In the early stages of the disease, rheumatoid arthritis can mimic other joint diseases, making it difficult to diagnose the disease. A careful physical examination by your doctor, however, might show characteristic findings of rheumatoid arthritis, including swelling of specific joints in the hands and the presence of rheumatoid nodules.
There is a blood test for rheumatoid arthritis that can clinch the diagnosis. It is called the “rheumatoid factor,” which is a test that detects the autoantibodies that are acting on your joints. Other tests for inflammation can help aid in the diagnosis of the disease.
There are characteristic x-ray findings for rheumatoid arthritis. The joints will look deformed and there will be a lack of joint space noted on x-ray as the disease progresses.
Because there is no cure for rheumatoid arthritis, the treatment is directed at controlling your symptoms and helping you feel better. There are some medications that will slow the degree of joint damage you will experience.
There are several types of drugs used in the treatment of rheumatoid arthritis. Some are relatively easy to tolerate, while others have serious side effects that you should be aware of. Doctors usually start with the medications that are easiest to tolerate first. Here are some good treatments for rheumatoid arthritis.
- Steroid medications, such as prednisone or prednisolone, are helpful in that they reduce the pain and inflammation of the joints and can reduce the rate of joint damage. Unfortunately, they have side effects, such as osteoporosis, diabetes, and weight gain. Steroids are especially good when you have flares of the disease and are not meant to take chronically.
- NSAID medication. These include medications like ibuprofen and naproxen (unless you get one prescribed by the doctor). They are not without side effects, however, and these include liver damage, kidney damage, irritation of the stomach, heart problems, and tinnitus.
- Anti-Rheumatic drugs. These medications can actually lessen the damage done by the autoantibodies so that the joints aren’t permanently damaged. Medications in this class include Plaquenil, Azulfidine, methotrexate, and leflunomide. Because they can affect your immune system, they can cause side effect including suppression of your bone marrow, lung infections, and liver problems.
- Biologic medications. These represent a new class of medications that act on the immune system so that there is less inflammation and less joint damage. They can cause an increase in infections because they affect the immune system. Choices of biologic medications include adalimumab, abatacept, certolizumab, rituximab, and infliximab.
- Physical therapy. You may wish to see a physical therapist who can help you learn various exercises that will keep your joints more flexible. They may also help you learn how to do things around the house that don’t involve using your hands. Assistive devices may be prescribed for you that will help you do things without stressing the joints too much.
- Surgery can be done that can repair the damage to your joints. This includes things like joint replacement in which the damaged joints are removed and a prosthetic joint is put in its place. Tendons can also be repaired. In the worst case scenario, the surgeon can fuse the joints together so they don’t rub against one another.