Early and Accurate Diagnosis Needed for Rheumatoid Arthritis

Early diagnosis of rheumatoid arthritis (RA) is very important. Damage to the joints is occurring Even before symptoms start. Making the diagnosis and starting treatment early can help preserve function and prevent disability. In this article, two rheumatologists (doctors specializing in RA) review the problems doctors face in making the diagnosis soon enough. They also discuss tests that are used to identify patients with RA. The authors point out that the American College of Rheumatology’s (ACR) Criteria for the Classification of RA are outdated. Improved technology for lab testing and advanced imaging have made it possible to identify the disease sooner. Studies show that patients with RA have the best results when the disease is treated within the first year of symptoms. Patients should be sent to a rheumatologist or arthritis clinic if they have any of the following symptoms:

Three swollen joints

Positive squeeze test (pain occurs with compression of the knuckle joints of the hand or the bones in the midfoot)

Morning stiffness that last more than 30 minutes

Joint symptoms for more than six weeks

Positive (abnormal) lab results for RA Early treatment with disease-modifying antirheumatic drugs (DMARDs) can prevent RA from getting worse. Studies show that DMARDs result in decreased pain and improved function. Reduced disease activity can also be seen on X-rays. The authors encourage primary care physicians to refer patients sooner than later when there is any suspicion of RA developing. Diagnosis can be difficult. Sorting out joint pain from joint swelling in these patients may require a specialist.

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