Q: I am 45 years old male who has tested positive for rheumatoid arthritis three years back. My present rheumatoid arthritis factor tested is 64%. Is it on higher side? Can proper medication improve rheumatoid arthritis?

A:You must realised that for making a correct diagnosis of any joint disease, we need a very detailed medical history that usually is possible only during actual clinical evaluation of the patient by the treating doctor who can cross-check the symptoms and their characteristics. After your medical history have been taken, you need to be physically examined and each and every joint is examined and noted down, This is then followed by the evaluation of acute phase reactants and RF and anti-CCP antibody in the blood. Finally, all this information is synthesised to reach a correct diagnosis.

As you have not undergone any of these procedures (at least you have not given any details), it is not possible to guess the joint disease that you have. Also, there is widespread misconception among doctors as well as patients that rheumatoid factor (RF – widely misrepresented as ‘RA factor’) gives the diagnosis of rheumatoid arthritis (RA). This is actually incorrect; rheumatoid arthritis is diagnosed by clinical evaluation. Once the diagnosis is made, then RF is done to see if the patient has ‘seropositive RA’ OR ‘seronegative RA’. This helps the treating doctor in predicting the prognosis and often gives a general idea of the best management strategy.

With the above details, it would be obvious to you that instead of trying to fathom these intricacies, it would be highly advisable that you MUST immediately arrange for consultation with a rheumatologist who are physicians specially trained in diagnosing and treating diseases of the joints (not Orthopaedic Surgeons as they are not trained in this filed). This is very important because only a correct diagnosis leads to correct treatment. And, correct treatment given in early stages may completely halt the progression of the disease. Therefore, get hold of a rheumatologist at your earliest as time is at premium here.