Sometimes a patient comes to the rheumatology clinic and when we ask him what his problem is, he would tell us he just discovered he had rheumatoid arthritis and that's why he's here in the clinic; he is coming to confirm the diagnosis and to start treatment of course before things complicate further.
So what is that you are complaining of?
Nothing. I am not complaining of anything. I just discovered the diagnosis of rheumatoid arthritis by mere chance.
Well, I would like to clarify here to any patient who has ever been in that situation that rheumatoid arthritis disease is not a diagnosis to discover by chance at all. Rheumatoid arthritis is a disease that causes inflammation of the joints and this inflammation has to have symptoms. The most important symptoms are pain in the joints or swelling of the joints or stiffness of those joints. If you have no symptoms, there is no rheumatoid arthritis. We don't discover rheumatoid arthritis by chance.
Usually the patient who comes to the clinic with the chance discovery that he has rheumatoid arthritis is actually referring to a positive result of a blood test, the rheumatoid factor test, or the anti-CCP test, that he did for some reason and that was positive. The value of any of those two tests is only minor or complementary in the diagnosis of rheumatoid arthritis.
The question here is: in a disease like rheumatoid arthritis that is basically diagnosed by symptoms and physical examination, why would a patient do such blood tests in an attempt to diagnosis this disease anyway?
Unfortunately, in some countries, patients can go to the lab and can self-request blood tests on their own based maybe on what they read on google. Another problem is that a non-specialist would sometimes also request lab tests that the specialist finds no point in requesting. Even if the rheumatoid factor test or the anti-CCP test were requested as part of general checkup lab tests for the patient, it is important to note here that neither the rheumatoid factor test nor the anti-CCP test are included in any routine checkup labs list for any age group.
Most important is this fact:
there are several medical reasons for a positive rheumatoid factor test or an
anti-CCP test other than rheumatoid arthritis. In addition, rheumatoid factor
test and anti-CCP test can be positive in a small percent of some of the
healthy subjects who are not complaining of any symptoms and who do not have
any diseases. So a positive test
for rheumatoid factor or anti-CCP, alone, does not make a diagnosis of
rheumatoid arthritis. Symptoms and examination are the most important
tools for the diagnosis followed by the accessory tool of blood tests.
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Social media hashtag:
#hatem_eleishi
#rheumatoid
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This post was prepared and published by Dr. Hatem Eleishi. Dr. Hatem Eleishi is a professor of rheumatology at Cairo university (Egypt) and is especially dedicated to supporting arthritis patients with online educational videos and articles about arthritis causes and treatment. He also runs a rheumatology clinic in Cairo and a center for online medical consultations that, in addition to providing online rheumatology consultations, also provides online medical consultations in several different medical specialties by expert consultants from Egypt, Canada and the United States.
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