Rheumatoid arthritis mainly affects the joints of various body parts such as wrists, ankles, knees, elbows, hips, shoulders and feet and causes the inflammation, stiffness, pain and swelling in the joints. As it is a systemic disease, it may involve other body parts and organs. It can cause limitation in mobility of the joints and makes the daily activities difficult. Hence, rheumatoid arthritis diagnosis is a very essential step to decide appropriate treatment plan.
Rheumatoid arthritis diagnosis is done on the basis of symptoms, physical examination and medical history of the patient. Some laboratory investigations and imaging tests also play an important role in the diagnosis. When you consult your doctor about your symptoms, the doctor asks few questions about your family and medical history, about your lifestyle and habits. In the physical examination, the doctor examines the condition of joints and other affected organs. After physical examination, some laboratory tests and imaging tests are prescribed by the doctor for confirmation of disease.
The laboratory investigations like complete blood count, erythrocyte sedimentation rate, determination of electrolyte levels, rheumatoid factor and analysis of synovial fluid are important for rheumatoid arthritis diagnosis. Complete blood count is performed to detect anemia, number of each type of blood cells and other irregularities in blood cells. Anemia is one of the significant symptoms of rheumatoid arthritis.
C-reactive proteins (CRP) and erythrocyte sedimentation rate (ESR) may indicate inflammation in the body. Raised levels of CRP and ESR may indicate the extent of disease activity. Besides this, determination of serum protein levels and serum electrolyte levels such as potassium, magnesium and calcium are also helpful for the diagnosis. Liver and kidney function tests are also recommended.
Some immunologic tests including determination of levels of antinuclear antibodies (ANA), rheumatoid factor (RF) and other antibodies (anti-CCP, anti-RA33) can be helpful in rheumatoid arthritis diagnosis. Positive RF results are found in the active periods of the disease. Positive ANA test is an indicative of abnormally active immune system. In addition to this, analysis of synovial fluid is very important for the diagnosis as it can give idea about the abnormal findings in this disease. Presence of white blood cells in the synovial fluid indicates the inflammation.
Besides these laboratory investigations, the imaging tests like x-rays, MRI scans, ultrasound, bone scanning; densitometry and arthroscopy are useful for the diagnosis of this disease.
The course of disease may vary from patient to patient. Some patients may have short-term and mild symptoms; while in most people, the disease is progressive and lifelong. Poor prognostic factors are early erosive disease, persistent synovitis, family history of RA, extra-articular findings (including subcutaneous rheumatoid nodules), positive serum anti-CCP autoantibodies, positive serum RF findings, elevated acute phase response (ESR and CRP), socioeconomic factors, poor functional status and increased clinical severity. Although rheumatoid arthritis can cause serious effects on life of a person, the treatment strategies like medications, balance exercise and rest and patient education and support programs can help to manage the symptoms and leads to productive and active lives.
