How is rheumatoid arthritis diagnosed?
The diagnosis of rheumatoid arthritis is based on a combination of factors,
including:
- The specific location and symmetry of painful joints
- The presence of joint stiffness in the morning
- Presence of bumps/nodules under the skin (rheumatoid nodules)
- Results of x-ray tests that suggest rheumatoid arthritis
- Positive results of a blood test called the rheumatoid factor*
*Many, but not all, people with rheumatoid arthritis have the rheumatoid
factor antibody in their blood. The rheumatoid factor may be present in people
who do not have rheumatoid arthritis. Other diseases can also cause the
rheumatoid factor to be produced in the blood. A new test called CCP antibody
can sometimes help to determine whether the rheumatoid factor antibody is due to
rheumatoid arthritis or some other disease. That is why the diagnosis of
rheumatoid arthritis is based on a combination of several factors and NOT just
the presence of the rheumatoid factor in the blood.
How is rheumatoid arthritis treated?
There are many different ways to treat rheumatoid arthritis. Treatments include
medications, rest and exercise, and surgery to correct damage to the joint.
The type of treatment prescribed will depend on several factors including the
person’s age, overall health, medical history and severity of the arthritis.
Medications
There are many medications available to decrease joint pain, swelling and
inflammation and hopefully prevent or minimize the progression of the disease.
These medications include:
- Non-steroidal anti-inflammatory drugs (NSAIDs – such as aspirin,
ibuprofen or naproxen)
- Corticosteroids (such as prednisone)
- Anti-malarial medications (such as hydroxychloroquine)
- Other medications* including gold, methotrexate, sulfasalazine,
penicillamine, cyclophosphamide, cyclosporin and minocycline
- New biologic agents that block a specific inflammation factor (cytokine)
called tumor necrosis factor (such as infliximab, etanercept or adalimumab)
or that block another inflammation factor called interleukin 1 (such as
anakinra) might also be used
*Some of these medications are traditionally used to treat other conditions
such as cancer, inflammatory bowel disease, infections or organ transplants.
When chemotherapy is used to treat rheumatoid arthritis, the doses are
significantly lower and the risks of side effects tend to be considerably less
than when chemotherapy is used to treat cancer.
When you are prescribed any medication, it is important to meet with your
physician regularly so he or she can detect the development of any side effects.
Rest and exercise
A balance of rest and exercise is important in treating rheumatoid arthritis.
During flare-ups (worsening of joint inflammation), it is best to rest the
joints that are inflamed. This may be accomplished by the temporary use of a
cane or joint splints.
When joint inflammation is decreased, guided exercise programs are necessary
to maintain flexibility of the joints and to strengthen the muscles that
surround the joints. Range-of-motion exercises should be done regularly to
maintain joint mobility.
Surgery
When bone damage from the arthritis has become severe or pain is not controlled
with medications, surgery is an option to restore function to a damaged joint.
Is there hope for people with rheumatoid arthritis?
Yes. Although there is not yet a cure for rheumatoid arthritis, there are many
different methods available for decreasing the pain and inflammation. Early
diagnosis and effective treatment is of great importance.
Research is in progress to determine the cause of rheumatoid arthritis and
the best treatment for it.