How is rheumatoid arthritis diagnosed?

Written by Yang Ya Meng
Rheumatology
Updated on September 28, 2024
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The diagnosis of rheumatoid arthritis primarily relies on blood tests, radiological examinations, and the patient's own symptoms. Rheumatoid arthritis is often referred to as internal rheumatoid arthritis. For a definitive diagnosis: Firstly, the patient must exhibit symmetrical swelling and pain in the joints of both hands, including the small joints. Further screening through blood tests shows elevated erythrocyte sedimentation rate (ESR) and C-reactive protein, which are two inflammatory markers. Additionally, the presence of rheumatoid factors, anti-CCP antibodies, and AKA antibodies being positive also play a role. Simultaneously, if radiological imaging suggests joint space narrowing and bone damage, this further supports the diagnosis of rheumatoid arthritis.

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Written by Yang Ya Meng
Rheumatology
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Rheumatoid Arthritis Diagnostic Criteria

The diagnostic criteria for rheumatoid arthritis include, first, the presence of swelling and pain in multiple joints, especially characterized and significant in the smaller joints. Second, serological tests show elevated levels of antibodies, commonly rheumatoid factor and anti-CCP antibodies. If both are elevated, it is most meaningful. Third, the duration of joint swelling and pain should be more than six weeks. Fourth, we must also check some inflammatory markers for joints, such as elevated erythrocyte sedimentation rate and C-reactive protein. If these markers are elevated, and the patient has swelling and pain in multiple joints, then we can consider a diagnosis of rheumatoid arthritis.

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Written by Yang Ya Meng
Rheumatology
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What should be avoided with rheumatoid arthritis?

Patients with rheumatoid arthritis should avoid the following three categories of food: The first category includes foods that can easily trigger photosensitivity, such as celery, coriander, shiitake mushrooms, seaweed, and leeks; these should be avoided. The second category includes overly warming and tonifying foods, such as dog meat, lamb, and longan; it is best to consume these sparingly. The third category includes high-protein seafood, such as shrimp and crab; these should be consumed in limited quantities because they may exacerbate rheumatoid arthritis symptoms and potentially trigger allergic reactions.

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Written by Wang Cheng Lin
Orthopedics
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The difference between osteoarthritis and rheumatoid arthritis.

Osteoarthritis and rheumatoid arthritis have distinct differences. Osteoarthritis commonly occurs in middle-aged and elderly women and is caused by the wear, degeneration, and rupture of joint cartilage, leading to swelling and pain due to friction during joint movement. On the other hand, rheumatoid arthritis is caused by bacterial infections leading to the proliferation of synovium in the joints, causing swelling and pain. Over time, this condition can damage the joint's cartilage and meniscus, severely affecting joint mobility. The treatments for these two diseases are different. Osteoarthritis can be alleviated through rest, oral medication, and physical therapy to ease local pain. If these methods are ineffective after more than six months, surgical treatment may be necessary, mainly total knee replacement. However, the treatment for rheumatoid arthritis primarily relies on medication to relieve local pain by removing rheumatism. (The use of medication should be under the guidance of a doctor.)

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Written by Yang Ya Meng
Rheumatology
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How long does it take to cure rheumatoid arthritis?

The symptoms of rheumatic arthritis, such as joint swelling and pain, generally improve on their own within about two weeks, with the longest duration not exceeding one month. However, since rheumatic arthritis is triggered by a Streptococcus infection, if the Streptococcus infection is not actively controlled, it is easy for the arthritis to relapse after the joint pain has improved. Therefore, for patients with rheumatic arthritis, it is essential to treat the Streptococcus infection early. Treatment with second-generation cephalosporin antibiotics for 10-14 days is recommended, followed by regular long-acting benzathine penicillin treatment at outpatient clinics to achieve a complete cure of rheumatic arthritis. (Specific medications should be used under the guidance of a doctor.)

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Written by Li Jing
Rheumatology
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Can people with rheumatoid arthritis donate blood?

Rheumatoid arthritis is a chronic systemic autoimmune disease characterized by symmetrical polyarthritis. It belongs to auto-immune diseases and is not an infectious disease; the cause of which is currently unclear. There is also considerable individual variation in its clinical manifestations. Because it is an autoimmune disease, it cannot be cured. This relates to whether or not one can donate blood: firstly, blood donors must not have any infectious diseases. Secondly, since this disease cannot be cured and patients often need to take regular doses of medications such as methotrexate, leflunomide, and sulfasalazine, there will be a certain concentration of these drugs in the body. If the condition allows and there are no infectious diseases, blood donation may be appropriately considered.