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.