Rheumatoid arthritis - Diagnosis 

Diagnosing rheumatoid arthritis 

Rheumatoid arthritis can be difficult to diagnose because many conditions cause joint stiffness and inflammation and there is no definitive test for the condition.

You should see your GP if you have these symptoms so they can try to determine the cause.

Seeing your GP

Your GP will carry out a physical examination, checking your joints for any swelling and to assess how easily they move. Your GP will also ask you about your symptoms.

It is important to tell your GP about all your symptoms, not just ones you think are important, as this will help the doctor make the correct diagnosis.

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.

Blood tests

No blood test can definitively prove or rule out a diagnosis of rheumatoid arthritis, but a number of tests can show possible indications of the condition. Some of the main tests used are outlined below.

Erythrocyte sedimentation rate (ESR)

In an ESR test, a sample of your red blood cells is placed into a test tube of liquid. The cells are then timed to see how fast they fall to the bottom of the tube (measured in millimetres per hour). If they are sinking faster than usual, you may have an inflammatory condition, such as rheumatoid arthritis.

C-reactive protein (CRP)

A CRP test can indicate if there is inflammation anywhere in the body by checking how much CRP is present in your blood. CRP is produced by the liver. If there is more CRP than usual, there is inflammation in your body.

Full blood count

The full blood count will measure your red cells to rule out anaemia. Anaemia is a condition where the blood is unable to carry enough oxygen, due to a lack of blood cells.

Anaemia is common in people with rheumatoid arthritis, although the problem can have many causes, so having anaemia does not prove that you have rheumatoid arthritis.

Rheumatoid factor and anti-CCP antibodies

Specific blood tests can help to diagnosis rheumatoid arthritis, but are not accurate in every person. About half of all people with rheumatoid arthritis have a positive rheumatoid factor present in their blood when the disease starts, but about one in every 20 people without rheumatoid arthritis also tests positive for this.

Another antibody test known as anti-CCP (anti-cyclic citrullinated peptide) is also available. People who test positive for anti-CCP are very likely to develop rheumatoid arthritis, but not everybody found to have rheumatoid arthritis has this antibody.

Those who test positive for both rheumatoid factor and anti-CCP may be more likely to have severe rheumatoid arthritis requiring higher levels of treatment.

Joint imaging

A number of different scans may also be carried out to check for joint inflammation and damage. These can help differentiate between different types of arthritis and can be used to monitor how your condition is progressing over time.

Scans that may be carried out to diagnose and monitor rheumatoid arthritis include:

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Page last reviewed: 04/08/2014

Next review due: 04/08/2016

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Blood tests

Blood tests are carried out for a variety of reasons and can provide a wide range of information