How to Recognize Rheumatoid Arthritis

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General Practitioner examining patients hand

Your finger joints are red, achy and swollen – especially when you first wake-up.

You are completely exhausted and can barely manage to get through your workday.

You’ve lost weight without really trying, and have been fighting off fevers for several months.

Something’s not right.

Could it be rheumatoid arthritis (RA)?

RA is an autoimmune disease that occurs when the body engages in friendly fire against its own joints and tissues. This causes joint pain and inflammation and may lead to problems performing activities of daily living such as cooking, brushing your teeth and getting dressed. Down the road, it can also lead to disability.

Close to 1.5 million people in the United States have RA, and it strikes women nearly three times more often than men.

Joint pain in the mornings, fatigue, weight loss and fevers are all signs of RA, but they’re also symptoms many other disorders.

Is it RA?

There is not one definitive test that will say ‘you have RA.’ Instead, making an RA diagnosis involves some detective work. The process starts with a thorough physical exam. Your doctor will examine your joints to look for warmth and swelling.

Clue: rheumatoid arthritis tends to equally affect joints on both sides of the body. 

Your doctor will ask about your personal and family medical history.  Having a family member with RA increases your changes of having RA.

Clue: If your father had RA, it could help tip the scale towards you developing RA.  Different types of autoimmune diseases may run in the family, so make sure to mention your dad’s psoriasis or your sister's multiple sclerosis (MS). Don’t leave anything or anyone out.

A physical may reveal other signs of RA, such as rheumatoid nodules (firm bumps of tissue under the skin on your arms), dryness of the mouth and eyes, or a low-grade fever.

Next up is likely blood work to get a better picture of what’s going on. These include tests for:

  • Anemia. A low red blood cell count is a symptom of RA.

  • Rheumatoid Factor. This is a dependable blood marker of RA. It’s found in about 80% of people with RA, but is not always present when the RA disease process starts.

  • Antibodies to cyclic citrullinated peptides (anti-CCP). This is another informative marker for RA. It’s seen in up to 70% of people with RA.

  • Elevated erythrocyte sedimentation rate (SED rate). This is a test that measures the overall level of inflammation in your body. It’s not specific to RA, but if you have active RA, your SED rate is likely elevated.

X-rays and other imaging tests can also help identify signs of joint damage. 
Taken together, all of this information will help your doctor make a diagnosis. Diagnosing RA early and starting treatment right away is the best way to preserve function and stave off lasting joint damage.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Aug 3
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