The main clinically useful biologic markers in patients with RA include rheumatoid factors (RF), anti-cyclic citrullinated peptide (anti-CCP) antibodies, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).
Anti-cyclic citrullinated peptide antibody (anti-CCP).
This blood test checks for anti-CCP antibodies, which appear in many people with rheumatoid arthritis. In addition, anti-CCP can appear before RA symptoms develop, which can help doctors diagnose the disease early.
Inflammatory markers such as the ESR or C-reactive protein (CRP) are normal in about 60% of patients with early RA. In a patient with preceding osteoarthritis, radiographic changes can be misleading, especially if those suggestive of inflammatory arthritis have not yet developed.
RF is the first well-known RA immunologic marker. It is observed in 80-85% of patients with RA. Elevated serum level of RF has been associated with increased disease activity, radiographic progression, and the presence of extraarticular manifestations. The sensitivity of RF is 50-90%, and specificity is 50-95%.
Anti-CCP antibody test (ACCP or CCP). This test is for a type of autoantibody called cyclic citrullinated peptide (CCP) antibodies, which can be found in the blood of 60% to 80% of people with rheumatoid arthritis. The test is often conducted along with an RF test.
If your GP thinks you have rheumatoid arthritis, they will refer you to a specialist (rheumatologist). Your GP may arrange blood tests to help confirm the diagnosis after conducting a physical examination and consulting your medical history, or they may refer you at the same time as requesting tests.
The normal range of RF is from 0-20 IU/ml. RF above 20 IU/ml is not considered enough to diagnose RA, as there other reasons the RF level may be elevated.
A person with RA may feel intense pain in their joints during flares. This can feel like sustained pressure, a burning sensation, or a sharp pain. However, people with RA may also experience periods of remission when they feel few to no symptoms. In addition to causing joint pain, RA can affect the whole body.
Signs and symptoms of rheumatoid arthritis may include: Tender, warm, swollen joints. Joint stiffness that is usually worse in the mornings and after inactivity. Fatigue, fever and loss of appetite.
The typical case of rheumatoid arthritis begins insidiously, with the slow development of signs and symptoms over weeks to months. Often the patient first notices stiffness in one or more joints, usually accompanied by pain on movement and by tenderness in the joint.
RA causes inflammation. In response, the body releases CRP into the bloodstream. Doctors measure CRP levels as part of the diagnosis and management of RA. While many factors influence a person's CRP levels, and there is no definitive normal range, CRP levels above 10 mg/l suggest substantial inflammation.
RA commonly affects joints in the hands, wrists, and knees. In a joint with RA, the lining of the joint becomes inflamed, causing damage to joint tissue.
The main difference between osteoarthritis and rheumatoid arthritis is the cause behind the joint symptoms. Osteoarthritis is caused by mechanical wear and tear on joints. Rheumatoid arthritis is an autoimmune disease in which the body's own immune system attacks the body's joints. It may begin any time in life.
People describe it as being overwhelming and uncontrollable. They feel worn out and drained of energy, and sometimes even lose all interest in anything. It can increase the need for sleep and make it hard to concentrate or do anything.
Methotrexate is usually the first medicine given for rheumatoid arthritis, often with another DMARD and a short course of steroids (corticosteroids) to relieve any pain. These may be combined with biological treatments.
A positive rheumatoid factor test result indicates that a high level of rheumatoid factor was detected in your blood. A higher level of rheumatoid factor in your blood is closely associated with autoimmune disease, particularly rheumatoid arthritis.
More rarely, rheumatoid arthritis can cause inflammation in the white part (sclera) of your eyes, which can result in redness and pain. If you have rheumatoid arthritis and experience eye pain, vision changes or other eye problems, consult an ophthalmologist for an evaluation.
Pain from these autoimmune diseases can make it difficult for some people to brush or floss their teeth. A study conducted at the Johns Hopkins Arthritis Center found that gum disease and tooth loss are more prevalent in people who have rheumatoid arthritis (RA).
No blood test can definitively prove or rule out a diagnosis of rheumatoid arthritis, but several tests can show indications of the condition. Some of the main blood tests used include: erythrocyte sedimentation rate (ESR) – which can help assess levels of inflammation in the body.
No one test can tell if you have RA or lupus. Instead, your doctor will ask about your symptoms and family history, do a physical exam, and order some lab and imaging tests. During the physical exam, your doctor will feel your joints to see if the swelling feels hard. If it does, it could mean you have osteoarthritis.
A CRP test result of more than 50 mg/dL is generally considered severe elevation. Results over 50 mg/L are associated with acute bacterial infections about 90% of the time.
Rheumatoid arthritis (RA)
When a person has RA, the immune system attacks healthy cells in the body for unknown reasons, causing an inflammatory response. RA commonly affects the hips, knees, ankles, or feet. Therefore, it can cause leg pain.