Rheumatoid arthritis (RA) is an autoimmune condition that causes pain and inflammation in the joints of your body. If left untreated, it can cause joint damage, which may lead you to need joint replacement surgery.
Unfortunately, there is no cure for RA. Still, medical treatments are constantly improving and are very effective at managing your symptoms, allowing you to lead as normal a life as possible.
Many people can go for years ignoring joint aches and pains and putting it down to age or overuse. However, once the symptoms become so unbearable that it starts to interfere with everyday activities, they seek the help of their GP to find the underlying cause.
Getting a referral for a diagnosis
If your GP suspects you have RA or another inflammatory health condition, they will usually refer you to a specialist rheumatologist for a proper diagnosis. GPs don’t have access to the specialist diagnostic tests and equipment that rheumatologists have, so the first step to getting a formal diagnosis for RA is usually through a referral from your GP.
However, if you are experiencing symptoms of RA and want to get a fast and accurate diagnosis of your condition, it can help to book a private consultation directly with a qualified rheumatologist. While there isn’t one definitive test that will confirm you have RA, your specialist rheumatologist will conduct a series of diagnostic tests, including blood tests, to either rule out or confirm RA.
Many other inflammatory health conditions can mimic RA symptoms, so having a comprehensive set of diagnostic tests will help clarify the cause of your symptoms and lead to the most appropriate short and long-term treatment plan to help manage your condition.
There are six most commonly used blood tests to help rheumatologists diagnose RA. These are:
1: Erythrocyte sedimentation rate (ESR) test
Your blood will be evaluated for the erythrocyte sedimentation rate (ESR) level, which shows how much inflammation is present in your body. Red blood cells are called erythrocytes, and the ESR test involves separating your blood in the lab with a substance that prevents blood clotting.
The erythrocytes clump together and separate from other blood cells when there is inflammation in the body, and the reaction is faster when more inflammation is present. Low ESR levels indicate low levels of inflammation, and high ESR results show high levels of inflammation.
Because RA causes inflammation throughout the body, rheumatologists use the ESR test to help diagnose RA, but it isn’t enough on its own to formally diagnose RA. ESR blood tests are usually used in conjunction with other blood tests to make a formal RA diagnosis.
2: C-reactive protein (CRP) test
A C-reactive protein (CRP) test looks for the amount of CRP protein present in your bloodstream. Your liver produces CRP and releases it when there is an infection in your body. The protein helps to trigger your immune system’s response to an infection, which in turn causes inflammation in your body.
Having an autoimmune condition such as RA can lead to high levels of CRP in your bloodstream, so the CRP test will confirm the presence of inflammation. Rheumatologists cannot rely on a single CRP test to diagnose RA, but it can give them a clearer idea about how much inflammation is present in the body and how strong your immune response is.
3: Full blood count (CBC)
A complete blood count (CBC) evaluates the cells that make up your blood. It counts your white blood cells, red blood cells, and platelets. In a healthy person, the levels of these cells are well balanced and regulated.
A disruption in these readings can indicate many inflammatory conditions that share similar symptoms to RA. However, RA doesn’t typically disrupt your blood cell count, so an abnormal reading can indicate another cause for your symptoms, and RA wouldn’t be the correct diagnosis, so this test can rule out RA.
4: Rheumatoid factor test
Rheumatoid factors are immune system proteins that can often attack healthy body tissues. The rheumatoid factor test will measure the level of rheumatoid factor proteins present in your blood.
High levels of this protein will indicate RA and other inflammatory diseases such as Sjogren’s syndrome or other autoimmune conditions that share similar symptoms to RA. High levels of rheumatoid factor can help confirm a RA diagnosis.
5: CCP antibodies test
Cyclic citrullinated peptide (CCP) antibodies are an autoantibody type of immune system protein. These are abnormal proteins that will attack healthy body tissues and blood cells.
It has been shown that 60 – 80 per cent of patients diagnosed with RA have CCP antibodies in their blood. An anti-CCP antibody blood test will look for the presence of autoantibodies to help confirm a RA diagnosis.
The Anti-CCP test can also help your rheumatologist determine your RA’s severity, forming an effective treatment plan to help slow the progression of joint damage.
6: Antinuclear antibody (ANA) test
Antinuclear antibodies (ANA) blood tests look for a specific type of autoantibody in your bloodstream produced by your immune system. These antibodies act against your immune system by attacking healthy tissues and blood cells. The presence of ANAs can indicate an autoimmune condition such as RA.
These six blood tests are used in diagnosing RA but are not the only method your rheumatologist will use to diagnose RA properly. You will usually have other tests and assessments such as:
- A physical assessment
- A joint scan
- Imaging tests
Blood tests are valuable tools that rheumatologists use to help diagnose or rule out RA in patients presenting with symptoms that indicate an inflammatory or autoimmune health condition. However, they are used in conjunction with other testing rather than as a sole source of diagnosis.
If you suspect you may have RA or another inflammatory health condition and would prefer to get a fast and accurate diagnosis from a leading consultant rheumatologist, then do not hesitate to contact Dr Naveen Bhaudauria and his team for a private consultation.
Article by Dr. Naveen Bhadauria
