What Blood Tests Are Done to Diagnose Rheumatoid Arthritis?

Reviewed on 5/25/2021

When seeking a rheumatoid arthritis diagnosis, your doctor may order some blood tests, which can include rheumatoid factor (RF) assay, antinuclear antibody assay (ANA), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, complete blood count, anti-cyclic citrullinated peptide (anti-CCP) and anti-mutated citrullinated vimentin assays, HLA tissue typing, Lyme disease, and uric acid.
When seeking a rheumatoid arthritis diagnosis, your doctor may order some blood tests, which can include rheumatoid factor (RF) assay, antinuclear antibody assay (ANA), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, complete blood count, anti-cyclic citrullinated peptide (anti-CCP) and anti-mutated citrullinated vimentin assays, HLA tissue typing, Lyme disease, and uric acid.

Blood tests that are used to diagnose rheumatoid arthritis (RA), an autoimmune disease that primarily affects the body’s joints, include:

Along with blood tests, imaging studies may also be used to diagnose rheumatoid arthritis, such as:

  • X-rays (first choice): Hands, wrists, knees, feet, elbows, shoulders, hips, cervical spine, and other joints as indicated 
  • Magnetic resonance imaging (MRI): Primarily cervical spine
  • Ultrasound of joints: Joints, as well as tendon sheaths, changes and degree of vascularization of the synovial membrane, and even erosions

In some cases, joint aspiration and analysis of synovial fluid may be indicated.

What Are Symptoms of Rheumatoid Arthritis?

The first signs and symptoms of rheumatoid arthritis tend to come on gradually, often before joint pain or stiffness is noticeable, and may include:

Joint pain and stiffness usually begin in small joints, such as the joints of the fingers or toes, or it may occur in a single, large joint, such as the shoulder or knee, or it may shift from one joint to another

Rheumatoid arthritis usually affects the same joints on both sides of the body (symmetrical). As the condition progresses, joint pain and inflammation become more prominent and symptoms include: 

  • Joint pain and stiffness that may affect the:
    • Hands
      • Finger deformities/bent fingers 
      • May result in carpal tunnel syndrome, which causes weakness, tingling, and numbness in the hand and fingers
      • Wrist: difficulty bending the wrist backward
    • Elbow: swelling may result in numbness or tingling in the fingers
    • Shoulder: pain and limited motion
    • Knee: difficulty bending the knee and development of a “Baker's cyst,” which is a fluid-filled cyst in the space at the back of the knee
    • Ankle: nerve damage may occur, leading to numbness and tingling in the foot
    • Foot: tenderness at the joints at the base of the toes may cause someone to stand and walk with weight on the heels. The top of the foot may be swollen and red, and the heel may be painful.
    • Hips: difficulty walking
    • Neck: painful and stiff, difficulty bending the neck and turning the head
    • Cricoarytenoid joint: inflammation of a joint near the windpipe that can cause hoarseness and difficulty breathing
  • Other symptoms of rheumatoid arthritis may include:

QUESTION

The term arthritis refers to stiffness in the joints. See Answer

What Causes and Risk Factors of Rheumatoid Arthritis?

The cause of rheumatoid arthritis is unknown but it is thought that susceptibility factors and initiating factors may affect a person's risk of developing the condition: 

Susceptibility factors increase a person’s susceptibility to developing rheumatoid arthritis when exposed to risk factors that initiate the inflammatory process. Susceptibility factors include:

  • Being female: females are twice as likely as males to develop RA
  • Age: middle-aged or older
  • Genetics: people with a relative who has RA have an increased risk of developing the condition

Initiating factors (triggers) increase the chances a susceptible person will develop the disease, such as:

What Is the Treatment for Rheumatoid Arthritis?

There are many different medications, therapies, and surgical treatments available to treat rheumatoid arthritis, which include:

Other medicines used to treat rheumatoid arthritis include:

Surgical treatments for rheumatoid arthritis include:

  • Synovectomy 
  • Tenosynovectomy 
  • Tendon realignment 
  • Reconstructive surgery or arthroplasty 
  • Arthrodesis 

Other therapies for rheumatoid arthritis include:

  • Physical therapy and exercise 
  • Occupational therapy 
  • Heat and cold therapies 
  • Joint-protection education 
  • Orthotics and splints 
  • Adaptive equipment 
  • Energy-conservation education 

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Reviewed on 5/25/2021
References
https://emedicine.medscape.com/article/331715-overview

https://www.uptodate.com/contents/rheumatoid-arthritis-symptoms-and-diagnosis-beyond-the-basics?search=rheumatoid%20arthritis&source=search_result&selectedTitle=5~150&usage_type=default&display_rank=5

https://www.uptodate.com/contents/rheumatoid-arthritis-treatment-beyond-the-basics?search=rheumatoid%20arthritis&topicRef=512&source=see_link