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Diagnosis of Rheumatoid Arthritis

There are no specific tests to completely confirm or eliminate the diagnosis of rheumatoid arthritis.

Your healthcare provider may begin to suspect rheumatoid arthritis after taking a careful history of your symptoms and performing a thorough physical exam.

According to The American College of Rheumatology, if you have four of the seven symptoms listed below for more than 6 weeks you are considered to have rheumatoid arthritis:

  • Morning stiffness that lasts over an hour
  • Arthritis in at least three joints
  • Arthritis of the joints of the hand
  • Arthritis on both sides of the body (for example, involving both hands or both feet)
  • A positive blood test for rheumatoid factor (RF)
  • Presence of lumps under the skin, called rheumatoid nodules
  • X-rays that show signs of rheumatoid arthritis affecting the joints

Testing

If there are any questions about the diagnosis, your healthcare provider may recommend other tests to confirm the diagnosis or to evaluate whether your internal organs are also involved. Such tests may include the following:

Blood tests – A number of blood tests can point to the presence of an autoimmune disorder. These include:

  • Rheumatoid factor
  • Erythrocyte sedimentation rate
  • Antinuclear antibody
  • C-reactive protein

Imaging tests – Imaging tests may be used to visualize the internal organs, in order to see whether rheumatoid arthritis has affected them. Specific areas of the body to be examined with imaging tests may be chosen based on your symptoms. Imaging tests may include:

Arthrocentesis – Removing some joint fluid for laboratory exam may reveal the presence of white blood cells, crystals, or bacteria. This test is most commonly used to exclude other causes of arthritis.

References:

Arthritis Foundation website. Available at: http://www.arthritis.org/ .

National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ .

Cecil Textbook of Medicine . 21st ed. W.B. Saunders Company; 2000.

Conn’s Current Therapy . 54th ed. W.B. Saunders Company; 2002.



Last reviewed February 2007 by Robert E. Leach, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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