Diagnosis of Rheumatoid Arthritis

How do I know if I have Rheumatoid Arthritis?

Rheumatoid Arthritis is usually diagnosed by a rheumatologist. In 1987, the American College of Rheumatology (ACR) published the first guidelines for classifying Rheumatoid Arthritis, but not all rheumatologists have used the guidelines in the same way. As more blood tests became available, some doctors became more reliant on blood tests for diagnosis although such tests are negative in a considerable percentage of RA patients.

If you think you may have RA, you should see a rheumatologist as soon as possible. If the diagnosis is unclear, a second opinion may be required. Early diagnosis with subsequent early treatment is believed to be more effective. Some people see several doctors before getting a diagnosis of RA.

New guidelines for Rheumatoid Arthritis

Since there is not yet a definitive objective test for RA, it is diagnosed in the judgment of rheumatology specialists with the help of clinical guidelines.

The American College of Rheumatology (ACR) devises guidelines, often in coordination with the European League against Rheumatism (EULAR), in order to classify rheumatic diseases such as RA. (1) Doctors normally rely on such guidelines to make a diagnosis. The latest RA classification criteria were adopted by the ACR in 2010:

RA classification is established through a point system. A patient is classified as having definite RA if there is a score of six or more using the criteria listed in the chart below. Points are scored individually for each section so that a patient would receive the single highest score for which he qualifies in a particular section.

2010_ACR_RA_disease_criteria

ACR RAD disease criteria

 

Clarifying your diagnosis

Some doctors may still use the former guidelines that they were trained to use or rely on personal instinct. Although the current guidelines are not ideal, they are likely to allow people to be diagnosed earlier than the 1987 guidelines. If you are uncertain about a diagnosis, ask the doctor to explain what criteria he is using to make your diagnosis.

Footnote

1)"Criteria for Rheumatic Diseases." American College of Rheumatology. 2010.