Rheumatoid Arthritis Diagnosis
RA can begin very gradually, or it can strike quickly. The first symptoms are pain, swelling, and stiffness in the joints. The most commonly involved joints include hands, feet, wrists, elbows, and ankles, although other joints may also be involved. The joints are affected in a symmetrical fashion. This means that if the right wrist is involved, the left wrist is also involved. Patients frequently experience painful joint stiffness when they first get up in the morning, lasting for perhaps an hour. Over time, the joints become deformed. The joints may be difficult to straighten, and affected fingers and toes may be permanently bent (flexed). The hands and feet may curve outward in an abnormal way.
Many patients also notice increased fatigue, loss of appetite, weight loss, and
sometimes fever. Rheumatoid nodules are bumps that appear under the skin around the joints
and on the top of the arms and legs. These nodules can also occur in the tissue covering
the outside of the lungs and lining the chest cavity (pleura), and in the tissue covering
the brain and spinal cord (meninges). Lung involvement may cause shortness of breath and
is seen more in men. Vasculitis (inflammation of the blood vessels) may interfere with
blood circulation. This can result in irritated pits (ulcers) in the skin, tissue death
(gangrene), and interference with nerve functioning that causes numbness and tingling.
Rheumatoid Arthritis Diagnosis - test
More detailed information about Rheumatoid Arthritis Diagnosis
There are no tests available that can absolutely diagnose RA. Instead, a number of tests exist that can suggest the diagnosis of RA. Blood tests include a special test of red blood cells (called erythrocyte sedimentation rate), which is positive in nearly 100% of patients with RA. However, this test is also positive in a variety of other diseases. Tests for anemia are usually positive in patients with RA, but can also be positive in many other unrelated diseases. Rheumatoid factor is an autoantibody found in about 66% of patients with RA. However, it is also found in about 5% of all healthy people and in 10-20% of healthy people over the age of 65. Rheumatoid factor is also positive in a large number of other autoimmune diseases and other infectious diseases.
A long, thin needle can be inserted into a synovial joint to withdraw a sample of the synovial fluid for examination. In RA, this fluid has certain characteristics that indicate active inflammation. The fluid will be cloudy, relatively thinner than usual, with increased protein and decreased or normal glucose. It will also contain a higher than normal number of white blood cells. While these findings suggest inflammatory arthritis, they are not specific to RA.
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