Exams and Tests for Rheumatoid Arthritis
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.