How is Rheumatoid Arthritis (RA) Diagnosed?

To diagnose RA, your physician will take a medical history and perform a physical examination. The doctor will look for certain features of RA, including swelling, warmth and limited motion in joints throughout your body, as well as nodules or lumps under the skin. Your doctor may also ask if you have experienced fatigue and morning stiffness, both of which are associated with RA. The joint areas affected by arthritis can help with the diagnosis of RA.

Your physician also may recommend certain blood tests and X-rays. The presence of an antibody called rheumatoid factor (RF) may indicate RA. Other lab test abnormalities that could indicate RA include anemia, an elevated erythrocyte sedimentation rate (ESR) or c-reactive protein (CRP), which indicates the extent of inflammation present, and a positive test for anti-cyclic citrullinated peptide (anti-CCP) antibodies. While blood tests can be helpful in making a diagnosis, there is no single test that can make the diagnosis of RA by itself.

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Although X-rays early in RA may be normal, the joint damage shown on X-rays as the disease progresses can help confirm the diagnosis. Typical findings that suggest RA include bone loss at the edges of the joint – called erosions – combined with loss of joint cartilage.

RA is characterized by joints on both sides of the body being affected in a symmetrical manner. For example, if your right wrist is affected, your left wrist is affected, too. It most often involves the small joints of the hands and feet in addition to other joints. With more than 100 forms of arthritis, the diagnosis and management of RA requires the expertise of a specialist. All patients with RA should see a rheumatologist.