Rheumatoid arthritis - Diagnosis (2024)

Rheumatoid arthritis can be difficult to diagnose because many conditions cause joint stiffness and inflammation and there's no definitive test for the condition.

See a GP if you have these symptoms so they can try to determine the cause.

Seeing a GP

A GP willdo a physical examination, checking your joints for any swelling and to assess how easily they move. The GP will also ask you about your symptoms.

It's important to tell the GP about allyour symptoms, not just ones you think are important, as this will helpthemmake the correct diagnosis.

If the GP thinks you have rheumatoid arthritis,they'll refer you to a specialist (rheumatologist).

Blood tests

The GP may arrange blood tests to help confirm the diagnosis.

No blood test can definitively prove or rule out a diagnosis of rheumatoid arthritis, but several tests can show indications of the condition.

Some of the main blood tests used include:

  • erythrocyte sedimentation rate (ESR) – which can help assess levels of inflammation in the body
  • C-reactive protein (CRP) – another test that can help measure inflammation levels
  • full blood count – this test can be used to help rule out other possible causes of your symptoms as well as provide an indicator of your general health

The full blood count test can also be used to check if you have anaemia. Anaemia means the blood is unable to carry enough oxygen because of a lack of blood cells.

Anaemia is common in people with rheumatoid arthritis, although having anaemia does not prove you have rheumatoid arthritis.

Rheumatoid factor and anti-CCP antibodies

One blood test measures levels of rheumatoid factors in the blood. Rheumatoid factors are proteins that the immune system produces when it attacks healthy tissue.

More than half of all people with rheumatoid arthritis have high levels of rheumatoid factors in their blood when the disease starts, but about 1 in 20 people without rheumatoid arthritis also test positive.

A related blood test known as anti-cyclic citrullinated peptide (anti-CCP) test is also available. Anti-CCPs are antibodies also produced by the immune system.

People who test positive for anti-CCP are very likely to develop rheumatoid arthritis, but not everybody with rheumatoid arthritis has this antibody.

Those who test positive for both rheumatoid factor and anti-CCP may be more likely to have severe rheumatoid arthritis requiring higher levels of treatment.

Joint scans

Scans may be done to check for joint inflammation and damage.

These can help tell the difference between types of arthritisand can be used to monitor howyour condition is progressing over time.

Scans that may be done to diagnose and monitor rheumatoid arthritis include:

  • X-rays
  • MRI scans(where strong magnetic fields and radio waves are used to produce detailed images of your joints)

Assessing your physical ability

If you have been diagnosed with rheumatoid arthritis, your specialist will do an assessment to see how well you're coping with everyday tasks.

You may be asked to fill in a questionnaire on how well you can do things like dress, walk and eat, and how good your grip strength is.

This assessment may be repeated after your treatment, to see if you have made any improvements.

Further information

Page last reviewed: 08 March 2023
Next review due: 08 March 2026

Rheumatoid arthritis - Diagnosis (2024)

FAQs

How is rheumatoid arthritis diagnosed clinically? ›

Physical exam: The doctor will check your joints for swelling, tenderness, and range of motion. RA tends to strike several joints. Antibody blood tests: Doctors look for certain proteins that show up in your blood when you have RA. These proteins mistakenly target healthy cells and kick off the inflammation process.

What are the 7 diagnostic criteria for rheumatoid arthritis? ›

The new criteria are as follows: 1) morning stiffness in and around joints lasting at least 1 hour before maximal improvement; 2) soft tissue swelling (arthritis) of 3 or more joint areas observed by a physician; 3) swelling (arthritis) of the proximal interphalangeal, metacarpophalangeal, or wrist joints; 4) symmetric ...

What's the worst that can happen with rheumatoid arthritis? ›

Complications of Rheumatoid Arthritis

This can also lead to problems such as depression and anxiety. RA can also affect many nonjoint parts of the body, such as the lungs, heart, skin, nerves, muscles, blood vessels, and kidneys. These complications can lead to severe illness and even death.

What are positive tests for rheumatoid arthritis? ›

What Abnormal Results Mean. An abnormal result means the test is positive, which means a higher level of RF has been detected in your blood. Many people with rheumatoid arthritis or Sjögren syndrome have positive RF tests. The higher the level, the more likely one of these conditions is present.

What mimics rheumatoid arthritis? ›

Conditions That Can Look Like RA
  • Lyme Disease.
  • Psoriatic Arthritis.
  • Sjögren's Syndrome.
  • Gout.
  • Fibromyalgia.
  • Lupus.
Sep 4, 2022

How can a doctor tell if you have rheumatoid arthritis? ›

Doctors diagnose RA by:
  1. Taking a medical history.
  2. Performing a physical exam.
  3. Ordering laboratory tests.
  4. Ordering imaging studies, such as x-rays or ultrasound.

What does an RA flare feel like? ›

A person with RA may feel intense pain in their joints during flares. This can feel like sustained pressure, a burning sensation, or a sharp pain. However, people with RA may also experience periods of remission when they feel few to no symptoms. In addition to causing joint pain, RA can affect the whole body.

What are usually the first signs of rheumatoid arthritis? ›

Early signs of rheumatoid arthritis include tenderness or pain in small joints like those in your fingers or toes. Or you might notice pain in a larger joint like your knee or shoulder.

What is the gold standard test for rheumatoid arthritis? ›

CCP antibodies test

An anti-CCP antibody test — also called an ACCP test or CCP-test — looks for the presence of these antibodies to help confirm rheumatoid arthritis. An anti-CCP test can also help doctors determine the severity of a rheumatoid arthritis case.

What is a red flag of rheumatoid arthritis? ›

Visibly swollen and tender joints can be a common sign. “It is a good idea to monitor which of your joints are affected by pain, stiffness, and/or swelling, as these may change from day to day and may increase over time, especially if your disease is undertreated,” said Dr.

What foods are bad for rheumatoid arthritis? ›

Foods You Should Avoid with Rheumatoid Arthritis
  • Grilled, broiled, or fried meats (and other fried foods). ...
  • Fatty foods full of omega-6 fatty acids. ...
  • Sugars and refined carbohydrates. ...
  • Gluten. ...
  • Preservatives and flavor enhancers. ...
  • Alcohol.
Sep 26, 2018

What is the life expectancy of a person with rheumatoid arthritis? ›

Nevertheless, with the right treatment, many people can live past the age of 80 or even 90 years while experiencing relatively mild symptoms and only minor limitations on day-to-day life.

What confirms rheumatoid arthritis? ›

Joint scans

Scans that may be done to diagnose and monitor rheumatoid arthritis include: X-rays. MRI scans (where strong magnetic fields and radio waves are used to produce detailed images of your joints)

What not to do with rheumatoid arthritis? ›

6 Rheumatoid Arthritis Mistakes to Avoid
  • Not Seeing a Rheumatologist.
  • Too Much Couch Time.
  • Canceling Doctor Appointments.
  • Not Taking All Your Medications.
  • Skipping Medication When You Feel Good.
  • Overlooking Your Mood.
Jan 20, 2022

What is the best diagnostic indicator of rheumatoid arthritis? ›

Blood tests

People with rheumatoid arthritis often have an elevated erythrocyte sedimentation rate (ESR, also known as sed rate) or C-reactive protein (CRP) level, which may indicate the presence of an inflammatory process in the body.

How do they do the RA test? ›

The RA latex turbid procedure

A doctor will take a blood sample from the person's vein, which they send to a lab for testing. They may take more than one blood sample if they will be performing other tests. Technicians at a lab will test the blood using a small latex bead with an RF-specific antibody attached to it.

Does rheumatoid arthritis show up on MRI? ›

An MRI is a good scan for diagnosing rheumatoid arthritis due to its sensitivity in detecting even early and subtle changes in joints and surrounding tissues. An MRI helps in developing a treatment plan by providing detailed insights into joint damage and inflammation, guiding personalized and effective therapy.

What is the best way to describe rheumatoid arthritis? ›

Rheumatoid arthritis, or RA, is an autoimmune and inflammatory disease, which means that your immune system attacks healthy cells in your body by mistake, causing inflammation (painful swelling) in the affected parts of the body.

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