There is a recent review on Clinics of North America:
Rheum Dis Clin North Am. 2014 Nov;40(4):669-683. doi: 10.1016/j.rdc.2014.07.009. Epub 2014 Oct 14.
Detecting the Earliest Signs of Rheumatoid Arthritis: Symptoms and Examination.
Attached.
Hoping to be useful.
You asked,What is the lab.dx? not what are.
I advice you only one test RA test. Additional test-CBC, ESR, CRP. Anti-CCP antibody, Joint imaging.
Rheumatoid arthritis is not diagnosed by laboratory test. If you are not able to diagnose it clinically with history and examination in the great majority of cases then you need further clinical training. All relevant tests can be normal in RA and all relevant tests can be abnormal without it being RA. There is no simple answer.
Dear Amr Mansour,
There is not a single laboratory test that can be used to diagnose Rheumatoid Arthritis.
Although the combination of both RF and ACPA predicted RA with an improved sensitivity of 49% to 56% and a specificity of 98% to 100% and even the presence of other antibodies like antibodies against carbamylated proteins (recently discovered) or anti-MCV, the diagnosis of RA is mostly based on clinical examination. Of course, serolgical and radiological examination can further support your diagnosis but the clinical presentation is still the first to orient you toward a correct diagnosis.
The answers you have been getting are specific to rheumatoid arthritis. When you are asking about "rheumatoid disease", are you including the possibility of other autoimmune diseases, e.g., lupus, scleroderma, Sjoegren's, etc.? If the question is intended more broadly, then you need to start with doing ANA testing by indirect immunofluorescence (IFA), preferably using human HEp-2 cell substrate. If that test is positive, then clinical symptoms would dictate what type of specific antibody testing would be appropriate.
Diagnosing RA includes the following-
a. Clinical - synovitis of the small joints of hand and feet associated with morning stiffness b. Rheumatoid factor and/or Anti CCP positivity c. radiology which shows joint space narrowing and later erosions d. esr and crp are usually positive.titres of these tests are important. no other cause to explain the symptoms especially if tests are negative.
however clinical suspicion and examination is the most important as 'sero negative' RA is a well known entity.
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