How is Rheumatoid Arthritis Diagnosed?
There is no single test to diagnose rheumatoid arthritis. The diagnosis is made from a combination of clinical symptoms and findings, supported by various blood tests such as rheumatoid factor, anti-CCP antibodies and elevated inflammatory markers. However, up to 30% of patients have completely normal blood tests.
Rheumatoid factor is a group of non-specific antibodies that can occur in healthy individuals who will never get rheumatoid arthritis. It can be elevated in many diseases such as hepatitis, chronic infection or other inflammatory diseases. It does not cause rheumatoid arthritis. The level can fluctuate during the course of disease but it does not correlate with disease activity and it does not normalise with treatment. If you have rheumatoid arthritis, it is not necessary to monitor the level regularly.
Anti-CCP antibodies are much more specific for rheumatoid arthritis, and the disease tends to be more destructive if you have this antibody. Similar to rheumatoid factor, the level does not fall or normalise with treatment, and hence it is not necessary to monitor the level regularly.
Inflammatory markers such as ESR and CRP are often elevated during active disease and can be good markers to monitor treatment response. The higher the level, the more active the disease is. However, both are also elevated during acute infection and care must be taken to interpret an elevated reading.
In some patients the blood tests can be normal and the clinical features are subtle. Your rheumatologist may consider further investigations to look for active joint inflammation, such as MRI or a Power Doppler ultrasound study to confirm the presence of active inflammation or erosion.
Joint X-rays are normal in early disease and normal X-rays do not exclude rheumatoid arthritis.
Get the help you deserve - talk to our friendly team today! 1300 252 698
Our Latest Articles
Like most rheumatologists, the doctors at BJC ....
Struggling with fatigue?
By Sarah Comensoli on May 19, 2020
We've had a number of clients reach out to us in the last few weeks expressing that it's more difficult at the moment to get a good handle on their ...BJC Health and Fitness
Restricting medical care to traditional in-clinic consultation is so 20th century!
By Dr Irwin Lim on May 17, 2020
Like most rheumatologists, the doctors at BJC Health have fixed session times at various clinics where we consult. We typically start at 0800 and end ...BJC Connected Care
Feeling more aches and pains?
By Sarah Comensoli on May 10, 2020
We totally appreciate at the moment that some of our clients are experiencing more aches and pains than they’re usually accustomed to, and we get it. ...BJC Health and Fitness
How our Rheumatology service might look after 6 months of the Covid-19 pandemic
By Dr Irwin Lim on April 20, 2020
On the 5th March, our team of BJC Health leaders met in my living room to discuss our plans for the next 10 years. The planning phase had commenced 4 ...BJC Connected Care
Emergency Rheumatology Service for those who can't attend hospital clinics during COVID-19 pandemic
By Dr Irwin Lim on April 14, 2020
Thank you for the kind words and support you’ve provided BJC Health on social media. Our multidisciplinary team is working hard to engage and develop ...BJC Connected Care
How Covid-19 sped up Rheumatology Telehealth delivery
By Dr Irwin Lim on April 7, 2020
It’s been a really challenging time for us at BJC Health as I am sure it has been for all of you. If one good thing has come out of the COVID-19 ...BJC Connected Care
Asked to see a Physio for a Metrology Assessment? Here's what to expect.
By Dominic Fitzgerald on March 11, 2020
If you have recently been diagnosed with Ankylosing Spondylitis (AS) or a Spondyloarthropathy (SpA), some Rheumatologists might look to refer you to ...BJC Health and Fitness
Living with a chronic disease is like living in a cell
By Sarah Comensoli on March 1, 2020
Those words came directly from a client who has recently started working with our allied health team here at the clinic. No-one has ever explained ...BJC Health and Fitness
Struggle with climbing stairs? Here are some tips to make it easier
By Paul Scalise on February 23, 2020
Picture this: You’re up and walking about, doing some shopping – you’re got some large bags, heavy with food for the week. You are done for the day, ...BJC Health and Fitness
Chewing the fat. Is the keto diet the way to go?
By Stephanie Hage on January 27, 2020
Ketosis, bulletproof coffees, keto flu, fat bombs… all buzzwords that you might hear related to the ketogenic (keto) diet. But what exactly is the ...BJC Diet and Nutrition
Game changers: is a plant-based diet the key to good health?
By Stephanie Hage on December 19, 2019
Game Changers - it’s the documentary that everyone is talking about. It seems as though one day I woke up, opened my Instagram account and found ...BJC Diet and Nutrition
The Portfolio Diet...Does it help with inflammation?
By Stephanie Hage on October 23, 2019
As a dietitian, the word “diet” is probably my least favourite word. I appreciate that for many, this single word can bring up past memories of ...BJC Diet and Nutrition
By Stephanie Hage on September 19, 2019
The internet can be both your best friend and worst enemy when it comes to finding information about food. If you have a rheumatic disease such as ...BJC Diet and Nutrition
Are you realllyy eating well?
By Stephanie Hage on August 23, 2019
What does eating well mean to you? It could be: Keeping your blood test results in check Eating adequate serves of food from each of the food ...BJC Diet and Nutrition
Introducing Rheumatology Republic - Join our community!
By Dr Irwin Lim on March 5, 2019
I’m sorry that I’ve been missing from this blog. I was galvanized to start blogging in late 2010 to try and rectify community attitudes to ...BJC Connected Care