MAKING THE DIAGNOSIS FOR RHEUMATOID ARTHRITIS: CLINICAL EVALUATIONMaking a diagnosis of rheumatoid arthritis is not easy. As with all other diseases, there are many ways that your disease might manifest itself. In addition, the first complaints might be very general and vague. The doctor initially tries to develop a differential diagnosis-one made by comparing and contrasting the symptoms of different disorders. Once the doctor suspects rheumatoid arthritis, he or she will look for the typical signs and symptoms of the disease. When enough of these signs are present, the doctor may order a few laboratory tests to confirm his or her diagnosis of RA.Unfortunately, there is no one specific test for rheumatoid arthritis, but the presence of certain findings on more than one test can confirm a positive diagnosis.
What are the clinical signs of rheumatoid arthritis?There are many clinical signs of RA. Chief among them is what doctors call arthralgia or, “joint pain.” As the disease progresses, the arthralgia worsens and eventually becomes arthritis, or inflammation of the joint, which makes movement very difficult. Morning stiffness exacerbates this problem.
Are there criteria for a diagnosis of RA?Yes, there are seven criteria a doctor looks for when establishing a diagnosis of RA. At least four of the following seven criteria must be present in order to make the diagnosis. If any of the first four are present, they must have been present for at least six weeks.1.  Stiffness in the morning that usually lasts for longer than an hour and gradually improves over the course of the day.2.  Inflammation, pain, and swelling of three or more joints at the same time.3.  Pain and inflammation of the hand joints (wrist, knuckle, and/or those in the middle finger).4.  Arthritis on both sides of the body at the same time (symmetry). This does not have to be the case with arthritis in the hands, where some of the smaller joints might not be affected in both hands.5.  Nodules over the bony parts of the joints or next to them.6.  Presence of the antibody called rheumatoid factor in the blood.7.  Evidence of bone erosions or early bleaching of bone on X-ray.*22/141/5*

Those so-called “misguided T-cells” are actually what are known as memory T-cells. In the arthritic process (whether rheumatoid, osteo, or other) these memory T-cells develop an internal program, just like some sort of computer,, which commands macrophage cells to attack and destroy cartilage. This destructive process results in the inflammation of the joints that is so typical in people afflicted with the disease.

The inflammation, in turn, affects the nerves and that’s what usually causes the associated pain. The inflammation may also push some bones out of place resulting in the disfigurement that is so typically found in arthritic joints.

Unfortunately, those memory T-cells never give up. It seems their malfunctioning programs go on forever. Moreover, they clone themselves, generating more and more misprogrammed

T-cells that direct more and more attacks against your cartilage. That’s why, as time passes, arthritis only gets worse, virtually never gets better.

But how does it all start? No one is absolutely certain, but probably it’s because some macrophages discover some particles of diseased or damaged cartilage that needs to be disposed of. Macrophages are like garbage collectors inside your body. Their job is to get rid of any foreign matter and organisms they encounter. They destroy invading organisms like viruses and bacteria, and they clean up waste matter as well. That includes any fragments of unhealthy cartilage damaged by some physical trauma or produced by some invading organism like that which causes rheumatic fever – or maybe even the flu. (Remember those achy feelings in your joints when you had a serious bout with the flu?).

*1\142\2*

The article reports on how all three of the most advanced scientific research projects today are intensely focussed on intervening in the immune system involvement in the arthritic process.

Of course the first thing you probably want to know is how any of this, can benefit you personally-specifically, how you, like the thousands before you, can be rescued from the crippling pain and inflammation of arthritis. First, it’s important for you to know a bit about the arthritic process in order to understand how it can be reversed.

Stopping the symptoms doesn’t stop the disease-There have been thousands of volumes written by thousands of authors on the how-and-why theories of arthritis. There are almost as many different theories as there are authors. Some of them are pretty screwy, but all of them are pretty scary.

The scary part is that no one has been able to stop the relentless, destructive advance of arthritis – until now!

Sure, you may sometimes slow it down a bit through diet and nutritional supplements. You can ease the symptoms with anti-inflammatory drugs and pain relievers. Your doctor can clobber your system with highly toxic anti-cancer drugs like

Methotrexate (also disguised under the less frightening name of Rheumatrex), which just maybe could give you some temporary relief at the cost of sacrificing your liver. But, until now, nobody has been able to halt the destructive onslaught against your cartilage and your joints.

*1\142\2*