An inflammatory disorder of the joints, rheumatoid arthritis causes inflammation, pain, stiffness and tenderness of the joints of ankles, wrists, hands, feet, knees, shoulders and hips. If left untreated, it can cause the destruction of the joints and give rise tom deformities. Hence, it is very essential to make an accurate diagnosis and get proper treatment as early as possible. The rheumatoid arthritis diagnosis is based on symptoms, medical history, physical examination, some laboratory tests and imaging studies.
The first important step in the rheumatoid arthritis diagnosis is the meeting between the patient and the doctor. The doctor gets the information about the medical history and performs the physical examination to check the swelling, tenderness, redness, loss of motion in the joints as well as signs of rheumatoid arthritis in other body parts such as eyes, lings and skin.
After the physical examination, the next step that the doctors takes is to suggest some laboratory tests for accurate rheumatoid arthritis diagnosis. As there is no particular test for the confirmation of this disease, the doctor may suggest various laboratory tests and imaging studies for the proper diagnosis. Some of the recommended laboratory tests include analysis for complete blood count, erythrocyte sedimentation rate, determination of electrolyte levels, rheumatoid factor etc.
Complete blood count determines the number of each type of blood cells. Anemia or other irregularities may indicate the rheumatoid arthritis. There may be increased number of white blood cells which indicates the presence of infection in the body. Besides this test, there are other tests such as determination of C-reactive proteins (CRP) and erythrocyte sedimentation rate (ESR) which are helpful for the diagnosis of this disease. ESR and CRP are the markers of inflammation and their elevated levels may indicate the extent of disease activity.
In addition to these investigations, the tests like determination of serum protein levels and serum electrolyte levels such as potassium, magnesium and calcium are helpful for the diagnosis. There are also some immunologic tests that are important for rheumatoid arthritis diagnosis such as a determination of levels of antinuclear antibodies (ANA), rheumatoid factor (RF) and other antibodies (anti-CCP, anti-RA33). Positive RF results are found in the active periods of the disease. The quantity of rheumatoid factor indicates the severity of this disease. Positive ANA test is an indicative of abnormally active immune system. In the first few months of onset of disease, these immunologic tests may result as negative.
Analysis of synovial fluid is another important laboratory investigation for the diagnosis as it can give an idea about the abnormal findings in this disease. Presence of white blood cells in the synovial fluid mostly leads to inflammation.
Some other tests helpful for the diagnosis of rheumatoid arthritis are the imaging tests like x-rays, MRI scans, ultrasound, bone scanning, densitometry and arthroscopy.
