How do health care professionals diagnose RA?
Diagnosis in its earliest form begins with a complete history and physical examination. When you visit your physiotherapist at Skill Builders they will ask questions about when and how your pain began, what joints are involved, and what activities aggravate or relieve your pain. It is best if you can be very specific about where your pain is and when precisely it started. We may also ask about any previous injuries you may have had to your joints, as well as overall general health questions and questions about any family history of disease. The history is an extremely important part of any examination and may already lead your physiotherapist to the suspicion of RA.
Next your physiotherapist will do a physical examination of your joints. First they will simply look and feel your joints for any signs of swelling which may include redness, increase in size, warmth, or possible abnormalities in the joint position or abnormalities such as nodules. We will always compare both sides of your body for differences or similarities and will often check many joints even if they do not feel painful to you.
Next your physiotherapist will ask you to actively move your affected joints to assess your willingness and ability to move and also to determine if there is a range of motion deficit. Your physiotherapist may also ask you to relax your muscles while they passively move your joints to further assess the range of motion. While your joints are moving we will also be assessing for crepitus, which is a high-pitched screech or grinding that you can feel or hear in the joint when bone rubs directly on bone.
This sound can indicate that inflammation in the joint has worn down the tissue inside such that the ends of the joints are rubbing on each other. Lastly, we will also check for any signs of damage or looseness in the joints by stressing the ligaments (the tissues that attach bone to bone.)
If your physiotherapist deducts from the history and physical examination that your problem is potentially due to RA, we will refer you on to your doctor for further examination and investigations.