How is rheumatoid arthritis diagnosed?

Written by Yang Ya Meng

Rheumatology

Updated on February 10, 2025

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Rheumatoid arthritis examinations include blood tests and imaging studies.

The blood tests include complete blood count, erythrocyte sedimentation rate, rheumatoid factor, C-reactive protein, anti-streptococcal antibodies, ANA, anti-CCP antibodies, and anti-AKA antibodies.

Imaging studies involve X-ray examinations of the hand joints. If the patient has significant increases in erythrocyte sedimentation rate and C-reactive protein, positive CCP and AKA antibodies, and the X-rays show bone destruction, then rheumatoid arthritis can be considered as a diagnosis.

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The difference between osteoarthritis and rheumatoid arthritis

The so-called osteoarthritis often occurs as the patient ages, featuring localized bone hyperplasia and degenerative changes, leading to the destruction of cartilage. This results in congested and swollen synovium, manifesting as clear local symptoms of swelling and pain. Rheumatoid arthritis, on the other hand, mainly occurs due to a streptococcal infection, causing localized pain and swelling, thus forming rheumatoid arthritis. This is the difference between the two. There are also differences in treatment. Early osteoarthritis can be treated with oral non-steroidal anti-inflammatory and analgesic drugs, as well as medications that nourish the cartilage. For rheumatoid arthritis, symptomatic treatment is often necessary, and active anti-rheumatic treatment can be completely effective.

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Is rheumatoid arthritis serious?

Patients with rheumatoid arthritis, if treated reasonably and formally, can achieve clinical remission, so in this sense, rheumatoid arthritis is not severe. However, if patients do not adhere to formal treatment for a long time, after a long period, they may develop joint deformities and ankylosis, resulting in disability. From this perspective, rheumatoid arthritis should be taken seriously. Commonly used drugs for treating rheumatoid arthritis include anti-inflammatory pain relievers, with non-steroidal pain relievers being the most commonly used, such as sustained-release diclofenac sodium tablets. The most important step in treating rheumatoid arthritis is the selection of immunosuppressants, with common immunosuppressants including methotrexate and leflunomide. (Medication should be used under the guidance of a doctor based on specific circumstances.)

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Written by Li Jie

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The difference between osteoarthritis and rheumatoid arthritis

In everyday life, many patients confuse osteoarthritis with rheumatoid arthritis, but these two diseases are indeed very distinct. Generally speaking, osteoarthritis is mostly caused by hyperplastic arthritis due to trauma or, in some cases, osteoarthritis resulting from overuse, The characteristic of osteoarthritic pain is that it is related to activity. The more a joint affected by arthritis moves, and the greater the overuse, the more severe the pain becomes. When resting, the pain in that joint will decrease, However, rheumatoid arthritis is different and has clear distinctions from osteoarthritis. Rheumatoid arthritis typically affects the small joints of the limbs, usually occurs symmetrically, and rarely affects only one limb. Once it occurs, it generally affects other parts too, appearing in both hands or both feet. These small joints are usually the first to be affected, with symptoms presenting symmetrically, and there is significant morning stiffness; that is, joints are stiff in the morning, Furthermore, rheumatoid arthritis can cause pain at rest or pain during inactivity, and nocturnal pain does not necessarily correlate with activity. Sometimes, pain may intensify after rest or during the night, and sometimes, physical activity may actually alleviate the pain. Thus, this symptom is a primary distinguishing feature from osteoarthritis. Understanding these points, the differences between osteoarthritis and rheumatoid arthritis can basically be mastered.

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Written by Yang Ya Meng

Rheumatology

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Characteristics of rheumatoid arthritis in the hand

The key hand features of rheumatoid arthritis primarily manifest as symmetrical joint swelling and pain in both hands in the early stages. These swollen and painful joints include both wrist joints, bilateral metacarpophalangeal joints, and bilateral proximal interphalangeal joints. Rheumatoid arthritis rarely affects the distal interphalangeal joints of the hands. In the later stages of rheumatoid arthritis, due to the destruction of the hand joints by synovitis, some patients may develop deformities in the hand joints, commonly including ulnar deviation, swan neck deformities, or boutonniere deformities. Some patients may experience significant stiffness leading to limited mobility of the hand joints.

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Can people with rheumatoid arthritis have children?

Rheumatoid arthritis is a systemic autoimmune disease primarily affecting multiple joints throughout the body and cannot be completely cured. Research by experts has linked it to genetic and environmental factors. Therefore, patients with rheumatoid arthritis can have children, but this depends on whether their condition is in a stable phase. If the condition is active and medication is being used, then it is not advisable to become pregnant at this time. Decisions about having children should be made in consultation with your specialist, or your primary care physician, under their guidance and advice. Firstly, the condition should be stable and the medication reduced to the minimum. Additionally, during pregnancy, it is essential to monitor the side effects of the medication.