How Do You diagnose rheumatoid arthritis?

Rheumatoid arthritis (RA) is a progressive, systemic, autoimmune disease that causes joint inflammation. At the beginning, to be involved mainly small joints such as hands, wrists and feet more than large joints. Since this is a systemic disease RA can have significant damage to internal organs such areas as the lungs, skin, blood-producing organs, heart and eyes.

More than 2 million Americans are affected by RA.

It is crucial for the diagnosis of RA to make, as soon as possible to prevent damage to both joints and internal organs.

The traditional criteria for establishing the diagnosis of rheumatoid arthritis are the American College of Rheumatology criteria:

1st Morning stiffness in and around joints, at least I hour maximum before the improvement.

2nd Arthritis of 3 or more joint areas simultaneously with soft tissue swelling from a doctor. The possible areas include the fingers, ankles, wrsits, elbows, ankles, knees and feet.

3rd Arthritis, the wrists with at least 1 area in a swollen wrist, ankle or a finger.

4th Symmetric arthritis with simultaneous involvement of the same joint areas on both sides of the body (bilateral involvement of the fingers, ankles or feet acceptable without absolute symmetry.

5th Rheumatoid nodules: Subcutaneous nodules over bony prominences or extensor surfaces or in the vicinity of joints, seen by a doctor.

6th Serum rheumatoid factors: Abnormal amounts of serum rheumatoid factor by any method, for which the result is positive in less than 5 percent of the control group.

7th Radiographic (X-) changes: typical of rheumatoid arthritis on radiographs of the hands, wrists. Do erosion or demineralization in or near affected joints are.

For purposes of classification, a patient must meet at least 4 of the 7 criteria. Criteria 1 to 4 must be present for at least 6 weeks. Patients with 2 clinical diagnoses are not excluded. While these criteria for standardization purposes, research, to be implemented to ensure consistency in policy, they are not intended to necessarily be rigidly followed in a clinic setting.

More recently, the use of assays such as the anti-cyclic citrullinated peptide (anti-CCP) assay, a specific method for identifying patients whose symptoms of arthritis, RA will be made available.

In a recently published study found Japanese researchers discovered that the “combination of a positive rheumatoid factor, C-reactive protein, swollen joints increased and a positive anti-CCP was highly specific and precise, it is easy to use for doctors and so positive for patients “(Yamane T, et al. Journal of Rheumatology, January 2008).

As a practicing rheumatologist, I find this book to be that useful, that confirms what many of us here in the United States have also found to be true. The diagnosis of RA, by all means is not necessarily easy.

But the diagnosis is crucial for the initiation of aggressive therapy. What is important to remember is that today, what is the diagnosis of rheumatoid arthritis is not necessarily a bad thing for a patient. Newer biologic drugs have the “placing of a patient not in remission” more than a likely scenario.

The data from the Japanese study supports a simple but direct method for the diagnosis quickly.