How can early rheumatoid arthritis be diagnosed?
Head of the Department of Medicine and Chief of Clinical Immunology and Rheumatology Services,
All-India Institute of Medical Sciences, New Delhi Consultant Rheumatologist, 'A&R Clinic'
Visiting Sr. Consultant, Rheumatologist, ISIC Superspeciality Hospital, New Delhi.
Q: I am a 26 years old girl. I am suffering from pain in my wrists and feet. My blood report has come negative for rheumatoid arthritis, osteoarthritis, lupus and thyroid. My ESR is 26. My rheumatologist has prescribed Mobic 7.5 mg once a day, which hasn't helped me much. He says it could be early arthritis, which is not showing up in the blood. Please advise.
A:The symptoms you have described are suspicious of early rheumatoid arthritis. You haven't mentioned how you feel when you get up from the bed in the morning. I strongly recommend 3 very sensitive and important tests for catching early rheumatoid arthritis:1. C-reactive protein (called CRP test) - a simple blood test2. A new recently introduced blood test called anti-CCP antibody test. Available ONLY in a few highly advanced laboratories.3. Ultrasonic examination of the wrists, finger joints and joints of the feet using high frequency specially designed probes (available in only some of the very advanced imaging centres in bigger cities)It is of utmost importance to diagnose rheumatoid arthritis at a very early stage because with newer modes of treatment (using anti-TNF agents or combos of DMARDs) the disease can be put in long remissions completely or even switched off completely (? cure). You must NOT waste any more time. Immediately get these tests done to either confirm or exclude rheumatoid arthritis with surety rather than simply keep taking Mobic or some such non-specific painkillers and lose precious time. This early period in rheumatoid arthritis is called Window of Opportunity when, if it is real rheumatoid, it can be put in complete remission.