Analyzes for rheumatoid arthritis

What tests should I take with rheumatoid arthritis?

Analyzes for rheumatoid arthritis are mandatory for the manifestation of symptoms of pathology and for differential examination.

Rheumatoid arthritis is an autoimmune disease, accompanied by inflammation, the symptoms of which are so are vague and nonspecific, that without differential studies it is not necessary to clarify the diagnosis possible.

What tests are specific, and which ones are important only when considering the totality of all indicators?

The importance of laboratory research

When specifying the diagnosis of such a complex type of pathology, tests for rheumatoid arthritis can be divided into:

• specific - allowing with a high degree of reliability to confirm or deny the preliminary diagnosis;
• nonspecific - identify the presence of individual traits and only in aggregate confirm the diagnosis.

As a rule, rheumatoid arthritis is diagnosed only for 7-8 years after its "debut". Moreover, more than 30% of patients at different stages of development of the disease make an erroneous diagnosis.

Especially often with diagnostic difficulties encounter when trying to diagnose early pathology in the age group of patients under 30 years. In the initial stage of disease progression, instrumental studies have a negative result.

Therefore, the development of methods for laboratory diagnosis of pathology at the earliest possible stage is of great importance.

A specific assay is the determination of rheumatoid factor and the detection of antibodies to cyclic citrullinated peptide (ACPC).

It was the study at the ATSPP that was an advanced step in the diagnosis of early forms of rheumatoid arthritis and the determination of pathology in the seronegative form of the disease or in the absence of severe symptoms.

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According to the NIIR RAMS study, signs of rheumatoid arthritis were noted in patients with the detected P-factor as early as a year after the study in 56% of the examined. Among those who had a negative result, the pathology developed in 44% in the same period of time.

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Whereas with a positive result, 70% of the patients developed a year later in ADPD, and in 30% of patients with negative disease. The presented results convincingly prove the high validity, sensitivity and informativeness of the method, which is being carried out by the ATSPP.

Markers of the pathological process

A nonspecific study of rheumatoid arthritis is an analysis of the presence of markers of an acute inflammatory process.

When rheumatoid arthritis is diagnosed, the blood test from the finger on the ESR (ESR) shows an increased (in comparison with the norm) result.

The value of the interval of the obtained indicators of markers and their reference values ​​testify to the active phase of the inflammatory process in the body.

But a positive result is noted not only with rheumatoid arthritis, but also in other types of pathology accompanied by inflammation.

Together with the sedimentation rate of erythrocytes, other blood indices are also studied - the level of fibrinogen, the presence and activity of C-reactive protein, and the amount of seromucoid.

To date, the ARC / EULAR criteria are the only reliable way to establish the correct diagnosis.

Mandatory diagnostic complex

If there is a suspicion of the presence of pathology and for the differentiation of rheumatoid arthritis, the doctor will prescribe the following tests:

• blood: clinical, biochemical, immunological, ATSTSP;
• common urine;
• intra-articular fluid;
• biopsy of articular membrane, etc.

A blood test helps determine the presence of rheumatoid arthritis even at the stage preceding the onset of the symptom complex. In the study of the clinical analysis of blood factors, attention is drawn to the following indicators, which are acute phase markers:

• activity of hemoglobin;
• ESR;
• leukocyte formula;
• number of platelets;
• number of cryoglobulins.

Decoding of biochemical analyzes

Biochemical blood tests of the patient are conducted to establish the activity of the following components:

• Haptoglobin - an acute phase protein that controls the course and progression of the inflammatory process;
• fibrinogen in the blood plasma - with increased activity indicates inflammation and an active phase of autoimmune disease;
• sialic acids - when exceeded, is a diagnostic and prognostic sign of an active inflammatory process;
• seromucoids - whey proteins;
• peptides;
• γ - globulins;
• cryoglobulins (IgM, IgG, IgA, etc.).

Specific and nonspecific tests

The determination of the level of ATSP is the most informative of the modern methods of early diagnosis of the disease, since antibodies to the cyclic citrullinated peptide are produced long before the patient feels the first symptoms disease. The difference between the possible and existing terms of establishing pathology is more than 10-15 years, which gives hope for a rapid onset of treatment, that is, before the onset of irreversible changes in joints.

For example, as a result of a variety of clinical studies, a reliable relationship was established between the presence P-factor and external influence on the body of external and internal factors, which reduces the predictive value of this indicator.

The diagnostic sensitivity of the tests is different, therefore, to obtain a whole picture, the results of all the studies listed are analyzed. Below in the table are the results of clinical studies of the sensitivity of research methods:

Accepted reduction	Explanation	Sensitivity index (%)
AMEC	Autoantibodies to modified citrulline vimentin	78
ACNC	antibodies to cyclic citrulline peptide	77
IgM RF	P-factor represented by immunoglobulin IgM	71
IgA RF	P-factor represented by immunoglobulin IgA	43
AKA	Anti-keratin antibodies	43
ARA33	Antibodies to nuclear antigen RA33	31
ANF	Antinuclear factor	31

Usually, if suspicion of this pathology should be submitted to the analysis of ATSTSP and RF. But if they are negative, an in-depth examination, which includes AMEC and ARA33, may be prescribed.

For example, IgM RF is determined not only in acute inflammatory process, but also in malignant processes in old age.

Therefore, complexes of analyzes are developed that will help increase the sensitivity of research methods.

Immunoassays are performed by enzyme immunoassay.

Currently, other methods of research are being tested, which will help to increase the reliability of the results and to calculate the risk of pathology before it occurs.

So, for example, methods of gene, transcriptomic and proteomic analyzes that allow to analyze the genetically determined risks of the appearance of joint pathologies are evaluated.

Interpretation of test results

In order to establish the diagnostic signs of the disease, it is necessary to compare the results of the analysis with the norm or the reference values ​​of the studied indicators.

One of the studied indicators is the level of hemoglobin.

It was found that with rheumatoid pathology, the activity of erythrocytes and quantity hemoglobin due to the shortening of the life span of red blood cells or the dysfunction of their products with bone brain.

Normally, the level of hemoglobin in the blood of an adult should be 120-160 g / l, but with this disease the threshold value is 110 g / l. With the progression of pathology - much less.

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The norm of ACPC is 3 U / ml. With rheumatoid arthritis, the value of this indicator can fluctuate in the range of 58-87 U / ml. The increase in the interval indicates a progressive process of destruction of the cartilaginous tissue.

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The more this difference, the more pronounced is the degenerative process. The norm of AMEC is less than 20 U / ml.

The pathology is indicated by an increase in the index, which, even after several years after the appearance of the first signs, can reach 62-86 U / ml.

It is noteworthy that there is a difference in these indicators for rheumatoid arthritis (RA) and other inflammatory diseases of the joints, which makes it possible to differentiate RA from gout, osteoarthrosis, erosive arthritis and others. The norms of indicators, which are determined in the biochemical analysis of blood, are:

• Haptoglobin - in the blood, g / l, in urine, mg / l;
• fibrinogen - 2-4 g / l;
• Sialic acid - 620-730 mg / l (-2033 mmol / l);
• seromucoids mmol / l;
• gamma globulin - 8-1, g / l.

An increase in these indicators indicates not only the presence of an inflammatory process.

So, for example, an increase in the amount of sialic acids occurs when collagen tissue is destroyed.

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An increase in the amount of haptoglobin indicates a process of erythrocyte destruction, characteristic of this disease.

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Comparison of changes in the components of the proteinogram helps to determine at what stage the pathology is, how much time has passed since the onset of degenerative disorders. To pass analyzes it is required and for definition of efficiency of the therapeutic methods applied to treatment of illness.

You need to go through the research if you are predisposed to this disease, and when you reach the age after 50 years.

The analysis of the obtained results and the interpretation of them allow at the initial stages to determine the presence of the disease or to calculate with a high degree of reliability the risk factor.

A source: https://OrtoCure.ru/kosti-i-sustavy/artrit/analizy-na-revmatoidnyj-artrit.html

Analyzes for rheumatoid arthritis: ESR of blood (norm of the indicator)

Rheumatoid arthritis is an autoimmune disease of chronic course. Typically, this type of arthritis strikes:

• ankles,
• joints of hands,
• knees.

Rheumatoid arthritis is formed imperceptibly for a person and is expressed by many blurred symptoms. Therefore, very often even doctors with extensive experience can not determine this disease.

Rheumatoid arthritis, usually, appears in women after 30 years. Men also suffer from it, but in women, this type of arthritis occurs 5 times more often.

Unfortunately, rheumatoid arthritis is quite a dangerous disease that affects people of working age.

The inflammatory process starts because of:

1. permanent strong stress,
2. infections,
3. injuries.

In addition, statistics show that 80% of patients with rheumatoid arthritis have antibodies to the Epstein-Barr virus.

Medicine is constantly and continuously evolving, but it is still impossible to completely cure or prevent the formation of rheumatoid arthritis. The disease does not develop quickly, but it is constantly progressing.

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A person can feel good, but in his body, antibodies are produced that attack not a foreign virus or an allergen, but their own organism.

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Rheumatoid arthritis, in fact, an inflammatory process that occurs in the joints and joints of the joints.

Symptoms of rheumatoid arthritis

Most patients have the following symptoms:

1. Arthritis of the joints of the hand,
2. Morning stiffness of the joints, which does not pass a long time,
3. Symmetry of the foci of inflammation,
4. Rheumatoid nodules are specific subcutaneous seals in the region of the elbows.

Please note that the presence of at least one of the above symptoms may signal the onset of the disease. In severe forms of rheumatoid arthritis, deformations are subject not only to joints, but also to organs such as:

• lungs,
• circulatory system,
• connective tissue.

In the list of common symptoms there is a visible increase in temperature (to subfebrile 38 C), as well as sleep disturbances and decreased appetite.

Measures to be taken

Independently rheumatoid arthritis does not pass. If the disease is not treated, it seriously worsens the overall quality of life, and most importantly, leads to significant disruption of the body, in some cases, death may occur.

When the first symptoms appear, consult a rheumatologist immediately. It is strictly forbidden to engage in self-diagnosis and treatment at home.

Only a qualified doctor will be able to distinguish rheumatoid arthritis of the fingers, for example, from other similar diseases and temporary disorders.

The rheumatologist will listen attentively to the complaints, carry out a visual examination, and necessarily send them to the appropriate tests. The study of rheumatoid arthritis includes:

• a general clinical blood test,
• biochemical and immunological analysis of blood,
• arthroscopy,
• MRI of the joints,
• fluoroscopy.

If the disease is already in the late stages of development, then doctors of other specializations are involved. Depending on the type of lesion of the internal organs, one can consult with:

1. gastroenterologist,
2. cardiologist,
3. pulmonologist and other doctors.

Analyzes for rheumatoid arthritis

With rheumatoid arthritis, a common blood test shows:

• a lowered level of hemoglobin, that is, moderate anemia,
• an increased level of cryoglobulins,
• leukocytosis, directly proportional to the intensity of arthritis development,
• a slight increase in ESR.

The degree of anemia with confirmed rheumatoid arthritis is directly related to the strength of the inflammatory process.

With the emerging Felty syndrome begins acute neutropenia - a reduced concentration of neutrophils, that is, one of the types of leukocytes. In addition, Felty syndrome is expressed by splenomegaly and polyarthritis.

In rheumatoid arthritis, biochemical blood indices show the presence of P-factor or rheumatoid factor. Previously, it was assumed that this factor clearly indicates the presence of autoimmune processes, and the patient can safely be diagnosed with "rheumatoid arthritis".

Thus, it can be concluded that the detection of P-factor is not the most significant reason for the decision about the presence of arthritis.

But on the basis of a biochemical blood test, one can determine the type of rheumatoid arthritis: seronegative or seropositive.

P-factor can be determined from 6-8 weeks after the onset of the disease.

Among other things, with the help of a biochemical blood test, those indices that are characteristic of other collagens are found:

• an increased level of fibrinogen and haptoglobin,
• high level of peptides and sialic acids.

If there is a seromucoid in the blood, then this indicates pathological inflammatory processes in the body. But his presence is not the final proof of rheumatoid arthritis. Arthritis is also indicated by the following symptoms:

1. increase lipid peroxidation,
2. reduction of antioxidant activity,
3. reduction of glucosaminoglycans.

Basic and additional tests for rheumatoid arthritis

In addition to the blood test, a person who is suspected of having arthritis is also prescribed a urine test. If the disease is present, doctors will see serious malfunctioning of the urinary system.

In many cases, the patient with arthritis has amyloidosis or nephrotic kidney damage. Amyloidosis is formed a few years after the onset of arthritis and acts as a complication of the underlying disease.

Rheumatoid arthritis is accompanied in many cases by characteristic dysfunction - renal failure.

Quite often physicians consider it necessary to diagnose synovial fluid.

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In people with rheumatoid arthritis, this fluid becomes turbid and has both whole and destroyed white blood cells (neutrophils there about 80%).

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Signs of the inflammatory process also show a biopsy of the synovial fluid.

The most reliable indicator, which makes it easy to determine the presence of rheumatoid arthritis, is research on antibodies to the citrulline peptide (ACPC). Thanks to this method, the disease can be identified not less than 80% of people.

It should be noted one more positive point of this study, it is about the ability to identify the disease in people who have normal indices of rheumatoid factor. This analysis is widely used due to the precise diagnosis of rheumatoid arthritis.

ESR is the rate of erythrocyte sedimentation. In a healthy person, it is within 5-12 mm / hour.

Analyzes for rheumatoid arthritis are determined by:

• antinuclear antibodies that occur with progressive disorders of connective tissue,
• antigen of the histocompatibility complex DR4 - with the progression of joint degeneration,
• LE cells are cells that occur in people with lupus erythematosus,
• anti-keratin bodies.

It is important to remember that timely diagnosis is a guarantee of successful treatment of rheumatoid arthritis.

A source: http://sustav.info/analizy/ostalnie/soe-krovi-revmatoidnyj-artrit.html

Diagnosis and analysis of rheumatoid arthritis

The timely treatment will help to preserve the functionality of the joints. This is especially true if there is a hereditary factor.

Diagnosis of rheumatoid arthritis

First signs

For an operative reaction, you should know which symptoms occur first:

• swelling of several joints, often the lesion is symmetrical;
• movement is difficult in the morning or after a long stay in a static position. Normal mobility returns within an hour;
• under the skin in the region of the joints, you can grope for small rheumatoid nodules (cones), which many confuse with hygroma;
• for a month and a half on the fingers or toes (on and around the folds) there is swelling and redness of the skin;
• Joints are enlarged in size, there is a palpable pain.

At an early stage, the disease is very important to recognize, so it is necessary to pass tests, including markers

Whatever symptoms are present, even not pronounced, it is necessary to address to the rheumatologist for consultation. If the diagnosis is confirmed - immediately begin treatment.

Laboratory diagnostics

• Markers. At an early stage, the disease is very important to recognize, but difficult. Therefore, differential diagnostics is used, during which it is necessary to pass tests, including on markers, and undergo instrumental examination.
• Rheumatoid factor. One of the early detection methods is a laboratory test for rheumatoid factor (RF). Serum of blood is checked for the presence of antibodies, which are formed in response to the development of pathological processes. The norm is less than 14 U / ml, the same for men and women (including pregnant women).

However, there are such arthritis, in which the excess of the rheumatoid factor in the blood is not fixed, even if the diagnosis is confirmed (whatever the disease stages) and the treatment is performed. Analyzes can show an increase in the norm against a background of completely different diseases.

Any acute inflammatory process can slightly increase the rheumatoid factor. The presence of antibodies in a healthy person indicates a predisposition to the development of arthritis, with age, indicators can increase.
Reliability of analysis: one confirmed case of three.

• ACAD. The assay detects antibodies to the cyclic citrulline peptide. In a healthy person, citrulline is completely eliminated from the body, and in the presence of arthritis it reacts and changes the blood composition. The method allows you to accurately determine the presence of the disease: in 8 out of 10 cases the diagnosis of "rheumatoid arthritis" is confirmed. High performance is due to the fact that antibodies are developed almost immediately with the onset of the disease, that is, a year and a half before the main symptoms appear. Informative analysis and with those forms of arthritis, when the rheumatoid factor does not increase. Normally the indicator should be no more than 5 IU / ml.
• ANF. The antinuclear factor in 2-4% of patients may not be fixed due to the peculiarities of the type of arthritis, but more often the absence of significant values ​​(the presence of titers above 1/640) excludes the presence of the disease.

The characteristics of the blood composition change in a certain way in the presence of arthritis

General and biochemical blood tests

The characteristics of the blood composition change in a certain way in the presence of arthritis, so general and biochemical analyzes will help to diagnose the presence of the disease. And also to determine the level of its activity in order to prescribe adequate treatment.

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The following indicators are informative:

1. Hemoglobin. Lowering its level to 130 g / l in men and up to 120 g / L in women causes symptoms of anemia, which manifests itself in 30-50% of cases.
2. ESR is a universal indicator of the presence of inflammatory processes in the body. Norms are the values ​​of ESR in the range from 5 to 10-12 mm / h. However, a slight excess does not yet mean the development of arthritis. But an increase in ESR up to 40 mm / hour is already considered a serious reason to suspect an acute phase of the disease.
3. C-reactive protein. Concentration of CRP in the blood is a more vivid indicator of the presence of inflammation than ESR. In diseased people, the diagnosis reveals an excess of 185%. Normally, the reactive protein should not be larger, 02 g / l.
4. The level of fibrinogen, sialic acids, haptoglobin in arthritis is elevated.

Arthroscopy is a minimally invasive method of surgical intervention with minimal loss of blood

• Investigation of synovial fluid. Diagnosis is carried out as follows: puncture takes a little fluid from the inflamed joint and examines its composition. In the presence of rheumatoid arthritis, turbidity and reduced viscosity are noted.
• Leukocytes. In the presence of an inflammatory process in the joint, the analysis shows a value of about 2, 00 in 1 μl. This indicates a significant excess of white blood cells, characteristic of the acute course of the disease.
• Lymphocytes CD4. If the result gives an increase in concentration not only in the blood, but also in the synovial fluid of CD4 lymphocytes (regulate the strength of the immune response), that is, an occasion to suspect a serious form of the disease with an unfavorable outcome. In the case when the analysis shows an increase in the ratio of CD4 / CD8 (the type of cells that suppress the immune response) to 3, this also indicates the development of an irreversible pathological process in the joints.

Treatment often involves the use of special bioagents that block the activity of CD4 cells, greatly alleviating the symptoms.

Instrumental methods

• Arthroscopy. It is a minimally invasive method of surgical intervention with minimal loss of blood: two punctures in the knee introduce a video camera and instruments. A detailed diagnosis of all internal changes is available. Based on the information obtained, it is possible to plan effective treatment of arthritis.
• Biopsy of the synovial membrane of the joint. The procedure is performed with arthroscopic access under anesthesia. For the study, a small piece of synovial tissue is taken. Further, a histological or microscopic examination is performed to determine the nature of the lesions.
• Scintigraphy of joints. One of the most informative methods of radiation diagnosis for detecting early stages of arthritis development, when any symptoms have not yet manifested. A small amount of a radioactive substance of technetium is injected into the body, then a gamma tomograph is started. A large concentration of technetium will be in the affected joints. A series of images can be performed to determine the dynamics of the process.

In rheumatoid arthritis, ultrasound diagnoses such a factor as a pathological change in the synovial membrane of the joint

Magnetic resonance imaging

Sensitive method, which allows diagnosing synovitis, bone erosion and edema. But these signs do not always belong to rheumatoid arthritis, so more research is needed.

Uzi of joints

An affordable, non-traumatic and economical method, the accuracy of the result is superior to the radiographic method, since it allows you to visualize the condition of muscles, ligaments, cartilaginous tissue, tendons.

But it is impossible to investigate any deep structures and subchondral foci (for example, the shoulder joint).

In rheumatoid arthritis, ultrasound can diagnose a factor such as a pathological change in the joint's synovial membrane.

Radiography

Often the method is used to monitor the development of bone erosion to correct treatment.

In the early stages of the symptoms of the disease using an X-ray can be found only on the hands and feet.

Otherwise, the radiography will show only what the rheumatologist is able to determine by touch - the effusion and swelling of the soft tissues.

All of the above types of research (blood test, including on the rheumatoid and antinuclear factors) are available to any citizen of the Russian Federation, and free of charge under the OMS program. Therefore, there is no reason to postpone the diagnosis and risk joint health, because the treatment is effective only in the early stages.

• All means have been tried, and nothing has helped?
• Are you in constant pain?
• And now you are ready to take advantage of any opportunity that will give you the long-awaited well-being!

A source: http://lechuspinu.ru/artrit/diagnostika-i-analizy-pri-revmatoidnom-artrite.html

What tests must be taken for rheumatoid arthritis - Home Treatment

Rheumatoid arthritis is an inflammatory autoimmune disease of the joints. Analyzes for rheumatoid arthritis are appointed by the doctor to confirm the diagnosis.

But even an experienced specialist to identify such a disease is quite difficult. This is due to its blurred symptoms.

The disease affects mainly the small joints of the hands and feet.

In women, rheumatoid arthritis is observed much more often than in men. Young women under 30 are at risk. After 50 years, sex differences are erased, and anyone can get sick. In men, the disease is more severe and progresses rapidly.

symptomatology of the disease

Often, rheumatoid arthritis begins imperceptibly and is characterized by certain signs. At absolutely healthy people suddenly joints inflame.

The causes of this disease have not yet been established, but it is known that the case in the immune system: it begins to produce antibodies to the tissues of the joints, thereby causing inflammation.

Over time, joints are deformed, their destruction occurs, as a result of which they lose their functions, and a person loses his ability to work and receives a disability.

# Image.јrdThe ability to develop rheumatoid arthritis can:

• genetic predisposition (if one of the relatives suffers from this disease, the probability of the disease increases dramatically);
• hypothermia (most often the disease develops in autumn and winter);
• infectious agents (especially the Epstein-Barr virus, which is found in 80% of patients);
• bacteriological infections;
• injuries;
• stress.

Despite the fact that medicine has moved far ahead, autoimmune diseases, including rheumatoid arthritis, can not be cured or prevented by doctors.

The patient at first does not notice anything special, rheumatoid arthritis may be asymptomatic for several months.

Approximately four months after the onset of the disease, the following symptoms appear:

• soreness, swelling of the joints;
• stiffness of the joints, especially in the morning;
• symmetry of inflammation (joints of both extremities are affected);
• presence of cones, seals under the skin (rheumatoid nodules).

Even the appearance of one of these symptoms is the reason for urgently calling a doctor.

Often, patients have decreased appetite, sleep is broken, fatigue appears, there may be a slight increase in temperature, weight loss, lethargy and weakness of the body as a whole.

From the onset of the disease to the diagnosis can take about a year. To establish it, a whole set of studies is carried out.

Back to zmistuDiagnostuvannya rheumatoid arthritis

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With a visit to a rheumatologist should not be delayed, self-medication with such a specific disease is not allowed. It is important to identify the disease as early as possible in order to stop its further development, since at the last stages it affects the circulatory system, the kidneys, the lungs and other internal organs.

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# Image.јard The doctor after the examination can prescribe the following tests:

• general blood analysis;
• biochemical blood test;
• immunological study;
• blood analysis of ATSTSP (Determination of antibodies to cyclic tsitrullen peptide);
• synovial fluid analysis;
• general urine analysis.

In addition to the delivery of analyzes, other studies are also being conducted:

• radiography;
• arthroscopy;
• MRI;
• Ultrasound of joints.

X-ray examination at the initial stage of the disease is of little informative, but at later stages it allows a reliable diagnosis. Usually, an overview radiograph is recommended.

Arthroscopy is a visual examination of the joint, which is carried out by the introduction of a special optical device. If necessary, arthroscopy is used for biopsy.

Magnetic resonance imaging is more indicative. It can detect the disease in the early stages. Approximately one month later, an edema of bone tissue is seen on the MRI.

Return to blood tests show blood tests

Taking a blood test for rheumatoid arthritis is considered mandatory.

In rheumatoid arthritis, such tests show the presence of inflammation and other characteristic changes in the composition of the blood: a slight decrease in hemoglobin, an increase in the rate of erythrocyte sedimentation, an increase in the number of cryoglobulins, white blood cells. With an exacerbation of the disease, thrombocytosis is present.

Indications directly depend on the stage of the inflammatory process, for example, anemia (a decrease in hemoglobin) can be more pronounced, like other indicators.

Immunological research helps to detect the presence of rheumatoid factor.

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But its presence can be considered the main reason for the diagnosis, since it can occur in about 5% of healthy people, and in patients, on the contrary, it is absent.

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Previously, doctors considered the presence of rheumatoid factor a sure sign of the presence of the disease. Today they can simply take it into account as one of the auxiliary indicators.

Biochemical analysis determines the increase in the concentration of haptoglobin, plasma fibrinogen, sialic acids, peptides, seromucoid. The level of gamma globulins increases.

The presence of C-reactive protein in serum is determined. Normally, its level does not exceed, 02 g / l, and with rheumatoid arthritis can reach, 1 g / l. With autoimmune diseases, the concentration of protein fractions changes dramatically.

Antinucleoclonal antibodies can be detected in the blood, but only in 10% of cases. They are not indicative for this disease, since they are considered markers of systemic lupus erythematosus.

One of the most reliable analyzes to date is a blood test on the ATSPP (definition of antibodies to the cyclic tsitrullin peptide). With its help, rheumatoid arthritis is detected in almost 90% of patients.

Citrulline (amino acid) appears in the blood during the inflammatory process. Protein fractions with citrulline are taken by the immune system for foreign cells and attack, respectively, the development of an autoimmune process occurs.

To return to zmistuynshi analyzes at a rheumatoid arthritis

The urine sample is taken in order to exclude any negative processes in the urinary system, since heavy forms of rheumatoid arthritis cause kidney damage leading to kidney failure and other disorders in organism.

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When analyzing the synovial fluid, the characteristic symptoms of inflammation will be visible: the liquid is cloudy, changes in color, the viscosity becomes lower, the level of protein rises. There is also an increase in the level of leukocytes.

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The test results depend on the degree of the disease. Additional tests and studies may be required.

In particular, biopsy of the synovial membrane, which allows to detect changes in the structure of cells and the presence inflammatory process: an increase in the number of villi and proliferation of synovial tissue, deposits on its walls fibrin.

Depending on the stage of rheumatoid arthritis, in addition to visiting a rheumatologist, the patient may be referred for examination to other specialists.

This can occur with a progressive course of the disease without proper treatment in about 10-15 years.

It is not yet possible to cure rheumatoid arthritis completely. It acquires a chronic character.

But to reduce the likelihood of onset of exacerbations, to avoid severe forms of the disease, to defeat other organs, competent treatment is fully capable.

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It is, as a rule, in relieving the exacerbation and maintenance therapy in the future.

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A source: http://ok-doctor.xyz/kakie-analizy-neobhodimo-sdat-pri-revmatoidnom-artrite/

Rheumatoid arthritis and other arthritis

Rheumatoid arthritis- progressive systemic autoimmune disease with chronic inflammation of synovial tissues of unclear etiology. If rheumatoid arthritis is suspected, a rheumat check is mandatory.

Diagnostic criteria

The American Rheumatology Association offerscriteria for diagnosis of rheumatoid arthritis:

1. 7 criteria are mandatory for diagnosing the classic type of rheumatoid arthritis,
2. 5 criteria specify the diagnosis,
3. 3 determine the probability of pathology.

Laboratory studies to determine these criteria for rheumatoid arthritis:

1. positive serum test for rheumatoid factor (in any method, positive in less than 5% of normal control subjects);
2. a mucin-poor thick synovial fluid;
3. characteristic histological changes in the synovial membrane; characteristic histological changes in rheumatoid nodules.

Analyzes

• Antibodies to the cyclic citrullinated peptide(a well-known reduction - ATSTSP) with rheumatoid arthritis - a newly discovered immunoprotein. ratio sensitivity / specificity = 41-80% / more than 89% 8.

  Becomes positive earlier than rheumatoid factor.

• Presence in serumrheumatoid factor IgM-class(autoantibodies of IgM class) is determined in 50-90% of patients with rheumatoid arthritis.

  The sensitivity / specificity ratio is 72% / 80%, and in the first 6 months of the disease the positive values ​​are approximately 40% of patients, and often other autoimmune diseases, including hepatitis, tuberculosis, and less than 5% healthy persons.

  The proportion of seronegative patients is less than,%.

• In serological studiesrheumatoid factor (autoantibodies to immunoglobulins)nephelometry, latex, bentonite, as well as sheep or human erythrocytes

• A slide test is used only for screening rheumatoid arthritis; positive results are confirmed by a test in diluted test tubes (nephelometry, ELISA). Significant titles are more than 1: 80. With rheumatoid arthritis, titles from 1: 640 to 1: 5120 and sometimes 1: 32, 00 are not uncommon. Titers in other conditions (not rheumatoid arthritis) are usually less than 1: 80.
• Useful for the detection of rheumatoid arthritis, however, negative results do not exclude rheumatoid arthritis. Negative in one third of patients with established diagnosis of rheumatoid arthritis. Positive results in less than 50% of patients in the first 6 months of the disease. Different methods give a sensitivity / specificity ratio of 50-75% / 75-90%. Positive in 80% of typical cases; high titers in patients with splenomegaly, vasculitis, subcutaneous nodules, neuropathy. Titres may decrease during remission, but rarely become negative. The progressive increase in the titers of the rheumatoid factor in the first 2 years of the disease indicates a severe course.
• Positive in 5-10% of healthy population; a progressive increase is observed in less than 25-30% of people older than 70 years.
• Positive in 5% of diseases with rheumatoid factor (arthritis, assisted with inflammatory intestinal diseases, Reiter's syndrome, juvenile rheumatoid arthritis, spondylitis, osteoarthritis, pseudogout).
• Positive in 5% of cases of scleroderma, mixed connective tissue diseases, polymyositis, rheumatic polymyalgia.
• Positive in 10-15% of patients with systemic lupus erythematosus.
• Positive in 90% of patients with Sjogren's syndrome or cryoglobulinemic purpura.
• Positive in 10-40% of patients with Waldenstrom macroglobulinemia, chronic infections (syphilis, leprosy, brucellosis, tuberculosis, systemic lupus erythematosus), viral infections (hepatitis, Epstein-Barr viruses, influenza vaccinated, including smallpox virus, and less than 10% of patients are positive with parvovirus B19 associated with arthritis), with parasitic diseases (malaria, schistosomiasis, trypanosomiasis, filariasis), chronic liver diseases, chronic pulmonary interstitial fibrosis, e.
• Positive in 20% of patients with psoriatic arthritis.
• Positive in 25% of patients with sarcoid arthritis.
• Negative in osteoarthritis, ankylosing spondylitis, rheumatic fever, purulent arthritis; Antinuclear antibodies are present in 28% of patients, there may be low titres of antibodies to DNA.

• With rheumatoid arthritisantinuclear antibodiesare found in 85-95% of patients.
• Rheumatoid factor is present in approximately 80% of patients. It is often observed with Sjogren's syndrome, less often with other connective tissue diseases, sometimes with a chronic infection, such as subacute bacterial endocarditis, gammopathy.
• Histonesare found in 20% of patients.
• Whey complementusually normal, except for patients with vasculitis; the level below the norm is usually associated with a very high level of rheumatoid factor and immune complexes.
• The study of immune complexes - monoclonal antibodies to rheumatoid factor and binding of Clq - gives positive result in rheumatoid arthritis more often than in other studies, but poorly correlated with activity disease. Positive results of studies on mixed cryoglobulins indicate the presence of immune complexes and are associated with an increased incidence of extraarticular manifestations, especially vasculitis.

Results of a general blood test for rheumatoid arthritis that have no clinical significance

• Increased ESR, C-reactive protein and other acute phase reactants. ESR and C-reactive protein are often used to determine the type and activity of treatment, but these may remain normal in 5% of patients.

  Very high ESR (more than 100 mm / hr) is extremely rare in the early stages of rheumatoid arthritis.

• Leukocytes in rheumatoid arthritis are usually normal, there may be a slight increase in the early stages of the active disease.
• Often there is an insignificant thrombocytosis - an increase in the number of platelets in the blood, as an acute phase reactant.
• Electrophoresis of serum proteins reveals an increase in globulins, especially gamma and alpha2-globulins, and a decrease in albumins.
• Moderate normocytic hypochromic anemia of a chronic disease, with a reduced serum iron level, normal total iron binding capacity Serum and normal iron stores (serum ferritin and bone marrow iron); non-treatable iron, folic acid and vitamin B12 or splenectomy. With a hematocrit less than 26%, another cause of anemia needs to be sought (eg, bleeding in the gastrointestinal tract). Anemia decreases with remission or effective therapy. Read about the diagnosis of anemia in the article "Diagnosis of anemia. What tests should I take? ".
• The level of serum creatine kinase is below the norm in more than 60% of patients, is not associated with a decrease in the level of serum aldolase, and myosin does not indicate a general deterioration in muscle function.
• The level of serum calcium, phosphorus, alkaline phosphatase, uric acid, anti-streptolysin-t titer is normal.

• Biopsy of the synoviumespecially useful in monoarticular form of rheumatoid arthritis, to exclude tuberculosis, gout, etc.
• Glucose of the synovial fluid can be significantly reduced (less than 10 mg / dl), rice corpuscles (mucin clots) - from abundant to small (see Fig. Table. 10.6).
• Laboratory evidence of extraarticular involvement (usually found in later stages of severe diseases) (eg, pleural or pericardial effusion, interstitial pulmonary fibrosis).
• Laboratory data showing the therapy with drugs, for example salicylates, non-steroidal anti-inflammatory drugs, gold salts, penicillamine).

Juvenile rheumatoid arthritis

Juvenile rheumatoid arthritis- A group of inflammatory arthropathies, affecting patients less than 16 years for more than 6 weeks with the exclusion of other causes; four types, based on clinical symptoms.

Tests for laboratory diagnostics are absent.

There are reports of variations in the values ​​of rheumatoid factor and antinuclear antibodies depending on the clinical type and the laboratory methods used - the results may be negative.

Laboratory data indicate concomitant conditions (eg, psoriasis).

Felty Syndrome

Felty Syndromeoccurs in 1% of cases with far-reaching rheumatoid arthritis associated with splenomegaly and leukopenia. Serological tests for the rheumatoid factor are positive and have high titers.

Antinuclear antibodies are usually present. The titers of immune complexes are high, and the levels of complement are lower than in patients with rheumatoid arthritis. There is a leukopenia (less than 2500 / μL) and granulocytopenia.

Due to hypersplenism, anemia and thrombocytopenia can occur, which are sensitive to splenectomy.

Psoriatic arthritis

Psoriatic arthritis- inflammatory arthropathy in less than 2% of patients with psoriasis (chronic autoimmune skin disease). There is no correlation between the activity of the skin disease and joint manifestations; the manifestations of one can surpass the manifestations of the other.

Analyzes for psoriatic arthritis

• The level of serum uric acid is increased due to the increased rate of renewal of skin cells in psoriasis.
• Serological tests for rheumatoid factor are negative, therefore the disease can not be classified as rheumatoid arthritis.
• There are no specific data from laboratory studies.

Reiter's syndrome

WhenReiter's syndromethe classical triad - acute inflammatory arthritis, urethritis and conjunctivitis - is present in less than 33% of patients; additional characteristic signs: dermatitis, ulceration in the oral cavity, circular balanitis, blennoragic keratoderma and ophthalmic manifestations.

Analyzes

Acid-phase reactants were increased:

• ESR - in accordance with the clinical course
• C-reactive protein;
• leukocytes (1, 00 - 2, 00 / μl), as well as the amount of granulocytes.

In a general blood test, moderate normochromic anemia.

The level of serum globulins is increased with persistent and prolonged course, illness.

Cultures or serological evidence of previous infections (eg, Chlamydia, Campylobacter, Salmonella, Shigella) are associated with 10% of these infections. There are non-bacterial cystitis, prostatitis, seminal vesiculitis and not manifested clinically, infection, ileum and colon.

In the synovial fluid, leukocytes are identified from , 00 to , 00; crop culture is negative.

HLA-B27 is present in almost 90% of white patients; has no diagnostic value.

Practicing therapist

A source: https://gradusnik.net/revmatoidnyj-artrit-i-nekotorye-drugie-vidy-artritov/