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.
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.
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This article was co-authored by Siddharth Tambar, MD. Dr. Siddharth Tambar, MD is a board certified rheumatologist at Chicago Arthritis and Regenerative Medicine in Chicago, Illinois. With over 19 years of experience, Dr. Tambar specializes in Regenerative Medicine and Rheumatology, with a focus on Platelet rich plasma and Bone marrow derived stem cell treatments for arthritis, tendinitis, injuries, and back pain. Dr. Tambar holds a BA in Economics from State University of New York at Buffalo. He earned his MD from State University of New York at Syracuse. He completed his Internship, Residency in Internal Medicine, and his Rheumatology Fellowship at Northwestern Memorial Hospital. Dr Tambar is board certified in both rheumatology and internal medicine. He also holds Musculoskeletal Ultrasound Diagnostic and Interventional certifications from the American College of Rheumatology and the American Institute of Ultrasound in Medicine.There are 9 references cited in this article, which can be found at the bottom of the page. This article has been viewed 22,865 times.
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They Ask About Other Symptoms
Although symmetrical joint pain and swelling are the hallmarks of rheumatoid arthritis, its a full-body disease that can cause full-body symptoms. Sometimes, people experience loss of appetite, exhaustion, low-grade fever, and even nerve damage, says Dr. Cohen. Neuropathymuscle weakness, numbness, or a pins-and-needles sensationmay be another clue RA is the culprit. Osteoarthritis, on the other hand, is much more of a localized condition.
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:
Polymyalgia rheumatica: This is more common over age 50, generally less painful than RA, and associated more with shoulders and hips.
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What Does An Orthopedist Do
Orthopedists handle the disorders, injuries, prevention, treatment, and repair of the skeletal system and its related joints, ligaments, and muscles.
Orthopedists and orthopedic surgeons are specially trained in the diagnosis and treatment of bone and joint disease. They use an array of testing modalities to aid in diagnosis and treatment.
Dont Allow Your Symptoms To Be Ignored
I wasnt misdiagnosed so much as just ignored, says Elizabeth P., 35, of Miami, Florida. Id fought chronic pain for years but doctors usually blamed it on my polycystic ovary syndrome and being overweight. This led me to avoid doctors until I literally couldnt use my hands.
But after years of putting up with this lack of treatment, she reached her breaking point. Elizabeth searched until she found a doctor who would really listen to her and not just tell her to go on a diet. After blood work came back positive for arthritis markers, she was referred to a rheumatologist and diagnosed with rheumatoid arthritis. Its so important to find someone who will listen. Dont be afraid to be honest and speak up, she says. Get a second or third opinion if you feel like youre being ignored.
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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.
Dont Let Docs Write You Off Because Of Your Age
Too many people hear arthritis and automatically think 80-year-old and that includes some doctors, unfortunately. It took me 10 years because of my age and lack of inflammatory markers, says Joy G., now 30, of Ireland. All my joints were swelling, I couldnt walk properly, my hips were twisted, and yet because my blood test was negative and I was so young, they kept telling me its couldnt be arthritis. When she learned that seronegative arthritis definitely does exist, she insisted on getting a referral to a rheumatologist. He diagnosed her with psoriatic arthritis on the second visit.
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Shed Your Misconceptions About Arthritis
There are many misconceptions about arthritis, Some of these can leave people feeling discouraged even before they’ve begun treatment, and worse yet, some myths can even leave people feeling blamed for their disease.
It is a misconceptionand probably the biggest misconceptionthat only old people develop arthritis. Anyone at any age can be affected by arthritis. Actually, it is a little-known fact that about 300,000 children have a juvenile type of arthritis.
Some of the other misconceptions include the claim that arthritis is curable, that arthritis is caused by a bad diet , that arthritis only causes mild aches and pains and that wearing a copper bracelet relieves arthritis. It is no wonder that people newly diagnosed with arthritis don’t know which way to turn.
The fact is that osteoarthritis and rheumatoid arthritis are just two of the many types of arthritis that exist, and these different forms require different treatments and are managed in different ways.
Start by learning basic facts about your type of arthritis. Find quality resources and always take questions that you may have to your doctor.
When To See Your Doctor About Arthritis Pain
Home treatment hasnât helped. Minor aches and pains usually get better with ice or heat therapy or over-the-counter pain relievers. But if your symptoms donât improve after about a week, it may be something more serious.
You have pain multiple joints.Rheumatoid arthritis, for example, can make several joints hurt. Quick treatment is important to prevent long-term damage.
Your joints hurt a lot. Your doctor should check out any severe pain so they can diagnose and treat it.
Pain doesnât go away after rest. This can be a sign that your condition may be serious. You may need therapy, such as medications or even surgery.
Your joints turn red or hot. It may be normal for you to feel a bit stiff first thing in the morning. But if your symptoms appear suddenly or are unusual, have them checked out.
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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:
X-ray. X-rays may show joint changes and bone damage found in some types of arthritis. Other imaging tests may also be done.
Ultrasound. Ultrasound uses sound waves to see the quality of synovial tissue, tendons, ligaments, and bones.
Magnetic resonance imaging . MRI images are more detailed than X-rays. They may show damage to joints, including muscles, ligaments, and cartilage.
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.
You Can Have Psoriasis And A Different Kind Of Arthritis That Is Not Psa
People with psoriasis can develop different types of arthritis including rheumatoid arthritis, gout, osteoarthritis, and reactive arthritis so diagnosing PsA involves ruling out those other conditions.
Its often difficult to say in a first visit whether a patient definitely has psoriatic arthritis or another type of arthritis that just co-exists with psoriasis, says Dr. Kumar. PsA can take a long time to diagnose because a patient can delay seeing the doctor, then confirming PsA can require multiple labs and imaging tests.
The good news is that the diagnosis process for psoriatic arthritis is improving. Whereas PsA wasnt even recognized as a distinct condition decades ago , doctors are now better equipped with improved lab tests and imaging studies that help identify this disease so more patients can find relief.
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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.
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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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.
Do Dermatologists And Rheumatologists Ever Work Together
- Combined rheumatology-dermatology clinics are a newer frontier in the treatment of psoriatic arthritis, with just over 20 clinics in the United States
- Depending on the clinic, some rheumatologists and dermatologists may see a patient at the same time in the same room. Sometimes, separate back-to-back visits are required
- Studies show this combined care approach could achieve better outcomes for both skin and musculoskeletal symptoms
- A survey from the Psoriasis and Psoriatic Arthritis Clinic Multicenter Advancement Network found over 80% of doctors thought a combined clinic accelerated an accurate diagnosis
- Challenges are largely related to scheduling and billing
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Learn Your Family History
Sure you know to ask about your family history of cancer and heart disease, but did you know you should also be asking about arthritis? Many types of inflammatory arthritis have a genetic component something Chris, 19, of Cardiff, Wales, found out the hard way. She was 10 years old when she first started having joint pain symptoms but her doctors didnt take her seriously. It was nine years before they finally ordered blood tests for arthritis and referred her to a rheumatologist. My uncle, grandmother, brother, and dad are all currently diagnosed with rheumatoid arthritis and seeing their experiences helped me recognize the symptoms in myself, she says. This knowledge was a big clue for her rheumatologist and also gave her the confidence to keep pushing for real answers even when doctors kept telling her nothing was wrong.
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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What Is Involved In Reviewing Your Medical History And Your Current Symptoms
When reviewing your medical history, your healthcare provider may ask the following questions:
Have you had any illnesses or injuries that may explain the pain?
Is there a family history of arthritis or other rheumatic diseases?
What medication are you currently taking?
Your healthcare provider may also ask:
What symptoms are you having? For example, pain, stiffness, difficulty with movement, or swelling.
About your pain:
What makes it worse?
How Osteoarthritis Is Diagnosed
The most common ways osteoarthritis is diagnosed include discussing your symptoms with your doctor and undergoing a joint examination. Your doctor may ask questions to see if you fit the profile of a typical osteoarthritis patient and to check for a range of symptoms associated with osteoarthritis, including:
- Joint pain
- The sound of bone rubbing on bone or a crunching feeling
- The formation of bony spurs
- The thinning of muscles
- Joint pain that worsens throughout the day
Your doctor may also ask about the duration, location and strength of your joint symptoms or if you are taking any other medications.
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Can An Internal Medicine Doctor Care For My Arthritis
If you are experiencing pain, stiffness, and swelling in your fingers, hands, wrists, hips, knees, or ankles, it may be arthritis. You should consult with a doctor for a diagnosis and treatment plan.
Unfortunately, there is currently no cure for arthritis. However, working closely with your doctor and following an appropriate treatment plan can help you control your symptoms and live a happy, active, and worthwhile life. The question is: which doctor should you see for arthritis?
If you have arthritis, you have a few choices when it comes to choosing a doctor for treatment. Orthopedic physicians can treat arthritis because they are specialists in the bodys musculoskeletal system. Another choice is to see an internal medicine doctor. Internal medicine doctors diagnose, treat, and prevent all types of diseases and conditions in adults, including arthritis.
The Hallmark Of Ankylosing Spondylitis
The hallmark of AS is involvement of the sacroiliac joints. Some physicians still rely on X-ray to show erosion typical of sacroiliitis, which is inflammation of the sacroiliac joints. Using conventional X-rays to detect this involvement can be problematic because it can take seven to 10 years of disease progression for the changes in the SI joints to be serious enough to show up on conventional X-rays.
Another option is to use MRI to check for SI involvement, but MRI can be cost prohibitive in some cases.
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