Exams and Tests for Rheumatoid Arthritis

To diagnose rheumatoid arthritis, the doctor will run through several exams and tests.
To diagnose rheumatoid arthritis, the doctor will run through several exams and tests. Photo Source: 123RF.com.

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.