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.
Diagnosing Rheumatoid Arthritis With Anti
In order to reach a rheumatoid arthritis diagnosis when a patient tests positive for anti-CCPs, several other criteria must be met. Doctors will perform a physical examination to look for clear clinical symptoms of rheumatoid arthritis.
Other blood tests are also performed in conjunction with the anti-CCP test, including testing for rheumatoid factor antibodies and increased inflammation levels. Doctors will also use imaging scans to observe any signs of bone and cartilage deterioration around the affected joints.
The anti-CCP test is thought to be slightly more specific than RF for diagnosing rheumatoid arthritis. The reason for this is RF is present in patients without rheumatoid arthritis who have other autoimmune disorders.
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.
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Will Changing My Diet Help My Rheumatoid Arthritis
When combined with the treatments and medications your provider recommends, changes in diet may help reduce inflammation and other symptoms of RA. But it wont cure you. You can talk with your doctor about adding good fats and minimizing bad fats, salt and processed carbohydrates. No herbal or nutritional supplements, like collagen, can cure rheumatoid arthritis. These dietary changes are safer and most successful when monitored by your rheumatologist.
But there are lifestyle changes you can make that may help relieve your symptoms. Your rheumatologist may recommend weight loss to reduce stress on inflamed joints.
People with rheumatoid arthritis also have a higher risk of coronary artery disease. High blood cholesterol can respond to changes in diet. A nutritionist can recommend specific foods to eat or avoid to reach a desirable cholesterol level.
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.
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How Else Can Your Gp Surgery Help
Your GP surgery can be involved in your RA care in many different ways. They continue to look after you in general and may want to keep a close eye on your blood pressure, cholesterol and blood glucose levels as there is a higher risk of heart disease in people affected by rheumatoid arthritis. This is often done as an annual review with one of the practice nurses. Many GP surgeries are involved in doing the blood monitoring for the specific drugs used in controlling and treating the joint inflammation , so you may get your regular blood tests performed by your surgery.
Rheumatoid arthritis, along with many of the treatments used affects the bodys immune response to infections. Your surgery may therefore contact you to offer you annual influenza jab and also a Pneumovax for pneumonia . With some of these treatments live vaccines should be avoided so please ensure you contact your Doctors surgery if you are planning to travel abroad.
Why Else Could Rheumatoid Factor Be Positive
Tested randomly, a positive RF result could sometimes show up in a person without arthritis or other autoimmune disease symptoms, but who has a family history of them, such as RA. But that doesnt mean theyll develop autoimmune problems. Without clinical correlation, it doesnt mean much, says Dr. Schulz. It also is more likely to be higher in healthy older patients.
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Blood Tests For Rheumatoid Arthritis
RA is an autoimmune disease. Several blood tests can detect immune system changes or antibodies that may attack the joints and other organs. Other tests are used to measure the presence and degree of inflammation.
For blood tests, your doctor will draw a small sample from a vein. The sample is then sent to a lab for testing. Theres no single test to confirm RA, so your doctor may order multiple tests.
When To See A Healthcare Provider
Anyone experiencing symptoms of joint swelling, pain or tenderness, particularly worse in the morning, and/or fatigue for several weeks, should be evaluated by a healthcare provider.
A rheumatologist is a specialist who diagnoses and treats RA and other autoimmune illnesses. While primarily targeting the joints, RA can lead to inflammation elsewhere in the body, including of the heart or lungs, so untreated disease can lead to serious complications and long-term disability.
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Whats The Age Of Onset For Rheumatoid Arthritis
RA usually starts to develop between the ages of 30 and 60. But anyone can develop rheumatoid arthritis. In children and young adults usually between the ages of 16 and 40 its called young-onset rheumatoid arthritis . In people who develop symptoms after they turn 60, its called later-onset rheumatoid arthritis .
How Is Rheumatoid Arthritis Diagnosed
Your healthcare provider may refer you to a physician who specializes in arthritis . Rheumatologists diagnose people with rheumatoid arthritis based on a combination of several factors. Theyll do a physical exam and ask you about your medical history and symptoms. Your rheumatologist will order blood tests and imaging tests.
The blood tests look for inflammation and blood proteins that are signs of rheumatoid arthritis. These may include:
- Erythrocyte sedimentation rate or sed rate confirms inflammation in your joints.
- C-reactive protein .
- About 80% of people with RA test positive for rheumatoid factor .
- About 60% to 70% of people living with rheumatoid arthritis have antibodies to cyclic citrullinated peptides .
Your rheumatologist may order imaging tests to look for signs that your joints are wearing away. Rheumatoid arthritis can cause the ends of the bones within your joints to wear down. The imaging tests may include:
In some cases, your provider may watch how you do over time before making a definitive diagnosis of rheumatoid arthritis.
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What Causes Rheumatoid Factor
It is not exactly known what causes rheumatoid factor to develop in the blood. However, it is thought to be a combination of genetics and other external risk factors. The uncertainty may be because certain people have low levels of rheumatoid factor, which may not ever be enough to trigger a significant autoimmune response.
On the other hand, people who have high levels of rheumatoid factor may go on to develop autoimmune disorders like rheumatoid arthritis, while others with elevated rheumatoid factor may not develop an autoimmune disorder. It isnt completely known what triggers the autoimmune response that causes rheumatoid arthritis.
Family & Personal Medical History
The patients medical history and family history are important factors in helping to reach a RA diagnosis. Studies have shown that the average risk of someone in the general population developing RA is about 1%. However, if there is a family history of the disease, the risk of another family member developing RA increases.
When diagnosing RA doctors ask about the following:
- Patients family members who have or had RA
- Patients existing or past autoimmune disorders
- Patients family members with other autoimmune disorders
- Other medical conditions, illnesses or complications
Depending on each patients unique set of answers, it can help doctors identify factors that lead to a RA diagnosis.
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Blood Tests To Help Diagnose Rheumatoid Arthritis
No single lab test can definitively diagnose the disease, but several lab tests can detect biological markers of RAmeasurable characteristics of the blood that are associated with rheumatoid arthritis.
The most useful biological markers for the diagnosis of RA are called rheumatoid factor and anti-CCP. Tests for these as well as several other biological markers are described below.
Rheumatoid factor. Rheumatoid factor is an antibody found in the blood. An elevated level of rheumatoid factor along with symmetrical joint pain is an indicator for rheumatoid arthritis.
While a helpful tool, this test alone cannot confirm or eliminate a diagnosis of rheumatoid arthritis. In fact, research shows:
- As few as 30% of people with early rheumatoid arthritis test positive for rheumatoid factor1
- About 80% of people with established rheumatoid arthritis test positive for rheumatoid factor1
- A small number of healthy people have elevated levels of rheumatoid factor
Elevated rheumatoid factor may also indicate another rheumatic disease, such as Sjögren syndrome, or other medical conditions, such as chronic lung disease and hepatitis C.
What Is Rheumatoid Factor
The immune system is an organized method through which the body fights off infections caused by bacteria, viruses and other organisms. A normal immune response to infection often involves the production of proteins such as antibodies to kill these invading organisms.
Sometimes, however, certain antibodies produced by the immune system may attack healthy proteins. In other words, the antibodies turn against the persons body damaging their health in the process.
When this occurs, the immune response that is triggered may result in what we now know as an autoimmune disorder. A variety of conditions have been shown to occur from these autoimmune responses.
Rheumatoid factor is one of many antibodies that are known to attack healthy tissue through an autoimmune process. When triggered, rheumatoid factor antibodies attack the healthy tissue resulting in a variety of symptoms.
Typically, these symptoms cause inflammation in the synovium a layer of soft tissue on the inner surface of joints, eventually leading to rheumatoid arthritis. Rheumatoid factor can also cause other symptoms seen in autoimmune disorders like Sjogrens Syndrome.
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What Types Of Lifestyle Changes Can Help With Rheumatoid Arthritis
Having a lifelong illness like rheumatoid arthritis may make you feel like you dont have much control over your quality of life. While there are aspects of RA that you cant control, there are things you can do to help you feel the best that you can.
Such lifestyle changes include:
When your joints are inflamed, the risk of injury to your joints and nearby soft tissue structures is high. This is why you need to rest your inflamed joints. But its still important for you to exercise. Maintaining a good range of motion in your joints and good fitness overall are important in coping with RA.
Pain and stiffness can slow you down. Some people with rheumatoid arthritis become inactive. But inactivity can lead to a loss of joint motion and loss of muscle strength. These, in turn, decrease joint stability and increase pain and fatigue.
Regular exercise can help prevent and reverse these effects. You might want to start by seeing a physical or occupational therapist for advice about how to exercise safely. Beneficial workouts include:
- Range-of-motion exercises to preserve and restore joint motion.
- Exercises to increase strength.
- Exercises to increase endurance .
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:
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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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.
The Role Of Blood Tests
Blood tests dont provide a simple yes-or-no answer to whether you have RA. But they can help your doctor steer toward a diagnosis. Blood tests narrow down options and suggest how your disease might progress.
After you receive a diagnosis of RA, continued blood tests will monitor the side effects of drugs used in treatment. They can also help track the progression of the disorder.
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Treatment Of Seronegative Rheumatoid Arthritis
Just like seropositive rheumatoid arthritis, seronegative rheumatoid arthritis cannot be reversed.
Treatment of this disorder is focused on alleviating pain and discomfort associated with inflammation around the body. Treatment can also slow the progression of this disease, or stop the progression altogether.
Its important to listen to your body and be aware of the signs and symptoms of RA, because the earlier we can detect this disorder, the greater our chances are of slowing its progression. Seronegative RA causes serious damage to the joints and bones because the body attacks the synovial tissues that cushion the bones. When the synovial tissue and supporting cartilage deteriorate, the bones no longer have the padding they need, and they start to rub against each other, which deteriorates the bones over time.
The symptoms of seronegative rheumatoid arthritis can be treated with NSAIDs medications, like ibuprofen. NSAIDs are nonsteroidal anti-inflammatory drugs that reduce inflammation and alleviate pain associated with joint swelling. These medications can increase range of motion, as they reduce the swelling that causes stiffness and inhibits movement.
Other medications, specifically disease-modifying antirheumatic drugs , can be taken to slow joint damage caused by seronegative RA. Sulfasalazine is a common DMARD used to slow the progression of seronegative RA and psoriatic arthritis.
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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