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Diagnosing Rheumatoid Arthritis

Learn what to expect when you see a rheumatologist about your joint pain symptoms.

When you see a rheumatologist about joint pain symptoms for the first time, he or she will look at several factors to determine if you have rheumatoid arthritis (RA) or another health condition. At your appointment, you can expect your doctor to:

  • Ask questions about your symptoms and medical history
  • Conduct a physical exam, and check your affected joints
  • Order or perform blood tests
  • Order or perform imaging tests (X-rays, an MRI, CT scan, or ultrasound)

Your Symptoms and Medical History
Your doctor is likely to start by asking about your symptoms—what brought you in. To help your doctor make a diagnosis, be as specific as possible about your joint pain and stiffness: when it hurts, where it hurts, how it feels, and whether your symptoms interfere with your daily activities. Tell your doctor if you're taking any medications or nutritional supplements, and how they've affected your symptoms. It may also help to make a note of your symptoms before your appointment, and bring your list to your doctor visit.

Your Physical Examination
In most cases, your doctor will do a thorough exam to check your temperature, blood pressure, reflexes, muscle strength, lungs, skin, nails, eyes, mouth, and nose. And of course, your joints: Are they inflamed, swollen, tender, warm to the touch, reddened, or stiff? Is your range of movement limited?

Blood Tests for RA
Blood tests can’t diagnose RA, but they can give your doctor important clues. Some tests your doctor may order include:

Rheumatoid Factor (RF). RF is an antibody protein found in most -- but not all -- people with RA. RF may not be found if you're in the early stages of RA, and it's sometimes found in people with other diseases. RF factor with symmetrical joint pain suggests RA is present.

Anti-CCP. CCP antibodies are present in many people with RA and are one of the strongest markers of rheumatoid arthritis. An anti-CCP test may help your doctor confirm that you have RA, even if your RF test shows no sign of it.

Erythrocyte (Red Blood Cell) Sedimentation Rate. Also called an ESR or “sed rate,” this test measures inflammation in your body. A higher sed rate means inflammation is present, and can tell your doctor how active your RA is.

Imaging Tests
X-rays can help your doctor distinguish between rheumatoid arthritis, osteoarthritis, and other conditions. But because bone damage may not yet be visible, early RA can't always be seen in X-rays. Magnetic resonance imaging (MRI), CT scans, and ultrasound may be better at finding early signs of rheumatoid arthritis. If RA is diagnosed, your doctor can use results from your initial exam as a reference point for measuring your progress and adjusting your treatments going forward.

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