Rheumatoid Arthritis Diagnosis 

Rheumatoid Arthritis can be difficult to diagnose because it may begin gradually, with few symptoms. Many diseases may behave in a manner similar to rheumatoid arthritis especially in their early stages. Early diagnosis and treatment with prescribed drugs are, however, vital for limiting joint damage. Joint pain, or stiffness or swelling around a joint, that lasts more than two weeks warrants a visit to your general physician (GP) to help arrive at a definitive diagnosis and to plan appropriate treatment.

There is no single test that conclusively establishes a diagnosis of rheumatoid arthritis, especially in its early stages. The diagnosis of Rheumatoid Arthritis is based on the patient’s history and a physical examination. Certain laboratory abnormalities commonly found in rheumatoid arthritis cases may help in establishing a diagnosis. These include the following.

• Positive rheumatoid factor (an antibody found in approximately 80% of patients with rheumatoid arthritis, but in only 30% at the start of the condition)

• Highly specific antibodies called anticyclic citrullinated peptides, which appear ten years prior to the development of clinical disease. If the test is available with your GP, it should be performed before referral to a rheumatologist.

• Anaemia

• An elevated erythrocyte sedimentation rate (ESR)

X-rays can be very helpful in diagnosing RA but these may show normal results in the early stages of the disease.

Rheumatoid Arthritis Treatment

Treatment for Rheumatoid Arthritis has improved greatly in the last few decades. The aim is not only to minimize symptoms, joint damage, and disability, but also to help patients lead a productive and active life.

This is because Rheumatoid Arthritis sufferers need not only medical care, but also physical and emotional support. As per current guidelines, referral to a rheumatologist is recommended as soon as the condition is suspected so that disease-modifying drugs can be prescribed early in the life of the disease.

The British Society of Rheumatology (BSR) standard is for a rheumatologist to see the patient within twelve weeks from the first diagnosis. In the meantime, supportive measures and symptomatic treatment through the administration of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) can be started.

Treatment can take the form of drugs, alleviating stress on the joints, physical and occupational therapy, and surgical intervention.

The drugs most commonly used in the treatment of rheumatoid arthritis are NSAIDs, corticosteroids, and disease modifying anti-rheumatic drugs (DMARDs). Corticosteroids, which are steroids injected into the affected joint, are useful for controlling local inflammation without changing the overall treatment. NSAIDs and low dose steroids are used in the management of less aggressive forms of the disease, while aggressive RA is treated with DMARDs. Methotrexate is now considered the first DMARD of choice in most such cases.

Maintaining an ideal body weight is essential to managing rheumatoid arthritis. It is also imperative for people with RA to remain physically active, while avoiding vigorous activity when the disease flares. A physical or occupational therapist can help determine what level and types of activities are appropriate.

Some patients with rheumatoid arthritis need surgical intervention. This could involve a synovectomy, which is the removal of the damaged synovium, repair of tendons, and the replacement of damaged joints, especially those of the knees or hips.

Living with Rheumatoid Arthritis 

rheumatoid arthritis cannot be prevented, but disease progression can be stopped or slowed by early initiation of treatment.

The diagnosis of a chronic illness like rheumatoid arthritis is an upheaval that may trigger feelings of anxiety, isolation or depression. These psychological and emotional reactions to the illness are normal. So, do discuss them with your GP or health care provider. These reactions will usually improve over time as treatment is initiated, energy levels rise, and symptoms regress.

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