Occasionally,
people with RA develop inflammation of the linings that surround the heart (pericarditis)
and lungs (pleuritis) or inflammation of the lung tissue itself. Dryness of the
eyes and mouth due to inflammation of tear glands and salivary glands (called
sicca syndrome or Sjogren's syndrome) is also occasionally seen. In
some cases, people with RA may develop vasculitis (inflammation of blood vessels)
that can cause inflammation and tissue damage affecting the skin, nerves and other
organs.
HOW
IS 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 nodule or lumps under the skin. Your doctor may also ask if you
have experienced fatigue and an overall feeling of stiffness, especially in the
morning, both of which are associated with RA. The pattern of joints affected
by arthritis can help distinguish joints affected by arthritis can help distinguish
RA from other conditions.
Your
physician also may recommend certain blood tests and X-rays. The presence of an
antibody called rheumatoid factor may indicate RA but rheumatoid factor (RF) is
also found in many people who do not have RA. Other
label 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 antibodies, to cyclic citrullinated
peptide (CCP). While blood tests can be helpful in making a diagnosis, there is
no single test that can make the diagnosis of RA by itself. Although x-rays early
in RA often are 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 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 arthritis, the diagnosis and management of RA requires the expertise of a specialist.
All patients with RA should see a rheumatologist.
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