Video Q & A:

Symptoms, Tests, & Diagnosis

Question:

How is rheumatoid arthritis diagnosed?

Expert:   Harry D. Fischer, MD, Chief of Rheumatology, Beth Israel Medical Center New York »

Even though rheumatoid arthritis can resemble other conditions, there are specific criteria a doctor looks for when diagnosing patients. Find out what they are.

Transcript: Researchers believe that rheumatoid arthritis begins to damage bones during its first couple years. That means early diagnosis and treatment is essential to prevent or slow joint deterioration. Unfortunately, though, rheumatoid arthritis is TRICKY to diagnose. The symptoms—including achy joints and stiffness in the morning --start out subtly and resemble those of OTHER joint conditions, such as osteoarthritis. Diagnosing rheumatoid arthritis includes an examination of your physical symptoms and a blood test. In 80 percent of RA cases, the test will reveal the presence of RHEUMATOID FACTOR, which is a term for the antibodies that the immune system makes when rheumatoid arthritis is present. The presence of rheumatoid factor is STRONG evidence towards identifying RA. However, it is possible to have a positive test result and still NOT have rheumatoid arthritis. That’s why it’s only one of SEVEN symptoms that help a doctor decide if you have RA or not. At least FOUR of these seven symptoms need to be present for a doctor to confirm a diagnosis. The other criteria are: morning joint stiffness that lasts at least an hour, pain of 3 or more joints for at least 6 weeks, HAND joint pain for at least 6 weeks, arthritis on BOTH sides of the body for at least 6 weeks, JOINT nodules under the skin, or EVIDENCE of rheumatoid arthritis in X-rays. X-rays won’t reveal much when RA is in its early stages, but they’re useful in tracking the disease once it starts to erode the joints. After an initial diagnosis, further lab tests may be done. An anti-CCP antibodies blood test will confirm a diagnosis. And an erythrocyte sedimentation rate test, also called an ESR or sed rate test, can indicate the severity of inflammation in the body. To get more answers to your arthritis questions, watch more videos in this series! More »

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