Optimizing an RA Appointment with a Family Doctor or Rheumatologist

Finding Help for Rheumatoid Arthritis

Rheumatoid arthritis (RA) generally affects the smaller joints of the hands and feet. As opposed to the “wear and tear" type of damage caused by osteoarthritis, RA affects joint linings.

This process results in painful swelling that can ultimately lead to deformity and potential misalignment of the joints as well as erosion of the bones.

Common signs and symptoms of rheumatoid arthritis include:

  • Warm, swollen, tender joints.
  • Stiffness occurring in the morning that may persist for hours.
  • Rheumatoid nodules (i.e. firm bumps of tissue which develop under the skin of the arms).
  • Unexplained loss of weight.
  • Fever.
  • Tiredness.

As mentioned above, early stages of RA tend to initially affect the smaller joints of the fingers and toes. As the condition advances, symptoms can spread to the elbows, shoulders, ankles, knees and hips. In the majority of cases, symptoms develop within identical joints on both sides of the body.

RA signs and symptoms can vary in their degree of severity as well as come and go. For example, “flare-ups" (episodes of elevated disease activity) can alternate with relative “remissions" (times when swelling and/or pain either fade or completely disappear).

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When you should see a doctor or specialist

If you are experiencing persistent swelling, pain and discomfort in your joints, make an appointment with your primary health care provider as soon as possible.

While you will likely discuss your signs and symptoms with your family doctor first, he or she may refer you to a rheumatologist (a specialist in the diagnosis and treatment of inflammatory conditions including RA) for additional assessment.

What you can do to help prepare for your rheumatologist appointment

In order to optimize the time you spend with the rheumatologist, compose a thorough list that includes the following:

  • Detailed description of current signs and symptoms.
  • As much information as you can remember concerning your past medical conditions.
  • As much information as you know related to your parents’ and/or siblings’ medical problems.
  • Every prescription, OTC medication including vitamins and dietary supplements you are taking currently.
  • Any questions/issues you want to discuss.

What you can expect from the rheumatologist

He or she will likely ask you several questions. Be ready to answer them as accurately and truthfully as possible. Your rheumatologist could possibly ask the following:

  • Being as accurate as possible, when did your symptoms first develop?
  • Have these symptoms changed at all over time?
  • Which of your joints are specifically affected?
  • Do any particular types of activities cause your symptoms to improve? Get worse?
  • Do any of your symptoms actually interfere with your daily tasks/activities?

During the course of the physical examination, be prepared for the doctor to check for joint redness, swelling and/or warmth. In addition, he or she will assess your overall muscle strength and reflexes. Wear appropriate clothing (e.g. track pants, shorts) or you may be asked to put on a patient gown.

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Getting tested

In its earliest stages, RA can be difficult to diagnose as it often mimics many other medical conditions. Unfortunately, there is no single blood test or physical finding that will definitively confirm a rheumatoid arthritis diagnosis.

Be prepared for the specialist to draw several vials of blood for diagnostic purposes or else you might be asked to go to a lab to have the blood tests done. You may also be asked to have an X-ray done as a “benchmark". This will assist in tracking RA progress within your joints over time.

It is important for you to have any prescribed tests and/or procedures performed as promptly as possible. Doing so will optimize your treatment goals.

Next page: how to prepare and what to expect. 

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