What Is The Correct Diagnosis Of Rheumatoid Arthritis?
Rheumatoid arthritis is a type of arthritis that affects more than just your joints. This chronic inflammatory disorder can have a negative impact on your skin, oral cavity, eyes, lungs, heart and blood vessels. An autoimmune disorder, this arthritis occurs when the body’s defense system attacks your own body cells. Rheumatoid arthritis affects the lining of your joints, tissues surrounding the joints, as well as connective tissues at other places in the body. The cells of the immune system present in the blood move into your joints and their linings. This causes inflammation leading to swelling, pain and stiffness in joints.
We spoke to Dr. Sarath Chandra Mouli Veeravalli, Clinical Director, Department of Rheumatology and Clinical Immunology at Krishna Institute of Medical Sciences and according to him the most common symptoms are pain and swelling of feet (ankles & toes) and hands (wrists & finger joints), affecting joints of both sides of the body.
“Typical patients will have more pain and stiffness of joints in the morning (>45 min). Rest pain is more, night pains are more and feel better with activity. Other than bones rheumatoid arthritis can affect the heart (pericardial effusion), lungs (fibrosis, effusion), eyes (red eyes, dry eyes), skin (dry skin, rashes), oral cavity (dry mouth, tooth decay) and nerves (neuropathy)”, he added.
Therefore, if you experience any symptoms of rheumatoid arthritis, it is important that you consult a doctor and specifically a Rheumatologist as soon as possible in order to receive prompt treatment. Joint pain can come up with many conditions so a timely diagnosis of the underlying cause and early treatment can help relieve your symptoms and control disease progression.
Rheumatoid arthritis is difficult to diagnose in its early stages. This is because this disorder resembles many other disorders and condition. Do visit your rheumatologist if you have any of the following symptoms:
1. Do your joints, especially the smaller ones, remain stiff even after hours of waking up in the morning?
2. Do notice swelling of your joints, especially more in the morning?
3. Do you have pain when moving your fingers and wrists?
4. Do you feel a general weakness or lack of energy throughout the day?
Some standard diagnostic tests for rheumatoid arthritis include ESR (erythrocyte sedimentation rate), CRP (C-reactive protein, RF (rheumatoid factor) and Anti-CCP (cyclic citrullinated peptide) antibody, Radiographs of affected joints, HRUS (high-resolution ultrasonography) of joints and rarely MRI of joints – and these tests aren’t painful and no specific precautions to be observed before testing”
Dr. Sarath Chandra Mouli VeeravalliSenior RheumatologistTelangana
According to Dr SC Mouli from Hyderabad, rheumatoid arthritis is diagnosed based on symptomatology, followed by physical examination findings and supported by laboratory tests. He says, “Some standard diagnostic tests for rheumatoid arthritis include ESR (erythrocyte sedimentation rate), CRP (C-reactive protein, RF (rheumatoid factor) and Anti-CCP (cyclic citrullinated peptide) antibody, Radiographs of affected joints, HRUS (high-resolution ultrasonography) of joints and rarely MRI of joints – and these tests aren’t painful and no specific precautions to be observed before testing”.
Some possible ways which can help diagnose Rheumatoid arthritis are:
1. Imaging tests
Some imaging tests such as X-ray, ultrasound, and magnetic resonance imagery (MRI) scans might help a doctor determine whether the joints have been damaged or not. These imaging tests can even help detect inflammation in the joints, erosion or fluids in the joint.
2. Physical examination
Physical exam might be the first option to detect Rheumatoid arthritis. The motive of this exam is, to determine the various characteristics of the joint pain and swelling. This can help distinguish it from other causes of joint pain, like psoriatis arthritis and osteoarthritis. During the physical exam, your doctor will check if your joints are swollen, red and stiff. The doctor might also check your reflexes and muscle strength during the examination.
3. Blood tests
A positive test for rheumatoid factor and anti-citrullinated protein antibodies (ACPA) in the blood. Studies have revealed that ACPA is a very sensitive and specific test for the diagnosis of RA. Inflammatory markers like ESR ( erythrocyte sedimentation rate) and CRP (C reactive protein) will help to detect disease activity in the body.
4. Imaging studies
X-ray can be done to take the images of joints which may have been affected by rheumatoid arthritis. The doctor can take a look at these images to assess the level of damage caused to the cartilage, bones and joints. Ultrasound and MRI of joints are useful to detect rheumatoid arthritis very early.
“If we diagnose and treat RA within one year after the onset of symptoms, then patients do very well, and they do not get deformity of joints, and all these patients can lead pretty much normal life” concluded Dr S.C.Mouli.(Courtesy:NDTV)