Rheumatologist Questions Rheumatoid Arthritis

How do I know if I have rheumatoid arthritis?

My joints hurt most of the time. How do I know if it is rheumatoid arthritis?

5 Answers

Great question! Historically, a key blood test to determine whether a person has rheumatoid arthritis checked for the presence of rheumatoid factor (RF): antibodies produced by the immune system that can attack healthy joints and tissues. More recently, an additional antibody called the anti-cyclic citrillunated protein (ACPA) has been considered a marker.
But now, the presence of RF or ACPA is no longer considered necessary for a rheumatoid arthritis diagnosis. When RF and ACPA are negative, but a person has symptoms similar to those of rheumatoid arthritis, seronegative arthritis can be diagnosed. People who have either RF or ACPA antibodies have seropositive RA. In either case, i would advise you to follow up with a Rheumatologist for further evaluation as there can be many different causes for your symptoms and it should be evaluated by a healthcare professional.
Rheumatoid arthritis is caused by inflammation in the joints. The hallmarks of inflammation are soft (feels “mushy”) swelling, redness and warmth of the joint. There is tenderness and often pain with use and restricted range of motion. Rheumatoid arthritis may have other more generalized symptoms such as fatigue, swollen glands and low grade fevers. Classically Rheumatoid Arthritis is in the hands, wrists and feet but can involve any joint. Usually blood tests will show signs of inflammation and often a positive rheumatoid factor or anti-CCP antibody. Your Primary Care physician or a Rheumatologist should be able to differentiate this from the more common osteoarthritis.
The diagnosis of rheumatoid arthritis is based on a combination of lab test results, patient history, and a physical exam. This disease can sometimes mimic other auto-immune diseases, including osteoarthritis, and a patient may have more than one disease. There are patterns of joint pain that are commonly found in rheumatoid arthritis and rarely in other conditions. In addition, the treatment options for RA are not the same as for osteoarthritis or other joint diseases. The best way to arrive at a diagnosis is to see a rheumatologist who is experienced in assessing these diseases.
There are specific lab markers and X-ray findings to diagnose rheumatoid arthritis. You should be evaluated by a rheumatologist.
If the small and medium joints of both hands, both wrists are swollen, tender, worse in the morning with swelling in the shoulders, knees, ankles, with incomplete relief from a high dose of motrin or naproxen, then see a rheumatologist.