How is rheumatoid arthritis diagnosed?

Written by Yang Ya Meng
Rheumatology
Updated on September 28, 2024
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The diagnosis of rheumatoid arthritis primarily relies on blood tests, radiological examinations, and the patient's own symptoms. Rheumatoid arthritis is often referred to as internal rheumatoid arthritis. For a definitive diagnosis: Firstly, the patient must exhibit symmetrical swelling and pain in the joints of both hands, including the small joints. Further screening through blood tests shows elevated erythrocyte sedimentation rate (ESR) and C-reactive protein, which are two inflammatory markers. Additionally, the presence of rheumatoid factors, anti-CCP antibodies, and AKA antibodies being positive also play a role. Simultaneously, if radiological imaging suggests joint space narrowing and bone damage, this further supports the diagnosis of rheumatoid arthritis.

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Written by Li Jing
Rheumatology
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Can people with rheumatoid arthritis donate blood?

Rheumatoid arthritis is a chronic systemic autoimmune disease characterized by symmetrical polyarthritis. It belongs to auto-immune diseases and is not an infectious disease; the cause of which is currently unclear. There is also considerable individual variation in its clinical manifestations. Because it is an autoimmune disease, it cannot be cured. This relates to whether or not one can donate blood: firstly, blood donors must not have any infectious diseases. Secondly, since this disease cannot be cured and patients often need to take regular doses of medications such as methotrexate, leflunomide, and sulfasalazine, there will be a certain concentration of these drugs in the body. If the condition allows and there are no infectious diseases, blood donation may be appropriately considered.

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Written by Yang Ya Meng
Rheumatology
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Rheumatoid Arthritis Diagnostic Criteria

The diagnostic criteria for rheumatoid arthritis include, first, the presence of swelling and pain in multiple joints, especially characterized and significant in the smaller joints. Second, serological tests show elevated levels of antibodies, commonly rheumatoid factor and anti-CCP antibodies. If both are elevated, it is most meaningful. Third, the duration of joint swelling and pain should be more than six weeks. Fourth, we must also check some inflammatory markers for joints, such as elevated erythrocyte sedimentation rate and C-reactive protein. If these markers are elevated, and the patient has swelling and pain in multiple joints, then we can consider a diagnosis of rheumatoid arthritis.

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Written by Yang Ya Meng
Rheumatology
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What should be avoided with rheumatoid arthritis?

Patients with rheumatoid arthritis should avoid the following three categories of food: The first category includes foods that can easily trigger photosensitivity, such as celery, coriander, shiitake mushrooms, seaweed, and leeks; these should be avoided. The second category includes overly warming and tonifying foods, such as dog meat, lamb, and longan; it is best to consume these sparingly. The third category includes high-protein seafood, such as shrimp and crab; these should be consumed in limited quantities because they may exacerbate rheumatoid arthritis symptoms and potentially trigger allergic reactions.

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Written by Li Jing
Rheumatology
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How long will rheumatoid arthritis get better?

Firstly, rheumatoid arthritis is often related to infections, with streptococcal infection being the most common. Some individuals have strong resistance and do not show many clinical symptoms, only presenting signs similar to those of a cold, such as a runny nose and sore throat. These symptoms can generally be relieved on their own after rest and increased water intake. For those with low immunity or immune dysfunction, the occurrence of streptococcal infection often leads to fever, joint pain, and valvular heart disease. Treatment at this stage requires the use of long-acting antibiotics to control the condition. Treatment during the acute phase generally lasts about a month. If the heart is involved and valvular disease occurs, there are often some residual sequelae.

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Written by Yang Ya Meng
Rheumatology
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Will rheumatoid arthritis RF be high?

Patients with rheumatic arthritis generally do not have elevated rheumatoid factor levels, but there may also be a slight, minor increase. Typically, high titers of positive rheumatoid factors are not present. If a patient with rheumatic arthritis has a significant increase in rheumatoid factor, that is, more than three times the normal value, we need to reconsider the diagnosis of rheumatic arthritis. At this point, further tests are required to refine the diagnosis, including ASO (anti-streptolysin O), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), anti-CCP antibody, and anti-AK antibody, to better determine whether the condition is rheumatic arthritis or rheumatoid arthritis.