Diagnosis of Rheumatoid Arthritis—What Do I Need to Know?

Published: October 16, 2023

Author: Prof. Maria José Rego de Sousa, Ph.D.

How Do I Know If I Need a Diagnosis of Rheumatoid Arthritis?

Among the diseases resulting from the body’s attack on itself—characterized by autoimmune disorders—rheumatoid arthritis is a chronic inflammatory disease that affects approximately 40,000 people in Portugal.

Typically, the first signs appear early in life, between the ages of 45 and 50, with a prevalence three times higher in women, but it can affect anyone at any age. Typically, the first symptoms are spontaneous pain in the small joints, followed by stiffness and difficulty moving.

Before making a decision regarding a diagnosis of rheumatoid arthritis—whether or not it applies to you—we recommend that you seek a better understanding of what rheumatoid arthritis is, as well as its symptoms and warning signs that may indicate its presence.

Why is a diagnosis of rheumatoid arthritis important?

A diagnosis of rheumatoid arthritis is very important, since structural damage occurs in the early years, and with timely treatment, there is an opportunity to slow the progression of the disease.

When not diagnosed and treated early—ideally within 3 months of symptom onset—it can lead to future complications that often prevent patients from performing daily tasks. Some of these complications may include:

• Carpal tunnel syndrome;
• Tendon rupture;
• Cervical myelopathy (in more advanced stages);
• Osteoporosis;
• Joint deformities;

However, there are other conditions that present with the same symptoms, such as gout and other forms of rheumatism. Therefore, laboratory tests are necessary to identify the cause.

What tests are used to diagnose rheumatoid arthritis?

Once a clinical suspicion has been raised, it is up to the clinical pathologist to clarify the situation through laboratory tests that distinguish the symptoms of rheumatoid arthritis from those of other conditions with similar symptoms.

As an autoimmune disease, it can cause changes in the levels of certain laboratory parameters, such as:

• Erythrocyte sedimentation rate and C-reactive protein: these are markers that indicate the presence of inflammation in the body.
• Rheumatoid factor (RF): a blood biomarker frequently used to aid in early diagnosis.
• Anti-cyclic citrullinated peptide (anti-CCP2) antibodies: This antibody is more specific than RF and may be more sensitive in erosive disease.
• Complete blood count (CBC): detects signs of anemia, leukocytosis, and thrombocytosis (increased platelet count) in the blood, which are common indicators of active disease.
• Antinuclear Antibodies (ANA): may be positive in 30% of affected patients.
• Synovial fluid analysis, if necessary.

Imaging tests, such as X-rays and joint ultrasounds, are also performed to assess the degree of joint erosion and inflammation.

However, it is the presence of a positive RF and a positive anti-CCP2 test that will confirm or rule out the diagnosis of rheumatoid arthritis. The presence of anti-CCP2 antibodies is specific to this disease and may appear years before the onset of the first symptoms, making early treatment possible, which will help reduce the effects of disease progression.

Learn everything you need to know about the treatment of rheumatoid arthritis.

At the Germano de Sousa Group, we are committed to providing excellent service, with the goal of offering our patients the best possible quality of life.

To undergo an early diagnostic test for rheumatoid arthritis, visit one of our Collection Points.