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Exams and Tests for Rheumatoid Arthritis

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To diagnose rheumatoid arthritis, the doctor will run through several exams and tests.

Physical Exam and History
An evaluation for rheumatoid arthritis (RA) includes a physical examination and careful history. In the physical exam, your doctor will assess:

  • joint inflammation
  • mechanical difficulty (do you have trouble moving?)
  • pain severity
  • range of motion (how far your joints move)
  • instability
  • misalignment
  • deformity

The doctor will also note symptoms of fatigue, stiffness, and weakness, and he or she will also ask how the disease affects your daily life.

Neurologic Exam
A neurologic exam helps the doctor understand how or if RA is affecting your nerves and nerve functions. A neurologic evaluation includes assessment of your symptoms, including:

  • motor and sensory function
  • pain
  • numbness
  • paresthesias (abnormal sensation, such as burning or prickling)
  • muscle spasm
  • weakness
  • bowel/bladder changes

Lab Tests
The doctor may order lab tests to:

  • check for the presence of an inflammatory process in the body
  • check the rheumatic factor level in the blood (learn how the rheumatic factor is related to RA here)
  • get a complete blood count
  • get an analysis of the synovial fluid

It's also possible that the doctor will order a urinalysis and / or a hepatic panel. The hepatic panel is used to determine your liver and pancreatic functions, and these tests provide a baseline and insight into the patient's general health.

Imaging Tests
Radiographs (x-rays)
are taken of the cervical spine (RA affects mainly the neck, also known as the cervical spine). These x-rays are used to assess:

  • joints
  • vertebral end plates
  • subluxation (if the vertebrae are out of alignment)
  • narrowing of intervertebral disc spacing
  • osteophyte (bone spur) formation
  • general structure

The degree of joint space, malalignment, or deformity is measured using radiographs.

A myelogram-enhanced MRI or CT scan may be performed to determine and evaluate spinal cord compression, if your doctor thinks that's a possibility.

Updated on: 09/07/12
Lawrence G. Lenke, MD
This article was reviewed by Lawrence G. Lenke, MD.
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