How You Can Beat Rheumatoid Arthritis Part 4: "I Want to Know How It's Diagnosed..."
When patients present to the rheumatologist they often have not yet received a definitive diagnosis. Because there are so many different types of arthritis that present in a similar fashion, the diagnosis is not always easy to make.
Despite all the high tech tools available today, the most important part of evaluating the patient remains a careful history and physical examination (see Part 3). Helpful diagnostic laboratory tests include the rheumatoid factor, erythrocyte sedimentation test (ESR), C-reactive protein (CRP), and more recently a new test called the anti cyclic citrullinated antibody (anti-CCP). One note of caution: the presence of a positive rheumatoid factor doesn't necessarily indicate the diagnosis of rheumatoid arthrits. Multiple other conditions can cause rheumatoid factor positivity. By the same token, roughly 20 % of patients with rheumatoid arthritis are rheumatoid factror negative.
Imaging procedures such as magnetic resonance imaging and ultrasound are helpful. Diagnostic x-rays are of limited use because significant damage can occur long before it shows up on x-ray.
The goals of management include: aggressive and early treatment, reduction of signs and symptoms, prevention of deformities, maintenance of joint function, control of co-morbidities (other associated disease such as hypertension, diabetes, etc., a patient might have), and possibly... cure. While this last option is still not quite achievable just yet , it is becoming more of a possibility.
In addition to medications, treatment of RA includes diet, exercise, joint protection, and occasionally joint surgery.
The approach to RA treatment has changed dramatically in the last 5 years. Future articles will discuss the current management of rheumatoid arthritis.
Dr. Wei (pronounced “way”) is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information on arthritis and related conditions, go to: Rheumatoid Arthritis
http://www.arthritis-treatment-and-relief.com/rheumatoid-arthritis.html