Rheumatoid arthritis (RA) is a chronic disease that causes swelling of the joints. RA can also lead to swelling of the tissues near the joints and the inflammation of other organs of the body.
Rheumatoid arthritis Diagnosis
The diagnosis of rheumatoid arthritis starts with the meeting of the doctor and the patient. The doctor would do an analysis of the symptoms, its history and then would inspect the joints for deformity and inflammation. He will also examine other parts of the body for inflammation and the skin for rheumatoid nodules. Some x-ray and blood tests are frequently taken.
The diagnosis will depend on the distribution of the joint inflammation, the symptoms pattern, and the x-ray and blood test results. A number of visits may be needed so that the doctor can be sure about the diagnosis.
The distribution of inflamed joints is vital for the doctor while making a diagnosis. Usually in rheumatoid arthritis, the small joints of the wrists, feet, knees and hands are swollen in a symmetrical distribution ie both sides of the body are affected. The diagnosis of rheumatoid arthritis gets tougher if only 1 or 2 joints are inflamed. The medical practitioner will then carry out other tests to eliminate arthritis due to gout or infection. The finding of rheumatoid nodules can imply the diagnosis.
Patients with rheumatoid arthritis can contain abnormal blood antibodies. Rheumatoid factor, a blood antibody, can be found in eighty percent of patients. Another antibody known as the Citrulline antibody is found in almost all patients with RA. It helps the diagnosis of RA while evaluating patients who have unexplained joint inflammation. Another antibody, the antinuclear antibody or ANA is often present in patients with RA.
A blood test known as the sedimentation rate is used as a rough measure of the joint inflammation. C-reactive protein is another blood test, which is used for calculating the extent of inflammation found in the body.
The ANA, rheumatoid factor, C-reactive protein and sedimentation rate tests are inconclusive for rheumatic arthritis as the results may also suggest other inflammatory and systemic autoimmune conditions.
Early in the disease Joint x-rays may only show inflammation of soft tissues or can be normal. When the disease advances x-rays can reveal bony erosions, a characteristic of rheumatoid arthritis in the joints. They can be of use in examining the advancement of disease and damage to joint with time. Bone scanning is a radioactive test method that demonstrates the inflamed joints.
Arthrocentesis is a procedure in which the doctor will drain out joint fluid using a sterile needle and syringe. Laboratory analysis of the joint fluid can be useful in excluding other arthritis such as gout and infection.