How
to diagnosis rheumatoid
arthritis?
Rheumatoid
arthritis can be difficult to diagnose in its early stages for several
reasons. First, there is no single test for the disease. In addition,
symptoms differ from person to person and can be more severe in some
people than in others. Also, symptoms can be similar to those of other
types of arthritis and joint conditions, and it may take some time for
other conditions to be ruled out as possible diagnoses. Finally, the
full range of symptoms develops over time, and only a few symptoms may
be present in the early stages. As a result, doctors use a variety of
tools to diagnose the disease and to rule out other conditions:
Medical
history: This
is the patient's description of symptoms and when and how they began.
Good communication between patient and doctor is especially important
here. For example, the patient's description of pain, stiffness, and
joint function and how these change over time is critical to the
doctor's initial assessment of the disease and his or her assessment of
how the disease changes.
Physical
examination:
This includes the doctor's examination of the joints, skin, reflexes,
and muscle strength.
Laboratory
tests:
One common test is for rheumatoid factor, an antibody that is eventually
present in the blood of most rheumatoid arthritis patients. (An antibody
is a special protein made by the immune system that normally helps fight
foreign substances in the body.) Not all people with rheumatoid
arthritis test positive for rheumatoid factor, however, especially early
in the disease. And, some others who do test positive never develop the
disease. Other common tests include one that indicates the presence of
inflammation in the body (the erythrocyte sedimentation rate), a white
blood cell count, and a blood test for anemia.
X
rays:
X rays are used to determine the degree of joint destruction. They
are not useful in the early stages of rheumatoid arthritis before bone
damage is evident, but they can be used later to monitor the progression
of the disease.
