Rheumatoid arthritis (or RA for short) is a long-term autoimmune disease. The immune system confuses foreign substances with healthy tissue causing the body to attack itself.
The condition leads to chronic joint inflammation but can also affect both surrounding tissues of the joints and other organs.
While more common in adults, rheumatoid arthritis can affect both adults and children. In adults, doctors classify all RA as Adult Onset, although treatment is individualized.
In children, there are three main subcategories of Juvenile RA that doctors recognize listed below in our RA patient education guide.
Doctors Who Treat Rheumatoid Arthritis
As your rheumatoid arthritis is diagnosed, treated and managed, there may be several specialists you are referred to for care. The most common doctors that treat RA are listed below in this patient education guide:
Rheumatologist - Doctor who diagnoses and non-surgically treats inflammatory conditions involving bones, joints, muscles and tendons.
Orthotist - Doctor who specializes in the creation and application of orthopedic devices or braces that aid or support the function of a limb. This specialty combines engineering, anatomy, physiology, gait analysis and biomechanics.
Devices are made for several reasons, including:
- Correct the shape or function of the body part to reduce pain
- Help in movement
- Lessen weight bearing to the affected joint
- Restrict unwanted movement in a particular direction
Allergy & Immunology Specialist - This doctor is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. They may be involve with your rheumatoid arthritis as they deal with problems related to the autoimmune disease.
These physicians are seen in conjunction with:
- Pediatrician
- Geriatrician
- Orthopedist
- Internist
How to Prepare for Your Rheumatoid Arthritis Doctor Visit
Having made your appointment with a healthcare provider, there are certain actions that you need to take in order to maximize the benefit of your doctor visit which are listed below in this patient education guide:
- Make a list of your symptoms including the date they started and when they occur.
- Provide for your doctor a list of all the medications you are currently taking. Include the dosage.
- Make a list of your allergies.
- If possible, bring a list of all x-rays, MRIs and blood tests that have been taken. It will save you from having to duplicate them.
Questions to Ask Your Doctor About Rheumatoid Arthritis
From your initial RA diagnosis throughout your treatment and care, you will have questions about your arthritis. Our patient education guide below lists helpful questions for you and your doctor to discuss so you can make informed decisions about your rheumatoid arthritis condition.
Question About My RA Diagnosis
- What are the symptoms of rheumatoid arthritis?
- Which new symptoms should cause alarm and which ones should I notify my healthcare provider about?
- Can I be cured or go into remission?
- Will other body parts be affected by rheumatoid arthritis or is the condition confined to my joints?
- Will rheumatoid arthritis make me more prone to cancer?
- Will rheumatoid arthritis shorten my life expectancy?
- How do my other medical conditions affect rheumatoid arthritis?
- Will it cause me to lose body function or become disabled? What long-term plans should I make with this diagnosis?
Questions About My RA Treatment
- What are the available RA treatment options?
- What are the risks of not going on a treatment regimen?
- Do I have to take the medication forever or can I take a break?
- Are there alternative therapies?
- Can physical therapy make me better? Can surgery?
- How will my other medications affect the rheumatoid arthritis?
Questions About My Lifestyle & Family
- Is this genetic? Will my children get it?
- Should I exercise or avoid it?
- Are there support groups for rheumatoid arthritis?
Common Tests or Labs to Diagnose Rheumatoid Arthritis
There is no one test that positively confirms the diagnosis of rheumatoid arthritis. Rather, it takes a combination of RA tests and lab results in concert with a well-taken history and comprehensive physical examination to arrive at a diagnosis.
Below are the most common RA tests and labs ordered, why you need them, and what they tell you about your condition.
RA Tests
| Test |
Why Test? |
What Happens? |
What is Normal/Abnormal? |
| X-Ray, Ultrasound or MRI |
Determines the extent of joint damage or fluid collection. |
A non-invasive test. Patient lies still as an image is taken. |
Doctor will look for any swelling of soft tissue or loss of bone around joints. |
| Synovial Fluid Analysis |
Used to diagnose:
Gout
Infection
Osteoarthritis
Joint injury
Inflammatory
illnesses
|
Needle collects fluid between joint space. |
Analysis will determine color, clarity, and content for red and white blood cells, crystals (in gout), and bacteria. Abnormal Chemical Analysis: Glucose less than 40 mg/dl Protein greater than 3 g/dl LDH greater than 333 IU/L |
RA Labs
| Test |
Why Test? |
What Happens? |
What is Normal/Abnormal? |
| Blood test |
C-reactive Protein |
Measures the concentration of this protein. When elevated, it suggests infection within the body. |
Normally not detected in the blood. Looking for measures higher than 6-10 mg/L |
| Blood test |
Complete blood count |
Elevation of white blood cells could indicate infection. |
A normal white count will range between 3.5-11 in most labs. |
| Blood test |
Erythrocyte sedimentation rate |
Denotes non-specific inflammation or infection. Abnormal is greater than 33 in most labs. |
ESR rates increase with age and tend to be greater in women than men. |
| Blood test |
Rheumatoid Factor Test |
Measures an antibody produced by the body's immune system. It is elevated in 75% of people with RA. |
Negative is less than 20 units per milliliter, 20-30 is equivocal and greater than 30 is positive. |
| Blood test |
Anti-CCP antibody test (anti-cyclic citrulinated peptide antibody test) |
Testing for the presence of this antibody helps diagnose RA, confirming it when high and used in conjunction with the RF. |
Any level of this antibody is considered a positive result. |
Common Medications and Treatments for Rheumatoid Arthritis
While rheumatoid arthritis cannot be cured, there are many drugs that can relieve pain by diminishing joint inflammation. They are listed below in this patient education guide.
Treatment used to start with anti-inflammatory agents. However, the thinking now is to begin early with more aggressive therapy to delay joint damage with increased pain.
Of course, your treatment plan will be is specific to you. Side effects and warnings should be discussed with your doctor and taken into consideration when taking rheumatoid arthritis medications.
| Class/Type |
How it Works |
Associated Drugs |
| DMARDs - Disease Modifying Antirheumatic drugs |
Plaquenil
Arava
Rheumatrex
Trexall
Dynacin
Minocin
Azulfidine
|
Slows the progress of RA, saving joints and other tissues from permanent damage. |
| Immunosuppressants |
Azasan
Imuran
Cytoxan
Gengraf
Neoral
Sandimmune
|
Controls the immune system. |
| NSAIDs: nonsteroidal anti-inflammatory drugs |
Advil
Motrin
Aleve
|
Decreases inflammation and pain. |
| Steroids: (corticosteroids) |
Medrol
Prednisone
|
Decreases inflammation and pain. Slows joint damage. |
| Target Agents: (Biologics) |
Orencia
Kineret
Rituxan
|
Inhibits various inflammatory substances made by your body. |
| TNF-alpha inhibitors: |
Humira
Enbrel
Remicade
|
Inhibitor works against the production of tumor necrosis factor-alpha, an inflammatory agent produced by your body, to decrease morning stiffness, pain, and swollen tender joints within two weeks of treatment. |
