Arthritis : Symptoms and Diagnosis, Part 2

by National Institute on Aging

(Page 4 of 7)

One common test for rheumatoid arthritis is the rheumatoid factor test. However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. Another test is called the citrulline antibody test.

Other common tests for rheumatoid arthritis include the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body; a test for white blood cell count; and a blood test for anemia.

Also, symptoms of rheumatoid arthritis can be similar to those of other types of arthritis and joint conditions, and it may take some time to rule out other conditions. Finally, the full range of symptoms develops over time, and only a few symptoms may be present in the early stages.

Quiz

1. Rheumatoid arthritis predominantly involves inflammation of the tendons.

FALSE is the correct answer. Rheumatoid arthritis predominantly involves inflammation of the joint lining.

2. Rheumatoid arthritis generally occurs in a symmetrical pattern.

TRUE is the correct answer. Rheumatoid arthritis generally occurs in a symmetrical pattern. If one hand is affected, the other one usually is, too.

3. Rheumatoid arthritis is easy to diagnose in its early stages.

FALSE is the correct answer. Rheumatoid arthritis can be difficult to diagnose in its early stages for several reasons. First, there is no single diagnostic test for the disease. Secondly, symptoms differ from person to person and can be more severe in some people than in others.

4. Certain tests, such as the rheumatoid factor test, are useful in diagnosing rheumatoid arthritis.

TRUE is the correct answer. Some tests that doctors use to help diagnose rheumatoid arthritis include the rheumatoid factor and the citrulline antibody test.

5. It is difficult to diagnose rheumatoid arthritis because there is no single test for the disease.

TRUE is the correct answer. There is no single test for the disease. In addition, symptoms differ from person to person and can be more severe in some people than in others.

Gout Symptoms and Diagnosis

Hyperuricemia - high levels of uric acid in the body - contributes to arthritis that develops in one day, producing a swollen, red, and painful joint. Gout attacks usually begin at night.

Gout typically attacks one joint at a time. Gout normally attacks joints in the lower part of the body, such as the knee, ankle or big toe. For many people the joints in the big toe are the first to be attacked. In fact, sometime during the course of the disease, gout will affect the big toe in about 75 percent of patients.

Drawing of foot with gout. To confirm a diagnosis of gout, the doctor inserts a needle into the inflamed joint and draws a sample of synovial fluid, the substance that lubricates a joint. A laboratory technician places some of the fluid on a slide and looks for monosodium urate crystals under a microscope. If crystals are found in the joint fluid, the person usually has gout.

Quiz

1. Gout attacks usually begin

A. in the morning
B. in the afternoon
C. at night

C is the correct answer. Gout attacks may begin anytime but frequently start at night.

2. Sometime during the course of the disease, gout usually affects the joints in the

A. thumb
B. big toe
C. knee

B is the correct answer. Sometime during the course of the disease, gout usually affects the joints in the big toe. The big toe becomes swollen, red, and painful.

3. The final step in confirming a diagnosis of gout is to

A. take x rays
B. get the patient's medical history
C. examine a sample of synovial fluid from the inflamed joint

C is the correct answer. To confirm a diagnosis of gout, the doctor inserts a needle into the inflamed joint and draws a sample of joint fluid for analysis under a microscope.

4. A person usually has gout if __________ are present in a sample of joint fluid.

A. monosodium urate crystals
B. proteins
C. red blood cells

A is the correct answer. If monosodium urate crystals are seen when looking at the fluid under a special microscope, the person usually has gout.

5. Gout

A. usually affects young women.
B. most often affects one joint at a time.
C. always causes flu-like symptoms.

B is the correct answer. Gout usually affects a single joint. In rare cases, many joints are affected at the same time. Gout frequently affects a joint in the lower part of the body such as a knee, ankle, or toe. Sometime during the course of the disease, gout will affect the big toe in about 75 percent of patients.

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.