Diagnosis of
Rheumatoid Arthritis (RA)
Rheumatoid Arthritis (RA) symptoms may be missed by patients for a long time and ignored as general pain. Even clinically, it can be difficult to diagnose RA in the early stages because initial symptoms are mild and clear changes show up on X-ray or ultrasound only after a few weeks or months of disease commencement.1
Initial assessment2
Thorough physical examination: Rheumatoid nodules may be present in 20% of patients with RA — elbows, heels, and toes. Other features may include the presence of carpal tunnel syndrome, tenosynovitis and finger deformities.
![Initial Assessment](https://goodhealthwecare.org/wp-content/uploads/brizy/imgs/diagnosis-of-ra-1-569x427x0x0x569x427x1611123638.png)
What the doctor is looking for:
![](https://goodhealthwecare.org/wp-content/uploads/brizy/imgs/icon1-1-140x140x0x0x140x140x1611123608.png)
Deformity
![Stiffness](https://goodhealthwecare.org/wp-content/uploads/brizy/imgs/icon2-1-140x140x0x0x140x140x1611123616.png)
Stiffness
![Swelling](https://goodhealthwecare.org/wp-content/uploads/brizy/imgs/icon3-1-140x140x0x0x140x140x1611123608.png)
Swelling
![Decreased range of motion](https://goodhealthwecare.org/wp-content/uploads/brizy/imgs/icon4-1-140x140x0x0x140x140x1611123603.png)
Decreased range of motion
![Inflamed joints](https://goodhealthwecare.org/wp-content/uploads/brizy/imgs/icon5-1-140x140x0x0x140x140x1611123604.png)
Number and duration of inflamed joints
![Tenderness](https://goodhealthwecare.org/wp-content/uploads/brizy/imgs/icon6-1-140x140x0x0x140x140x1611123605.png)
Tenderness of the small joints of the hands, wrists, and knees
Imaging
The criteria for patient identification as given by the American College of Rheumatology3
*These 4 criteria are valid only if they persist for at least 6 weeks
![Morning stiffness](https://goodhealthwecare.org/wp-content/uploads/brizy/imgs/diagnosis-of-ra-3-1-1-258x258x0x0x258x258x1611123624.png)
Morning stiffness
![Arthritis in 3 or more joints](https://goodhealthwecare.org/wp-content/uploads/brizy/imgs/diagnosis-of-ra-3-2-258x258x0x0x258x258x1611123647.png)
Arthritis in 3 or more joints
![Arthritis in the hands](https://goodhealthwecare.org/wp-content/uploads/brizy/imgs/diagnosis-of-ra-3-3-258x258x0x0x258x258x1611123640.png)
Arthritis in the hands
![Symmetrical arthritis](https://goodhealthwecare.org/wp-content/uploads/brizy/imgs/diagnosis-of-ra-3-4-258x258x0x0x258x258x1611123649.png)
Symmetrical arthritis
![Rheumatoid nodules](https://goodhealthwecare.org/wp-content/uploads/brizy/imgs/diagnosis-of-ra-3-5-275x275x0x0x275x275x1611123648.png)
Rheumatoid nodules
![Rheumatoid factor](https://goodhealthwecare.org/wp-content/uploads/brizy/imgs/diagnosis-of-ra-3-6-275x275x0x0x275x275x1611123633.png)
+ve serum rheumatoid factor
![Bony decalcifications](https://goodhealthwecare.org/wp-content/uploads/brizy/imgs/diagnosis-of-ra-3-7-276x276x0x0x276x276x1611123657.png)
Bony decalcifications
Patient has to correspond with at least 4 of these 7 criteria for the diagnosis of rheumatoid arthritis.
References –
- InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Rheumatoid arthritis: Overview. 2013 Oct 23 [Updated 2016 Aug 11]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK384455/.
- Chauhan K, Jandu JS, Al-Dhahir MA. Rheumatoid Arthritis. [Updated 2019 Oct 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441999/.
- Rheumatoid Arthritis. Available from https://www.physio-pedia.com/index.php?title=Rheumatoid_Arthritis&oldid=223690. Accessed on 17 December 2019.