There is a growing list of blood tests that help determine the diagnosis of RA.
Yet, I was negative for the Rheumatoid factors, a variety of antibodies frequently present in people with RA. I was also negative for the anti-CCP antibodies, used to predict RA. I did have at least 15 joints inflamed for at least several months. Together the extremely high inflammatory markers plus the number of inflamed joints made the diagnosis an easy one.
There was also a test to rule out Lupus. It is the ANA profile. If it is negative, you don’t have Lupus. Mine was negative. CBC, metabolic panel, tests for thyroid function are also given. I had a chest x ray and x rays of my hands and feet.
I feel thoroughly tested. On going tests are the ERS and the CRP to check inflammation and treatment progression. The metabolic panel keeps track of liver and kidney function. The CBC checks the levels of red and white blood cells plus platelets, hematocrit and hemoglobin. These are done about every month.
The following is criteria for diagnosis of RA for research purposes
You can find the full report for this classification criteria online. This is a summery of that report that was posted on Wikipedia.
In 2010 the 2010 ACR / EULAR Rheumatoid Arthritis Classification Criteria were introduced. These new classification criteria overruled the “old” ACR criteria of 1987 and are adapted for early RA diagnosis.
The “new” classification criteria, jointly published by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR)establish a point value between 0 and 10. Every patient with a point total of 6 or higher is unequivocally classified as an RA patient, provided he has synovitis in at least one joint and given that there is no other diagnosis better explaining the synovitis. Four areas are covered in the diagnosis:
- joint involvement, designating the metacarpophalangeal joints, proximal interphalangeal joints, the interphalangeal joint of the thumb, second through fifth metatarsophalangeal joint and wrist as small joints, and shoulders, elbows, hip joints, knees, and ankles as large joints:
- Involvement of 1 large joint gives 0 points
- Involvement of 2-10 large joints gives 1 point
- Involvement of 1-3 small joints (with or without involvement of large joints) gives 2 points
- Involvement of 4-10 small joints (with or without involvement of large joints) gives 3 points
- Involvement of more than 10 joints (with involvement of at least 1 small joint) gives 5 points
- serological parameters – including the rheumatoid factor as well as ACPA – “ACPA” stands for “anti-citrullinated protein antibody”:
- Negative RF and negative ACPA gives 0 points
- Low-positive RF or low-positive ACPA gives 2 points
- High-positive RF or high-positive ACPA gives 3 points
- acute phase reactants: 1 point for elevated erythrocyte sedimentation rate, ESR, or elevated CRP value (c-reactive protein)
- duration of arthritis: 1 point for symptoms lasting six weeks or longer
The new criteria accommodate to the growing understanding of RA and the improvements in diagnosing RA and disease treatment. In the “new” criteria serology and autoimmune diagnostics carries major weight, as ACPA detection is appropriate to diagnose the disease in an early state, before joints destructions occur. Destruction of the joints viewed in radiological images was a significant point of the ACR criteria from 1987. This criterion no longer is regarded to be relevant, as this is just the type of damage that treatment is meant to avoid.