on how it can be treated. What the blood test does is that it finds the disease in your system and affirms if you do in fact have rheumatoid arthritis. Through these blood tests you can get an accurate diagnosis because having these tests are crucial indicators to find out about a patients condition.
Blood Test Types
The are four different types of blood tests performed for those who want to know the source of their symptoms of rheumatoid arthritis. Here are some helpful descriptions of each of them.
C-Reactive Protein is the second type of blood test to check for rheumatoid arthritis. This test is almost similar to ESR in that it can be a helpful diagnostic tool and detects irritation in your body.
The Importance of Blood Testing
What Do Rheumatoid Factor Test Results Mean
Testing positive for rheumatoid does not necessarily mean the patient has rheumatoid arthritis. A positive for rheumatoid factor test results means that it can lead to or is the cause of inflammatory symptoms from an autoimmune disorder.
In certain cases, however, patients may test positive for rheumatoid factor, yet remain healthy and never experience any obvious symptoms.
Rheumatoid factor can be present in patients several months or even years before clinical rheumatoid arthritis symptoms develop. Depending on the level of symptoms a patient exhibits, the rheumatoid factor test results can assist doctors in reaching a rheumatoid arthritis diagnosis.
Positive rheumatoid factor results in someone who has been clinically diagnosed with rheumatoid arthritis may also indicate the potential for a more aggressive disease course. This is possible in both children and adult patients.
Patients who test negative for rheumatoid factor but still exhibit symptoms and meet other diagnostic criteria may still be diagnosed with rheumatoid arthritis.
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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.
The Erythrocyte Sedimentation Rate
The ESR measures the degree of inflammation in the joints. Blood is taken and placed in a small, thin tube, and the distance the red cells settle in one hour is measured. The more rapidly the red cells settle the more inflammation in the joints. One of the aims of treatment is to reduce the ESR to normal levels.
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Understanding Routine Lab Tests For Ra
Find out what tests youll need as you manage your disease.
Sometimes it can feel like youve been poked, prod¬ded and have had enough blood drawn to feed a million mosquitoes. Now that you have a rheumatoid arthritis diagnosis, you may have hoped you could give the phlebotomist a Starbucks gift card and say goodbye.
Then, you find out that having a diagnosis in hand wont put an end to bloodwork. Your rheumatologist uses regular tests to monitor disease activity, check for medication effects and screen for common comorbidities.
Maria Danila, MD, associate professor of medicine at the University of Alabama at Birmingham, says that once she has diagnosed a patient, she runs a series of tests to get baseline values before she starts any treatments. As part of a treat-to-target treatment protocol, she sees her patients frequently and makes therapy adjustments until a goal is reached usually remission or low disease activity. Assessing disease activity and taking regular lab tests are part of that process.
Other lab tests help to determine if any medicines are damaging your organs. How frequently youll have these tests depends on the medicines you take.
Heres a run-down of the most common lab tests your doctor may order and what they look for.
Sed Rate and CRP
Neither ESR nor CRP is specific to RA, but both are used to help determine disease activity. Dr. Danila says the two measures dont always correlate with one another or with how you may be feeling.
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How Accurate Is The Rheumatoid Factor Test
Rheumatoid arthritis cannot be diagnosed with a blood test alone. The RF test is helpful in making the diagnosis of RA, but it isnt foolproof. Notably, this test produces both falsepositive and false-negative results.
Rheumatoid arthritis cannot be diagnosed with a blood test alone. The rheumatoid factor test is helpful in making the diagnosis of RA, but it isnt foolproof.
With a false-positive result, a positive RF test doesnt necessarily mean that you have RA. Many reasons other than the presence of RA can cause a person to test positive for RF. For example, the following autoimmune diseases are associated with elevated RF levels:
- Sj?grens syndrome
A variety of infections may also be associated with a positive RF test:
- Bacterial endocarditis
Crooked or bent refers to stiffening of the joint.
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Next Steps After A Positive Result
Positive results do not necessarily mean a person has PsA, but negative results do not necessarily mean a person does not have the condition either.
A doctor will likely use the tests to help rule out other conditions, like RA, that can present similarly to PsA.
Some other symptoms a doctor may look for to help confirm a diagnosis include:
- swollen fingers and toes
- changes in nails, such as pitting or separation from the nail bed
- pain, stiffness, swelling, throbbing, and tenderness in one or more joints
- reduced range of motion
- redness and pain eyes
When describing their symptoms, a person should try to be as specific as possible. This can include describing the level and extent of pain in a joint and describing any other symptoms that may be occurring.
People should also let the doctor know if they have a rash or already have a diagnosis of psoriasis. This is because approximately 85% of cases of PsA occur after skin involvement.
To help diagnose PsA, a doctor may order the following blood tests:
Rheumatoid Arthritis: Blood Tests For Diagnosis
Rheumatoid arthritis is an autoimmune condition that mostly affects the joints. Obtaining an RA diagnosis can feel like putting together a puzzle because this disease has symptoms that are similar to other disorders. In addition to checking your medical history and doing a physical exam, your healthcare provider may order multiple tests before diagnosing RA.
There is not a test for RA that can definitively diagnose this condition, so you may have several imaging and blood tests. The blood tests can show if your body has inflammation and is making specific proteins that are common when you have RA.
The blood tests may include:
- Rheumatoid factor
Verywell / Joshua Seong
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What Happens If Ra Is Left Untreated
RA is a systemic inflammatory disease, which can affect various organs throughout the body. That is why timely and effective treatment is crucial for better long-term outcomes. If an RA diagnosis is missed or if RA is left untreated, chronic inflammation can lead to long-term disability and organ damage.
Can The Test Be Done In Children
Juvenile Rheumatoid Arthritis or JRA often referred to as Juvenile Idiopathic Arthritis or JIA is an autoimmune disorder that is quite common in children below 17 years of age. It can trigger many symptoms like joint pain and inflammation, stiffness, and even can affect the childs overall growth.If your child is JRA positive, your doctor may ask you to do several tests including the rheumatoid factor test, which is the most common tool to diagnose rheumatoid arthritis.
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Other Tests For Psoriatic Arthritis
You will likely also be required to take the following tests for your diagnostic examination to be considered complete:
- Bone density scans can check for joint damage or bone loss and look for other conditions like osteoporosis , osteopenia , and demineralized bones .
- Imaging tests like X-rays and MRIs are used to examine bones and joints in detail to see the level of damage or inflammation.
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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Who May Need A Rheumatoid Arthritis Test
Rheumatoid Arthritis tests are designed to help physicians diagnose the condition known as rheumatoid arthritis in patients. At times, it may be difficult to diagnose the condition because early signs often mimic symptoms of other diseases. Physicians will often perform a physical exam first, looking for swelling, redness and warmth in a patient’s joints, as well as checking a patient’s reflexes and muscle strength. If your doctor suspects you may have rheumatoid arthritis, this test may be prescribed in order to determine whether or not you have the condition, or if you are already undergoing treatment for RA, as a way to track the progress of treatments.
How To Test For Rheumatoid Factor
Testing for rheumatoid factor is done through a blood test. The blood is drawn then analyzed for the presence of this particular protein. If the results show a certain level of rheumatoid factor, then the test is said to be positive. Rheumatoid factor tests can also detect lower levels of rheumatoid factor, but the test result is not considered positive unless it crosses that threshold.
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Lab And Blood Tests For Ra
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.
- Rheumatoid factor : high levels
- Anti-CCP : high levels
- ANA, or antinuclear antibodies: the results are positive or negative
Not all people with RA have these proteins.
Other blood tests: Besides RF and anti-CCP, other blood tests could include:
Complete blood count: It helps your doctor find anemia , which is common in RA. It looks for four things:
- White blood cells 4.8-10.8
- Hematocrit 42-52
- Platelets 150-450
Erythrocyte sedimentation rate: This measures how fast your red blood cells clump and fall to the bottom of a glass tube within an hour. Your doctor might call it a sed rate.
Normal ranges are:
- Men younger than 50: 0-15 mm/h
- Men older than 50: 0-20 mm/h
- Women younger than 50: 0-20 mm/h
- Women older than 50: 0-30 mm/h
Tests For General Inflammation In Ra
Autoantibody tests including RF and anti-CCP are the mainstay of diagnosis in RA. However, other tests that measure general inflammation in the body are also used in the following ways in RA:
- Help in diagnosis
- Monitoring response to therapy
There are two tests that are most commonly used to diagnose RA: the erythrocyte sedimentation rate and the C-reactive protein .
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What Else Could It Be
When a doctor thinks about how likely you are to have one disease over another, or over several others, this is called a differential diagnosis. There are many conditions your doctor may consider besides RA, and besides other forms of autoimmune arthritis:
Viral arthritis: Rubella, parvovirus, and hepatitis B and C can lead to short-term arthritis symptoms that resemble RA.
Palindromic rheumatism: Periodic joint inflammation that may lead to RA, lupus, and similar diseases
Polymyalgia rheumatica: This is more common over age 50, generally less painful than RA, and associated more with shoulders and hips.
Seronegative Rheumatoid Arthritis Prognosis
Determining a prognosis or outcome for any rheumatoid arthritis patient is difficult. Seronegative patients are no different. The disease itself may start out with mild symptoms and involve into more severe symptoms that make treatment more difficult.
Seronegative patients are often regarded as having a milder set of symptoms compared to seropositive patients. Generally, seronegative patients dont develop rheumatoid nodules, which are commonly displayed in seropositive patients. This is never a certainty, however, and each patients individual symptoms and disease progression will differ.
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Arthritis Comprehensive Blood Test Panel Women
The Arthritis Comprehensive Blood Test Panel for Women includes a C-Reactive Protein , Rheumatoid Arthritis Factor, Antinuclear Antibody, Sedimentation Rate, Uric Acid plus Wellness #2 Essential Panel that includes Complete Blood Count , Comprehensive Metabolic Panel , Lipid Panel with Total Cholesterol: HDL Ratio, Thyroid Panel plus TSH plus Cyclic Citrullinated Peptide Antibodies, Creatine Kinase , Aldolase and Complement C3.
Also Known As:
Methodology: See Individual Tests
Preparation: Patient should be on a stable diet, ideally for two to three weeks prior to collection of blood, and should fast for 14 to 16 hours before collection of the specimen. Stop biotin consumption at least 72 hours prior to the collection. Avoid exercise prior to collection.
Test Results: 3-4 days. May take longer based on weather, holiday or lab delays.
Also Known As:
Methodology: See Individual Tests
Preparation: Patient should be on a stable diet, ideally for two to three weeks prior to collection of blood, and should fast for 14 to 16 hours before collection of the specimen. Stop biotin consumption at least 72 hours prior to the collection. Avoid exercise prior to collection.
Test Results: 3-4 days. May take longer based on weather, holiday or lab delays.
Difference Between Lupus And Rheumatoid Arthritis
These two diseases are almost similar in nature. But a closer look displays some distinct differences. Lupus attacks joints and any other part of the body, including the internal organs. It can manifest with skin rashes, fever, and pain. Rheumatoid arthritis primarily attacks the joints. Unlike lupus, it attacks corresponding joints in the body. While rheumatoid arthritis deforms the joints, lupus does not.
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Diagnosing Rheumatoid Arthritis With Blood Tests
Rheumatoid arthritis blood tests are only one way to help doctors reach a diagnosis. If a patient is positive for any of these tests, they must also exhibit specific symptoms of rheumatoid arthritis. Doctors look at multiple other criteria besides blood test results when determining their diagnosis.
In some cases, patients can still be diagnosed with rheumatoid arthritis even if they dont test positive for the various types of antibodies found in rheumatoid arthritis blood tests.
Read more about diagnosing rheumatoid arthritis and the different types of rheumatoid arthritis here.