Seven Key Diagnostic Criteria for Rheumatoid Arthritis

Early diagnosis and immediate, aggressive treatment of rheumatoid arthritis are crucial because only a brief window of opportunity exists to prevent permanent disability and lifelong complications. But early diagnosis of rheumatoid arthritis is often difficult because the initial symptoms may mimic those of osteoarthritis, influenza (flu) and other viral illnesses. Also, in the early stages of rheumatoid arthritis, joints may not be red or swollen and may appear normal on X-rays.

Rheumatologists follow standardized guidelines for evaluating anyone who might have rheumatoid arthritis. No single laboratory test or diagnostic procedure can confirm the diagnosis. Instead, seven diagnostic criteria are used:

Morning stiffness
Arthritis in three or more joints
Arthritis in the hand joints
Symmetrical arthritis
Rheumatoid nodules
Elevated blood level of rheumatoid factor
Radiographic (X-ray) changes

The diagnosis will be rheumatoid arthritis if the first four criteria have been present for at least six weeks, long enough to rule out the possibility that a virus has caused the arthritis symptoms.

Even if you don't meet the four-of-seven criteria standard, you still may have rheumatoid arthritis. If you have two or three of the criteria, more testing is necessary because if you do have rheumatoid arthritis, even a short delay in beginning treatment can be harmful.

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