Diagnosing RA

We often notice valuable discussions taking place within our community forums or Facebook page that we like to highlight as a part of our Headlines. Below is a discussion on diagnosing RA that we thought our community members would find interesting. Please note that the opinions represented here are solely those of their authors.

Unfortunately, there is currently no single blood test or physical test that is used to confirm a diagnosis of rheumatoid arthritis.1,2 An elevated erythrocyte sedimentation rate (ESR, or sed rate) is commonly seen in people with RA, as it indicates the presence of inflammation in the body. A doctor may also look for rheumatoid factor (RF), anti-citrullinated protein antibodies (ACPA) (including anti-cyclic citrullinated peptide [anti-CCP] and anti-mutated citrullinated vimentin [MCV] antibody tests), C-reactive protein (CRP), antinuclear antibody (ANA), complete blood count (CBC) as part of a patient’s assessment. In addition to laboratory testing, the diagnostic process includes imaging, physical examination, and recording information about family history. One of our community members asked the following question about potential false-positive laboratory test results for RA:

Community Question – Is it possible to test positive for all three of these tests: rheumatoid factor, Anti-CCP antibodies, and Anti-MCV antibodies – yet not have rheumatoid arthritis?

Response from Andrew:

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All of these tests have a certain amount of false positive results meaning that you show a positive result, but not have the disease. That said, it may also be that a person can have the antibodies to these tests in their bodies and not be showing symptoms of the disease yet because the disease is still in the early stages of development. This is more so the case with ACCP and AMCV tests and is actually one of the benefits of those tests in that it allows doctors to catch the disease early. In fact, ACCP is highly specific with up to 95% of people with a positive test having the disease. All this to say that you could be positive and not yet be having physical symptoms. Please talk about what all this means with a rheumatologist.

What criteria did your doctor use when diagnosing RA? Did you have concerns about false-positive test results? For more information about how RA is diagnosed, click here.

 

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