How rheumatoid arthritis is diagnosed

When I wanted to write this post, the idea was to write out everything you need to know about rheumatoid arthritis, but I chose to focus on its diagnosis because I discovered there is not much knowledge of how rheumatoid arthritis is diagnosed. 

While still holding to the originality of this idea, I will also show you the types of rheumatoid arthritis along with the risk factors.

Who can get rheumatoid arthritis? How is rheumatoid arthritis diagnosed? What are the symptoms of rheumatoid arthritis, and does it have a cure?

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a type of arthritis and an autoimmune disease that occurs due to the body’s immune system mistaking the linings of the joints for foreign bodies, and it starts attacking the linings. 

RA causes joint inflammation, stiffness, swelling, and pain. It affects the small joints of the body at first and later affects the big joints like the knees and hips.

Rheumatoid arthritis is considered a chronic illness because there is no cure for it; instead, it is a condition that is constantly and continuously managed. The best help for arthritis is early diagnosis and proper management, which you can achieve by detecting the early signs, tracking symptoms, and using natural remedies and medications.

Symptoms of Rheumatoid Arthritis

If you have RA, here are some of the symptoms you might experience:

  • Joint stiffness
  • Joint pain
  • Joint swelling
  • Fatigue
  • Malaise
  • Depression
  • Loss of appetite
  • Weight loss
  • Fever
  • Morning stiffness
  • Tingling
  • Numbness
  • Symmetrical pain
  • Multiple joint pain
  • Joint deformity (link to the blog post on RA in the hands)

These symptoms do not necessarily occur in everybody and can vary. 

Some persons will experience the classic RA disease progression, where the typical symptoms of joint inflammation and deformity after a prolonged period occur, while some experience the palindromic RA disease progression, where there is an on-and-off pattern with the symptoms.

Types of Rheumatoid Arthritis

  • Seropositive RA.

This is the most common type of rheumatoid arthritis where the anti-cyclic citrullinated peptide during blood testing. These peptides form antibodies that attack the joints and result in the physical symptoms experienced by RA patients.

  • Seronegative RA.

This is the opposite of seropositive rheumatoid arthritis. People with seronegative RA do not have anti-cyclic citrullinated peptides and rheumatoid factor (RF) in their blood, and this type of rheumatoid arthritis is less common.

How Rheumatoid Arthritis is diagnosed

People often fail to get how rheumatoid arthritis is diagnosed. 

You should note that rheumatoid arthritis isn’t diagnosed by a single test but involves a series of tests where points are given for each result. 

These points are calculated, and if it exceeds the standard baseline, it is classified as a positive result, but if not, it is classified as a negative result.

The series of tests carried out for RA include:

  • Physical examination
  • Symptoms

The symptoms experienced by patients are examined and analyzed.

Physical analysis usually involves joint analysis like the number of joints affected, the type of joints affected, and the duration and frequency of the symptoms.

The points for each symptom are according to the 2010 rheumatoid arthritis classification criteria.

1. Blood tests

Blood tests are carried out to measure inflammation in the body, which will help identify the type of inflammation and determine if it is associated with rheumatoid arthritis.

2. Rheumatoid factor (RF)

Rheumatoid factor is an autoantibody that is produced when you have rheumatoid arthritis. Although RF tests do not always show positive for all arthritis patients, it is estimated that about 70% of RA patients have a positive RF result.

High levels of RF in the blood are indicative of an inflammatory condition.

RF test is not conclusive for rheumatoid arthritis because people with other inflammatory conditions like Sjögren’s syndrome and lupus can also have it. Also, it is not seen in every RA patient, and having a positive RF result doesn’t mean you have arthritis.

3. Anti-citrullinated protein antibodies (ACPA)

This antibody is specific to rheumatoid arthritis and is found only in people with RA. It is released when the body’s immune system fights against itself.

4. Erythrocyte sedimentation rate (ESR)

This inflammatory marker indicates the presence or absence of inflammation. It is not a conclusive diagnosis for RA but can support the doctor’s diagnosis and help measure the inflammation’s activeness.

5. C-reactive protein (CRP)

This is an inflammatory marker but is also not conclusive of rheumatoid arthritis. It is a protein produced by the liver when there is inflammation in the body and can be used as a marker for other inflammatory conditions.

How rheumatoid arthritis is diagnosed

6. Imaging

Medical imaging is additional tests carried out by the doctor when the physical examination and blood tests are not conclusive enough.

7. Ultrasound

Ultrasound is used to check damage to the synovial tissues that surround the joint and a tendon. There are two types of ultrasound imaging, which are: 

  • The Grayscale Ultrasound
  • The Doppler Ultrasound
  • X-ray imaging

X-ray imaging is used later in disease progression because the X-ray cannot detect joint swellings early on in rheumatoid arthritis. It is used to detect the extent of bone damage and the level of cartilage deterioration.

8. MRI (Magnetic resonance imaging)

MRI is a last resort RA diagnostic test to detect inflammation and changes in the soft tissues of the joints. It can also show the extent of bone damage, although it is more expensive and takes more time than the other imaging options.

Risk factors for Rheumatoid Arthritis

Several factors can make you susceptible to rheumatoid arthritis, and they include:

1. Exposure to smoking

Smoking has been researched to have a connection with rheumatoid arthritis. People who smoke are more likely to have RA.

2. Obesity

Increased weight can increase the risk of rheumatoid arthritis, according to research published in 2017.

How rheumatoid arthritis is diagnosed; a person holding on to belly fat

3. Genetics

People with certain genes like HLA class II genotypes are more likely to have RA, especially when exposed to certain environmental factors and bad habits like smoking.

4. Gender

Females are more at risk of having rheumatoid arthritis than males. The risk factor is greatly more for females.

5. Age

Adults are more prone to RA than children, but this doesn’t mean kids do not get arthritis.

6. Lifestyle

Unhealthy lifestyle habits like alcohol, drugs, and smoking can increase the risk of having rheumatoid arthritis.

7. Diet

Unhealthy diets, especially those with more inflammatory properties like monounsaturated fats, are also risk factors.

Treatment of Rheumatoid arthritis

There is no proven cure for RA. However, there are proven ways to slow down the progression of joint deterioration and also help manage the symptoms that come with it.

I decided to categorize these treatment options into five categories:

1. Diet

Anti-inflammatory diets are used for arthritis management, and this is because the anti-inflammatory properties of the food in this diet help to fight inflammation.

2. Exercises

Exercises have known effects on rheumatoid arthritis as it has been found to relieve joint pain and stiffness. There are several approved exercises for rheumatoid arthritis patients, but most are low-impact, water, and stretching exercises.

3. Medications

There are over-the-counter medications and prescribed medications that are used for the treatment of rheumatoid arthritis. Aside from these, some topical creams and gels are used to treat arthritis pain.

4. Home remedies

You can also use natural remedies to treat and manage rheumatoid arthritis if you do not fancy taking drugs. These home remedies include exercises, supplements, heat therapy, and acupuncture.

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5. Lifestyle

Healthy lifestyle changes are also crucial in the treatment of arthritis. Avoiding smoking, alcohol, and drugs are some lifestyle changes you should have.

how rheumatoid arthritis is diagnosed - Coach Ashley jogging across the bridge

Duration of Rheumatoid Arthritis

Rheumatoid arthritis is a progressive disease, and there is no cure. However, early diagnosis can help to curb the progression of arthritis early and hence increase the chances of patients attaining remission.

But remission does not indicate that there is no rheumatoid arthritis anymore; it means that the symptoms have been suppressed enough that it is almost as if the rheumatoid arthritis is cured.

How rheumatoid arthritis is diagnosed

Final Thoughts

Now, you know how rheumatoid arthritis is diagnosed, and you can talk about it the next time you meet your service provider. There are different reasons to learn this, and one is that you get the necessary knowledge to advocate for yourself and educate others.

If you are experiencing some early signs of rheumatoid arthritis and want to make sure you have an accurate diagnosis, you can ask your doctor what tests have been done and request a more precise test that will leave you without a doubt.

No one wants an incorrect diagnosis, especially a life-changing one like rheumatoid arthritis.

What tests did you carry out to get your diagnosis? Do you think you need to do more? 

READ ALSO: 20 Interesting facts about arthritis you should know now

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