Blood Test For Rheumatoid Arthritis

How To Test For Rheumatoid Factor

Testing for rheumatoid factor is done through a blood test. The blood is drawn then analyzed for the presence of this particular protein. If the results show a certain level of rheumatoid factor, then the test is said to be positive. Rheumatoid factor tests can also detect lower levels of rheumatoid factor, but the test result is not considered positive unless it crosses that threshold.

Diagnosis Of Rheumatoid Arthritis

• Ordering laboratory tests.
• Ordering imaging studies, such as x-rays or ultrasound.

It can be difficult to diagnose rheumatoid arthritis when it is in the early stages because:

• The disease develops over time, and only a few symptoms may be present in the early stages.
• There is no single test for the disease.
• Symptoms differ from person to person.
• Symptoms can be similar to those of other types of arthritis and joint conditions.

As a result, doctors use a variety of tools to diagnose the disease and to rule out other conditions.

What To Expect During The Tests

You usually do not need to do anything before a blood test for RA, fasting is not required. Tell your healthcare provider if you are taking any prescription or over-the-counter medications that may affect your tests.

Wear a garment that allows access to your elbow area for the blood draw. Bring your identification. The healthcare professional drawing the blood will ensure your identification and label the blood draw sample tubes.

A tourniquet will be placed on your arm, the vein area sanitized, and a needle will be used to collect the blood into one or more vials.

After drawing the blood, the site will be bandaged. You should not have any side effects and usually do not need to take any precautions after the test.

These tests are sent to the lab rather than being done in the clinic as a rapid test. Your results will not be available immediately but will be reported to your healthcare provider in hours to a day or more.

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Impact Compared To Existing Technology

There is currently no evidence to support the use of RF or ACPA as diagnostic tests for RA in primary care. ACPA and RF are not useful in patients with a low pre-test probability of RA . In patients with a moderate pre-test probability the effect of a positive ACPA test is better than a positive RF. In patients with a high pre-test probability of RA, either test will perform well. Since both tests have poor sensitivities, negative results should not deter the clinician from a diagnosis of RA.8

One study investigated the outcome of a positive RF or ACPA in patients before the onset of RA symptoms.9 Out of 79 RA patients, 39 had RF and/or ACPA on at least one occasion before symptom onset. Analysis of the RF status in known RA cases showed a positive predictive value of developing RA, 05 years before the onset of symptoms, of 88%. In contrast, the PPV was 97% with an initial positive ACPA result. But in healthy individuals, a positive RF test resulted in a 1.5% risk of developing RA in the subsequent 5 years, whereas a positive ACPA test had a 5.3% risk of developing RA.

Measures To Reduce Bone Loss

Inflammatory conditions such as rheumatoid arthritis can cause bone loss, which can lead to osteoporosis. The use of prednisone further increases the risk of bone loss, especially in postmenopausal women.

You can do the following to help minimize the bone loss associated with steroid therapy:

• Use the lowest possible dose of glucocorticoids for the shortest possible time, when possible, to minimize bone loss.
• Get an adequate amount of calcium and vitamin D, either in the diet or by taking supplements.
• Use medications that can reduce bone loss, including that which is caused by glucocorticoids.
• Control rheumatoid arthritis itself with appropriate medications prescribed by your doctor.

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Getting Tested For Rheumatoid Arthritis

Testing for rheumatoid arthritis is ordered by a doctor or specialist if indicated by a patients symptoms. Blood and urine samples used for testing can be obtained in a doctors office or other medical setting.

Synovial fluid is a liquid that is located in spaces between a persons joints, helping to cushion ends of bones and reduce friction during movement. For a synovial fluid analysis, a sample of synovial fluid is obtained during a procedure called a joint aspiration or arthrocentesis. During a joint aspiration, a doctor uses a needle to withdraw a sample of synovial fluid from a joint.

Getting A Referral For A Diagnosis

If your GP suspects you have RA or another inflammatory health condition, they will usually refer you to a specialist rheumatologist for a proper diagnosis. GPs dont have access to the specialist diagnostic tests and equipment that rheumatologists have, so the first step to getting a formal diagnosis for RA is usually through a referral from your GP.

However, if you are experiencing symptoms of RA and want to get a fast and accurate diagnosis of your condition, it can help to book a private consultation directly with a qualified rheumatologist. While there isnt one definitive test that will confirm you have RA, your specialist rheumatologist will conduct a series of diagnostic tests, including blood tests, to either rule out or confirm RA.

Many other inflammatory health conditions can mimic RA symptoms, so having a comprehensive set of diagnostic tests will help clarify the cause of your symptoms and lead to the most appropriate short and long-term treatment plan to help manage your condition.

There are six most commonly used blood tests to help rheumatologists diagnose RA. These are:

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What Imaging Techniques May Be Used To Diagnose Arthritis

Imaging techniques may give your healthcare provider a clearer picture of what is happening to your joint. Imaging techniques may include the following:

• X-ray. X-rays may show joint changes and bone damage found in some types of arthritis. Other imaging tests may also be done.

• Ultrasound. Ultrasound uses sound waves to see the quality of synovial tissue, tendons, ligaments, and bones.

• Magnetic resonance imaging . MRI images are more detailed than X-rays. They may show damage to joints, including muscles, ligaments, and cartilage.

• Arthroscopy. This procedure uses a thin tube containing a light and camera to look inside the joint. The arthroscope is inserted into the joint through a small incision. Images of the inside of the joint are projected onto a screen. It is used to evaluate any degenerative and/or arthritic changes in the joint to detect bone diseases and tumors to determine the cause of bone pain and inflammation, and to treat certain conditions.

Who Should Get Testing

Patients who experience inflammation, pain, or loss of mobility in joints should discuss testing for rheumatoid arthritis with their doctor, especially if symptoms occur in multiple joints or in matching joints on both sides of the body, such as both wrists. Other symptoms of rheumatoid arthritis include:

• Stiffness in the morning for 30 minutes or longer
• Dry eyes and mouth
• Firm lumps beneath the skin

These symptoms are often due to something other than RA when they last less than six weeks. The longer a patient experiences symptoms, the more likely the symptoms are to be due to RA.

Diagnosing rheumatoid arthritis in its early stages can be challenging, as patients may experience few symptoms, but early diagnosis is important because early treatment may prevent joints from worsening or at least slow the process. When symptoms are present, they often differ from person to person and mimic the symptoms of other diseases. Testing is an important part of the process of determining whether symptoms are due to RA or another condition.

After receiving a diagnosis of RA, its important for patients to continue rheumatoid arthritis testing. Testing can assist doctors in assessing the severity of RA, as well as monitoring the efficacy of treatment, tracking disease progression, and detecting potentially serious side effects of treatment drugs.

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What Causes Rheumatoid Factor

It is not exactly known what causes rheumatoid factor to develop in the blood. However, it is thought to be a combination of genetics and other external risk factors. The uncertainty may be because certain people have low levels of rheumatoid factor, which may not ever be enough to trigger a significant autoimmune response.

On the other hand, people who have high levels of rheumatoid factor may go on to develop autoimmune disorders like rheumatoid arthritis, while others with elevated rheumatoid factor may not develop an autoimmune disorder. It isnt completely known what triggers the autoimmune response that causes rheumatoid arthritis.

Erythrocyte Sedimentation Rate Test

An erythrocyte sedimentation rate test evaluates how much inflammation is present in your body. The test measures how quickly your red blood cells, called erythrocytes, separate from your other blood cells in a lab when they are treated with a substance that prevents clotting.

Red blood cells clump together when theres inflammation in your body, making them separate from your other blood cells much faster. Low ESR levels indicate low levels of inflammation while high ESR results indicate high levels of inflammation.

Doctors use this test to diagnose rheumatoid arthritis because this condition causes inflammation throughout your body. An ESR test on its own, however, is not enough to diagnose rheumatoid arthritis.

Inflammation and a rise in ESR levels can be caused by other chronic conditions, and by infections or injuries. However, your ESR rate can help point doctors in the right direction. For example, very elevated ESR levels would likely indicate an infection and not rheumatoid arthritis.

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The Role Of Blood Tests

Blood tests dont provide a simple yes-or-no answer to whether you have RA. But they can help your doctor steer toward a diagnosis. Blood tests narrow down options and suggest how your disease might progress.

After you receive a diagnosis of RA, continued blood tests will monitor the side effects of drugs used in treatment. They can also help track the progression of the disorder.

Liver Enzyme Tests Sgot Sgpt Bilirubin Alkalin

These tests measure the amount of liver damage. Certain medications used in the treatment of arthritis can damage the liver. Aspirin, for example, has been known in rare instances to damage the liver especially in children or in people who have had previous liver damage. Other NSAIDs can cause liver inflammation . Methotrexate can cause liver damage especially in people who drink alcohol.

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What Are The Goals Of Treating Rheumatoid Arthritis

The most important goal of treating rheumatoid arthritis is to reduce joint pain and swelling. Doing so should help maintain or improve joint function. The long-term goal of treatment is to slow or stop joint damage. Controlling joint inflammation reduces your pain and improves your quality of life.

What Vitamin Helps With Arthritis

Top 4 Supplements to Treat Arthritis Pain

• Curcumin Evidence suggests the turmeric root has anti-inflammatory properties.
• Vitamin D. If you have arthritis pain or are at high risk for arthritis, your doctor may recommend a vitamin D supplement.
• Omega-3 fatty acids.
• Glucosamine and chondroitin sulfate.

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Seronegative Ra Has Become More Common In Recent Years

According to CreakyJoints, a support, education, advocacy, and research organization for people living with arthritis and rheumatic disease, the majority of rheumatoid arthritis patients are seropositive. But while youre far less likely to be diagnosed with the seronegative type of the disease, those numbers are on the rise, according to a study published in the March 2020 issue of Annals of the Rheumatic Diseases. Between 1985 and 1994, only 12 out of 10,000 people with RA were seronegative. Between 2005 and 2014, that number crept up to 20 out of 10,000.

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Joint Stiffness And Deformity

People with RA may have difficulty properly using or bending their joints. If you have RA, you may experience joint stiffness upon waking up or after sitting for long periods of time. RA-related joint stiffness typically lasts for longer than 30 minutes, and it can take several hours to gain a full range of motion.

If RA goes untreated, you may experience cartilage or bone damage, which can eventually lead to joint deformities. Following your treatment plan and doing flexibility exercises can help prevent joint issues from worsening.

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Rheumatoid Arthritis Blood Tests

The rheumatoid arthritis blood tests that doctors perform to help diagnose the disease include:

• Rheumatoid factor
• C-Reactive Protein
• Antinuclear Antibody

None of these tests can singularly conclude that a patient has rheumatoid arthritis. Rather, doctors look at the combined results from all, alongside a number of other criteria including physical symptoms and genetics, in order to reach a rheumatoid arthritis diagnosis.

Symptoms Of Seronegative Rheumatoid Arthritis

Seronegative rheumatoid arthritis patients must possess a distinct set of symptoms in order to be diagnosed. This is because the lack of antibodies in the blood makes it more difficult to reach a rheumatoid arthritis diagnosis.

Some of the most important symptoms in diagnosing seronegative rheumatoid arthritis include:

• Joint pain, stiffness specifically in the hands but also in knees, elbows, hips, feet and ankles
• Joint swelling and redness
• Morning stiffness lasting longer than 30 minutes

Though this is not an exhaustive list, the majority of these will support a rheumatoid arthritis diagnosis. If we compare these symptoms to seropositive rheumatoid arthritis symptoms, there are many similarities. However, many patients see these symptoms evolve and change over time.

It is thought that seropositive patients experience a more severe disease course than seronegative patients. But studies have also shown that in some patient cases, the progression is comparable and sometimes is there is little difference. This is where it becomes complicated in trying to classify rheumatoid arthritis into sub-types and to reach a solid diagnosis.

There are some symptoms that are thought to be rheumatoid arthritis in seronegative patients, but later turn out to be other conditions. These cases mainly involve differences in the types of joints and areas affected as well as the levels of inflammation.

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If Youre Having Inflammatory Arthritis Symptoms Your Doctor Will Likely Test Your Blood For The Presence Of Rheumatoid Factor Heres What The Results Mean

Blood tests are usually an important part of the workup for diagnosing inflammatory arthritis and other autoimmune diseases, but its not common that a single blood test can clinch a diagnosis. Certain blood tests detect the presence of antibodies or proteins, which can signal that your immune system is in overdrive or attacking itself. Others measure levels of inflammation in the body, which can help your doctor monitor how controlled your disease is over time.

But blood tests have their limitations, so its important to know what any given test can and cant tell you, as well as what the numbers actually mean. Heres what you need to know about getting a blood test for rheumatoid factor.

Whats The Age Of Onset For Rheumatoid Arthritis

RA usually starts to develop between the ages of 30 and 60. But anyone can develop rheumatoid arthritis. In children and young adults usually between the ages of 16 and 40 its called young-onset rheumatoid arthritis . In people who develop symptoms after they turn 60, its called later-onset rheumatoid arthritis .

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How Is Rheumatoid Arthritis Diagnosed

Your healthcare provider may refer you to a physician who specializes in arthritis . Rheumatologists diagnose people with rheumatoid arthritis based on a combination of several factors. Theyll do a physical exam and ask you about your medical history and symptoms. Your rheumatologist will order blood tests and imaging tests.

The blood tests look for inflammation and blood proteins that are signs of rheumatoid arthritis. These may include:

• Erythrocyte sedimentation rate or sed rate confirms inflammation in your joints.
• C-reactive protein .
• About 80% of people with RA test positive for rheumatoid factor .
• About 60% to 70% of people living with rheumatoid arthritis have antibodies to cyclic citrullinated peptides .

Your rheumatologist may order imaging tests to look for signs that your joints are wearing away. Rheumatoid arthritis can cause the ends of the bones within your joints to wear down. The imaging tests may include:

In some cases, your provider may watch how you do over time before making a definitive diagnosis of rheumatoid arthritis.

Why Is Measuring The Progression Of Ra Important

The main feature of RA is persistent joint inflammation that affects joints on both sides of the body equally . The severity of RA will change over time. For people with untreated or undertreated RA, it is a progressive condition that eventually leads to some degree of joint destruction and a significant decline in function.

People with RA might report struggles with performing activities of daily living, such as walking, standing, getting dressed, caring for themselves, and any activity that involves the use of the hands.

Fortunately, the last few decades have seen drastic improvements in the treatment of RA, with disease remission becoming a reality for many. To reach these goals, healthcare providers need to measure disease activity. Research shows monitoring the condition is the best way to improve treatment outcomes.

There are different methods for this, including disease activity scoring and the Vectra blood test.

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