This condition requires different criteria to establish the diagnosis.
Dr. Paloma Alejandro, rheumatologist at the Soto-Raíces Mindful Rheumatix & Medical Research Group. Photo: Archive of the Journal of Medicine and Public Health. Fabiola Plaza.
“There is a 30% patients with rheumatoid arthritis that does not show antibodies on the blood“, as indicated by the Dr. Paloma Alejandrorheumatologist at the Soto-Raíces Mindful Rheumatix & Medical Research Group, who added that the physical assessment and follow-up of the patient’s discomfort must be followed up.
An MRI, for example, or other imaging tests help in patients whose diagnosis is not defined, they require more in-depth examinations to see tissue damage. “One must think of practicing effective medicine, without patients have to spend money unnecessarily,” reflects the expert.
For his part, Dr. Oscar Soto Raíces, director of the Soto-Raíces Mindful Rheumatix & Medical Research Group, added that the diagnosis requires a physical exam that counts how many joints might be affected.
“Sometimes a patient is received with a diagnosis possible, but the most important thing is the clinical, In these criteria there are no images, these are necessary, but there are other studies that are also used to establish the diagnosis“, said.
“If we like to be academic and follow the criteria of the academy, because this involves a number of things, such as counting how many joints are involved and depending on the number of joints, a number is assigned on the scale of the finding. Another part is the test of serology, where some criteria are also taken,” he said.
In this sense, he specified that a patient who has this type of manifestations does not always have rheumatoid arthritisbecause in the middle of the classification of pain and swelling must be present for 5-6 weeks in a row.
Regarding this process, Dr. Soto highlighted that in the case of the rheumatoid arthritis This usually affects small joints, so he indicated the importance of taking this into account for the diagnosis prompt.
As the assessment progresses, according to Dr. Soto, the images of the patient and his affected joints are a complement, but they are to be part of the visual of the damage caused by the disease, but they cannot by themselves decide a diagnosis total.
“In a sonogram, what we rheumatologists look for are two essential aspects: Thickening of the synovium or a positive Doppler signal, that is, active inflammation”, highlighted the Dr. Alejandro.
Regarding nuclear studies, the two specialists agreed that this is not even approved by the Academy of Rheumatologists of the United States, therefore, it is not the process by which a disease can be diagnosed. rheumatoid arthritis.
“Simply put, we don’t recommend using this process to screen for arthritis, because what we see in this study doesn’t reveal whether the patient has arthritis. It’s not the right study to screen for these patients“, said Soto Raíces.
Regarding this, Dr. Paloma Alejandro indicated that it is suitable for other conditions, but not for the different types of arthritis that are known.
In conclusion, specialists recommend that primary care physicians use as an examination diagnosis known as the emaray study, which consists of an image assessment of the rheumatoid arthritis.
“We have to make medicine effective and put ourselves in the shoes of the patient, not make them spend time and money on unnecessary tests. Cost-effective medicine,” concluded the Dr. Paloma Alejandro.
Listen to our full podcast here.