Diagnosis and treatment of rheumatoid arthritis

Diagnosis and treatment of rheumatoid arthritis

A physician will refer a patient to a rheumatologist if he or she suspects the signs and symptoms of rheumatoid arthritis. This disease is chronic and can often last a lifetime. Although there is no cure, treatment through pain medicines and dietary changes can help one manage the condition. A single test cannot confirm rheumatoid arthritis, and a proper look into medical and family history, physical examination, and diagnostics tests are required.


Medical history
This covers a detailed analysis of family and medical history and analysis of recent symptoms such as pain and tenderness in joints and difficulty in movements.

Physical exam
Physical examination will include an examination of each joint, swelling, and painful movement in the joints. As rheumatoid arthritis affects joints of both sides, a pattern and number of joints affected will also be recorded. This will also reveal other associated symptoms such as fever, muscle strength, and reflex.

It is used to image the joints affected by rheumatoid arthritis. An x-ray scan is done to determine the extent of damage to the cartilage, tendons, and bones. However, this scan cannot detect inflammation in the soft tissues. X-ray imaging of affected joints will also help in understanding the disease progression.

MRI uses a powerful magnetic field to image the soft tissues. For rheumatoid arthritis, these images can detect the inflammation present in the synovium, where the synovium is the membrane that is attacked by the immune system. MRI can detect inflammation in earlier stages of rheumatoid arthritis compared to an x-ray.

Blood tests
Different blood tests are conducted to detect circulatory antibodies and inflammatory proteins in the blood, which are as follows:

  • Rheumatoid factor test
    A high level of this factor is linked with auto-immune diseases, especially rheumatoid arthritis.
  • Anticitrullinated protein antibody test (anti-CCP)
    Anti-CCP antibodies are associated with rheumatoid arthritis and can be an early diagnostic marker. A positive test for this antibody also indicates that disease is now likely to progress more rapidly.
  • Antinuclear antibody test (ANA)
    The ANA test is an indicator of auto-immune disease. An elevated level of this antibody could mean that the immune system is evading its own tissues. Since rheumatoid arthritis is an autoimmune disorder, ANA tests are usually positive for rheumatoid arthritis patients. However, a positive test for ANA does not necessarily mean that person has rheumatoid arthritis.
  • Erythrocyte sedimentation rate (ESR)
    An ESR test is generally performed to study the degree of inflammation in the body. However, it doesn’t indicate the cause of the inflammation.
  • C-reactive protein test (CRP)
    CRP is an inflammatory protein and is synthesized by the liver during infection. Elevated levels of CRP can indicate inflammation in the joints.

There is no permanent cure for rheumatoid arthritis, but pain or anti-inflammatory medications, anti-rheumatic medicines, and dietary changes can help in treatment. The treatment strategy for rheumatoid arthritis generally focuses on reducing pain and inflammation in the body, which helps in controlling further damage to the joints and other organs.

Heating pads can be used by the patient at home to achieve temporary relief as they soothe joints and relax painful muscles. Stretching exercises taught by a trained physiotherapist can also help. In extreme cases, a joint may have to be repaired or replaced through surgery.

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