Diagnosing rheumatoid arthritis
Rheumatoid arthritis is diagnosed by a combination of a medical history, a physical examination and specialised tests or investigations. If a diagnosis of rheumatoid arthritis is suspected, patients should be referred to a specialist called a rheumatologist.
History
The history of an illness refers to the pattern of symptoms it causes in an individual patient. Symptoms that would lead a doctor to suspect a diagnosis of rheumatoid arthritis include:
- pain, stiffness and swelling affecting several joints on both sides of the body, especially the small joints of the hands, wrists, feet or knees
- morning stiffness that lasts an hour or more
- tiredness, lethargy or flu-like symptoms
- loss of appetite and weight
Examination
A physical examination involves inspecting the joints for signs of rheumatoid arthritis. During an examination, a doctor looks carefully at the joints for any sign of swelling, redness or joint deformities. The doctor will also look for other signs of rheumatoid arthritis, such as rheumatoid nodules or paleness due to anaemia.
A physical examination also involves feeling and moving the joints. In patients with rheumatoid arthritis, affected joints feel hot, swollen and ‘boggy’, are stiff and painful when moved and have a limited range of movement (i.e. cannot bend as far as usual).
