The earlier the diagnosis of rheumatoid arthritis is made, the lower the risk of joint deformity with treatment. The disease falls within the scope of the rheumatology specialty. Diagnosis and treatment procedures are followed by rheumatologists.
The first step in diagnosis is to take a good anamnesis. When the patient’s complaints started, the shape and timing of joint pain, morning stiffness, the presence of recovery periods, etc. are questioned.
In the physical examination, swelling, stiffness, tenderness, redness, subcutaneous nodules, limitation of movement, deformities in the joints are investigated. If there is evidence of extra-articular organ involvement, it is coordinated with the relevant specialties.
Radiographic examinations: Bone erosion and deformities can be seen on direct radiographs. MRI may be requested for further examination.
Blood tests: Rheumatoid factor is checked. CCP antibody can be checked. The number of erythrocytes decreased. Sedimentation rate, CRP (C-reactive protein) levels are examined. The CCP test also helps determine a person’s risk for rheumatoid arthritis.
Involvement of extra-articular organs such as eyes and lungs can be examined.
Classification of rheumatoid arthritis:
The ACR/EULAR 2010 rheumatoid arthritis classification criteria are as follows:
According to joint involvement:
- Involvement of one major joint (shoulder, hip, elbow, knee, ankle) (0 points)
- 2-10 major joint involvement (1 point)
- Involvement of 1-3 small joints (hand, foot joints, wrist) (with or without large joint involvement) (2 points)
- 4-10 small joint involvement (with or without large joint involvement) (3 points)
- More than 10 small joint involvement (5 points)
According to serology:
- Rheumatoid factor negative, CCP negative (0 points)
- Rheumatoid factor low positive (less than 3 times the upper limit of normal), CCP low positive (2 points)
- Rheumatoid factor high positive (more than 3 times the upper limit of normal), CCP high positive (3 points)
According to the acute phase reactants:
- CRP normal, sedimentation normal (0 points)
- CRP increased, sedimentation increased (1 point)
By symptom duration:
- less than 6 weeks (0 points)
- More than 6 weeks (1 point)
The patient with a score of 6 and above according to the ACR/EULAR classification is a Rheumatoid Arthritis patient.