Rheumatoid Arthritis (RA) Diagnosis

Rheumatoid Arthritis (RA) Diagnosis

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    There are several known genetic combinations that could put one at risk for rheumatoid arthritis. However, current genetic screening methods are not specific or sensitive enough to justify screening for the general population.
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    If you think you may have rheumatoid arthritis (RA), you should visit a healthcare professional. He or she will take several elements into consideration before rendering a diagnosis:
    • Medical history. Your description of the symptoms -- including their duration and intensity -- can help with the diagnosis.
    • Physical examination. Your healthcare professional will do a physical exam and pay particular attention to your joints, skin, reflexes, and muscle strength.
    • Laboratory tests. Some lab tests can help establish the presence of RA. Your healthcare professional will probably order a test to detect rheumatoid factor (an antibody eventually present in the blood of most people with rheumatoid arthritis). It's inconclusive, however, since not all people with RA test positive for rheumatoid factor, especially in the early stages. Some people with other types of rheumatic disease and a small number of healthy individuals also have a positive rheumatoid factor test, so you could test positive and never develop the disease. A test called anti-cyclic citrullinated peptide, or anti-CCP, is now available and might be somewhat more specific than rheumatoid factors. Specificity is much higher when both tests are positive. Other common tests include one that indicates the presence of inflammation in the body (the erythrocyte sedimentation rate and the C-reactive protein), a white blood cell count and a blood test for anemia.
    • X-rays. These can help determine the extent of joint destruction. If you identify RA in its early stages, X-rays may not be helpful in diagnosis. However, they can be used to monitor the disease's progress. Other imaging techniques, such as MRI and ultrasound, also may be used to assess inflammation and joint damage.
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    Diagnosing and treating rheumatoid arthritis can sometimes be difficult. It may require a team effort between you and several types of healthcare professionals, including a rheumatologist, a physician who specializes in arthritis and other diseases of the joints, bones, and muscles. Physical therapists, psychologists, and social workers can also play a role.
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    The need for a second opinion of rheumatoid arthritis (RA) diagnosis is a very personal matter. You need to feel comfortable with your physician and treatment plan. If you are not, then seek a second opinion. When getting your second opinion, involve the doctor who gave you the original diagnosis to make sure the doctor providing the second opinion has all the necessary information.

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    The anti-CCP (inated peptide antibody) is a blood test that is commonly used to confirm a diagnosis of rheumatoid arthritis (RA). Anti-CCP tests are one of the most specific markers for the disease and may be positive even if the rheumatoid factor (RF) is negative.

    For many, an anti-CCP test can be positive years before the first signs of RA are recognized.

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    Your doctor will evaluate your symptoms and use tests to determine if you have rheumatoid arthritis (RA). A typical examination may include:

    • Joint assessment - a general inspection of your joints see if they are swollen and/or painful.
    • Rheumatoid factor (RF) - a blood test used to distinguish RA from other forms of arthritis.
    • Anti-CCP (or anti-cyclic citrullinated peptide antibody) - a blood test that is used to confirm diagnosis, typically conducted after the rheumatoid factor (RF).
    • X-rays of your joints to see if there is bone damage
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    While X-rays are still the most effective way to diagnose RA, ultrasound technology is becoming more popular in the rheumatology setting. Rheumatologists are using ultrasound to determine how active a person's RA is.

    The ability to look inside the joint allows doctors to see even the smallest amounts of fluid. This will help decide if the current treatments are working or if adjustments should be made.

    Ultrasound technology can also be used when delivering medication to affected joints. While injecting medications, doctors can see where the needle is inside the joint allowing them to direct medication to affected spots. The result is better pain management and relief.

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    In diagnosing rheumatoid arthritis, your doctor may order some blood tests to confirm what is discovered during the physical exam. There are several different tests that the doctor may choose from:

    • ESR-erythrocyte sedimentation rate. This shows that there is inflammation somewhere in the body. It may mean rheumatoid arthritis.
    • C-reactive protein levels. Also may show inflammation.
    • Rheumatoid factor. This is an antibody that the body produces in response to rheumatoid arthritis or other diseases.
    • Anti-cyclic citrullinated peptide (anti-CCP) antibodies. Testing for these antibodies may be the most accurate test available for rheumatoid arthritis, since people without rheumatoid arthritis almost never have these antibodies.
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    When going to an appointment to diagnosis or evaluate rheumatoid arthritis symptoms, be prepared with your medical history and a list of questions. Your doctor will need to know details about your symptoms, such as when they started and when they occur. Family medical history and all the medications you take will be noted. The doctor will give you a physical exam during which your joints, muscle strength, and reflexes will be examined. Blood tests, x-ray, or MRI may also be a part of the overall examination.

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    The anti-CCP blood test, a new test for rheumatoid arthritis (RA), measures the level of antibodies that bind to citrulline modified proteins. These proteins tend to be elevated only in patients who have or will have RA. The anti-CCP blood test can be used to determine the severity of RA a person may experience.