How is it Diagnosed?
Rheumatoid arthritis (RA) is diagnosed using a combination of clinical findings,
laboratory markers, and imaging studies. It typically presents with symmetrical joint
pain, stiffness (especially in the morning), swelling, and fatigue.
Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies are
specific markers, with anti-CCP offering higher specificity. Elevated ESR and CRP
indicate systemic inflammation.
X-rays of hands, wrists, and feet are done to assess joint space narrowing and bone
erosions. Ultrasound or MRI can detect synovitis and erosions earlier than X-rays,
especially in early or atypical presentations.
Synovial fluid analysis may be performed in cases with joint effusion, revealing
inflammatory changes (elevated WBC count, predominantly neutrophils) but sterile fluid.
Other tests, like CBC, liver/renal function tests, and ANA, help assess comorbidities and
rule out differential diagnoses (e.g., lupus, psoriatic arthritis). Baseline screenings are
also essential before initiating immunosuppressive therapy.
Early diagnosis is vital, as untreated RA can lead to irreversible joint damage and
disability. Multidisciplinary management begins with accurate and timely diagnosis.