A thorough physical examination is one of the first and most important rheumatoid arthritis diagnostic tests done by the rheumatologist. The doctor will carefully feel and examine the joints to check for tenderness, swelling, warmth or redness. Signs such as scaly nodules under the skin or a rheumatoid rash can indicate rheumatoid arthritis. The extent and location of joint involvement is also noted. Other exams like checking range of motion and assessing muscle strength help determine disease progression and disability. Comprehensive exams aid in distinguishing rheumatoid arthritis from other joint disorders.

Laboratory Tests For Confirming RA

Several laboratory tests are used to help confirm a rheumatoid arthritis diagnosis. A complete blood count checks for anemia while an erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) test shows inflammation levels in the body. Rheumatoid factor (RF) is an antibody that is present in around 80% of people with rheumatoid arthritis. However, a negative RF result does not rule out the condition as some patients may not produce this factor. Antibodies to cyclic citrullinated peptide (anti-CCP) have a higher specificity for rheumatoid arthritis compared to RF. Anti-CCP antibodies are detectable even before clinical symptoms appear, increasing their diagnostic usefulness.

X-Rays Assess Joint Damage

Plain x-rays of the hands, wrists, feet and certain other joints help identify early rheumatoid arthritis diagnostic signs like soft tissue swelling, bone erosion or joint space narrowing. Patients typically undergo initial x-rays followed by repeat imaging over time to monitor disease progression and treatment effectiveness. X-rays remain an important part of longterm management by quantifying structural damage changes. While x-rays do not detect early inflammation, they indicate where erosion has already occurred in the joints permanently affected by rheumatoid arthritis.

MRI For Detecting Inflammation

MRI (magnetic resonance imaging) plays a key role in rheumatoid arthritis diagnosis by detecting inflammation in the joints even prior to the onset of symptoms. As it does not use ionizing radiation like x-rays, MRI can safely be performed serially to observe disease activity fluctuations. The technique allows doctors to visualize soft tissues like tendons, ligaments and bone marrow edema in great detail. Any abnormal signals showing synovitis (swelling of the synovial membrane) support an active inflammatory process consistent with rheumatoid arthritis. MRIs are superior for diagnosing early inflammatory arthritis compared to regular x-rays which only detect later stage structural damage.

Joint Ultrasound and Bone Scans

Joint ultrasounds performed by a rheumatologist also effectively identify subtle signs of inflammation like synovial thickening, fluid accumulation and developing erosions. Moreover, it is a convenient technique for examining multiple joints during a single session. Bone scans using radioactive tracer substances highlight areas of abnormal new bone formation signifying sites of active rheumatoid arthritis. While not as commonly used anymore, bone scans provide a whole body overview to detect involvement of joints other than those obviously affected. Together, these imaging tests better establish a rheumatoid arthritis diagnosis compared to relying solely on clinical exams and bloodwork.

In Summary, the purpose of this article is to summarize the main diagnostic tests that are typically performed to confirm a rheumatoid arthritis diagnosis. A combination of comprehensive physical exams, blood tests, imaging procedures and careful monitoring over time help doctors accurately diagnose and monitor this chronic autoimmune condition which attacks the joints. Prompt diagnosis through these rheumatoid arthritis diagnostic tests allows appropriate treatment to be initiated as soon as possible, potentially preventing irreversible joint damage from occurring.