Screen Yourself for Rheumatoid Arthritis

Is your hand pain from Rheumatoid Arthritis?

Pain Locator

PainSpot.com pain locator. First click on a painful area, such as a hand, then pick a knuckle

You can check for the possibility that you might have rheumatoid arthritis (RA).  Usually one or more finger knuckle joints is swollen. This swelling may be in the middle or large knuckles of your hands – not the knuckles next to your fingernails. The swelling does not feel ‘bony’, but feels tender and slightly soft.

Screen yourself to see if you are at risk of having RA.

Take the PainSpot quiz. Clicking here will take you to the Pain Locator (above) where you click on a painful  hand and then locate a tender knuckle shown on the zoomed picture (below).

Swelling in the knuckles where the fingers attach to the hand is often seen in RA.

How can Rheumatoid Arthritis be diagnosed in the early stages?

If you have at least one swollen, tender middle or large finger knuckle and if you have abnormal blood tests.

If at least one middle or large knuckle has been swollen and painful for more than six weeks, for no other reason, certain blood tests may help to confirm if you have RA.  Large joints may be swollen also, but at least two (wrists, knees, elbows etc.) are necessary. The balls of your feet are also targets for rheumatoid arthritis. The base of your thumbs and the big toes don’t count because more often pain there is from ‘wear and tear’ arthritis (osteoarthritis), and not rheumatoid arthritis.

Which blood tests do you need to have done?

Rheumatoid arthritis is very likely if you also have abnormalities in certain blood tests. If you or your doctor simply order an ‘arthritis panel’ there are four important tests usually included. Two measure antibodies (Rf and CCP).  The other two measure inflammation (ESR and CRP). High levels Rf or CCP, along with abnormal ESR or CRP levels are very useful in confirming the diagnosis of RA. Other tests often will included in the arthritis panel, and any abnormalities in those should be checked out at well.

To explain further, you have a higher risk of RA if you have increased levels of either of the following: Rheumatoid factor (Rf) or anti-Cyclic Citrullinated Peptide (CCP) antibodies.  If the levels are more than three times the normal limit, the risk of having RA is higher.

Abnormal results of ESR (Erythrocyte Sedimentation Rate) or CRP (C-reactive protein) also are risk factors and hint that the arthritis is causing inflammation in your system.

It is very important to understand that abnormal test results are not enough to give you a diagnosis of rheumatoid arthritis. Your health care provider may order these tests, or there are companies (such as Walk-In Lab) which allow you to order these tests yourself for a fee. If you order them yourself and they are abnormal make sure you see a doctor! If the blood tests are normal there are many other reasons you might have joint pain, and you should review your symptoms with your doctor. Sometimes even these four tests are normal with rheumatoid arthritis. A list of arthritis specialists in your area can be found at the American College of Rheumatology website.

Rheumatoid arthritis is treatable!

Although rheumatoid arthritis is a severe disease, which may not only severely damage your joints, it can affect other organs and can reduce your life expectancy. Newer treatments are very successful in reducing joint pain and damage. Remission of this disease now is a real possibility, but early treatment is very important to reduce permanent damage and disability (see other articles in this blog about the newest treatments and side effects of the medicines).
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About Doug Roberts MD

Board certified practicing rheumatologist and founder of PainSpot.com
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