Rheumatoid arthritis is an autoimmune disease that causes inflammation and pain in the joints. Joint damage can occur over time. There is no cure for rheumatoid arthritis, but treatment can relieve symptoms. The first step in planning treatment is a diagnosis of rheumatoid arthritis. No test can confirm the diagnosis of rheumatoid arthritis. However, some blood tests show that rheumatoid arthritis is the likely cause of symptoms.
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Erythrocyte sedimentation rate (ESR) test
Erythrocyte sedimentation rate (ESR) tests assess how much inflammation is present in the body. This test measures how quickly red blood cells, called red blood cells, separate from other blood cells in the laboratory when treated with substances that interfere with clotting. When there is inflammation in the body, red blood cells clump together and separate more quickly from other blood cells. A low ESR value indicates a low level of inflammation and a high ESR result indicates a high level of inflammation. Doctors use this test to diagnose rheumatoid arthritis because the condition causes inflammation throughout the body. However, the ESR test alone is not sufficient to diagnose rheumatoid arthritis.
Inflammation and an increase in her ESR value can be caused by other chronic diseases or infections or injuries. However, the ESR rate can help point your doctor in the right direction. For example, a very high ESR value may indicate an infection rather than rheumatoid arthritis.
C-reactive protein (CRP) test
The C-reactive protein (CRP) test looks at the amount of CRP protein in your bloodstream. CRP is a protein made in the liver. When there is an infection in the body, CRP is released from the liver. CRP helps initiate the immune system’s response to infection. This leads to inflammation throughout the body.
Autoimmune diseases such as rheumatoid arthritis can lead to high levels of her CRP in the bloodstream. A CRP test measures CRP and indicates the presence of inflammation. Like the ESR test, the CRP test alone cannot confirm rheumatoid arthritis. However, your doctor can tell you how much inflammation is present in your body and how active your immune system.
Complete blood count (CBC)
A complete blood count, also called a complete blood count (CBC), evaluates the cells that make up the blood. This includes white blood cells, red blood cells, and platelets. If you are healthy, you can make, release, and regulate the amount of each type of blood cell that your body needs to function.
Rheumatoid arthritis does not usually cause destruction of blood cells, but many medical conditions with similar symptoms do. A blood test with very abnormal results may indicate that rheumatoid arthritis is not the correct diagnosis.
Rheumatoid factor test
Rheumatoid factor is an immune system protein that can attack healthy tissues of the body. A rheumatoid factor test measures the level of rheumatoid factor protein in the bloodstream. High levels of rheumatoid factor often indicate rheumatoid arthritis, Sjogren’s syndrome, and other autoimmune diseases. Results showing high levels help confirm the diagnosis of rheumatoid arthritis.
However, even people without autoimmune diseases may have elevated levels of rheumatoid factor protein, and not all people with rheumatoid arthritis have elevated levels of rheumatoid factor protein.
CCP antibody test
Antibodies against cyclic citrullinated peptides (CCPs) are a class of immune system proteins called auto antibodies. Auto antibodies are abnormal proteins that attack healthy blood cells and tissues. 60-80% of rheumatoid arthritis patients have her CCP antibodies in their blood. The anti-CCP antibody test (also called the ACCP or CCP test) looks for the presence of these antibodies to confirm rheumatoid arthritis.
Anti-CCP testing also helps doctors determine the severity of rheumatoid arthritis. High CCP levels at diagnosis indicate a high risk of rapidly progressive joint damage. Doctors usually do both rheumatoid factors (RF) testing and anti-CCP testing when examining people with suspected rheumatoid arthritis. A positive result from either test indicates an increased risk of RA, and a positive result from both tests increases this risk. However, both tests are negative in up to 50% of her RA patients, and her 20% of RA patients remain negative at follow-up.
Antinuclear antibody (ANA) test
Antinuclear antibodies (ANA) are a type of autoantibody produced by the immune system. They look abnormal and attack healthy tissues and cells. The presence of ANA may indicate an autoimmune disease. The ANA test looks for the presence of ANA and can help confirm a diagnosis of rheumatoid arthritis.
Other diagnostic methods to confirm rheumatoid arthritis
Blood tests are not the only methods available for diagnosing rheumatoid arthritis. Various other tests can also be done to check for rheumatoid arthritis.
Medical checkup: A physical examination helps determine how much the symptoms are affecting daily life. You may be asked how well you do routine tasks such as showering, eating, and dressing. A physical therapist can also assess your grip strength, gait, and balance.
Common scan: Joint scans look for joint inflammation and damage. Helps confirm the diagnosis of rheumatoid arthritis.
Imaging test: X-rays and MRIs create detailed images of bones, muscles, and joints that can help diagnose rheumatoid arthritis.
There is no single test that can confirm rheumatoid arthritis. However, some blood tests can help show that rheumatoid arthritis is the correct diagnosis.
Blood tests look for proteins in the inflammation and immune system that often accompany rheumatoid arthritis. The results of these tests, along with imaging tests and evaluation of symptoms, can be used to diagnose rheumatoid arthritis.
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