5th June 2025

Investigations

Diagnosis is clinical however investigations can speed up the process. The first line investigations include:

• Rheumatoid factor (RF) – positive in 60-70% of RA patients, found in 90% of patients with rheumatoid nodules
• Anti-cyclic citrullinated peptide (anti-CCP) antibodies – found in 80% of RA patients
• X-rays of hands and feet – can aid diagnosis but often helpful to monitor progress of disease
• Ultrasonography – may detect synovitis of the wrist and fingers at the initial presentation

All people suspected to have RA should have a rheumatology appointment within 3 weeks to confirm this. If the small joints of the hands and feet are affected, more than one joint is affected or there has been a delay of 3 months or more between onset of symptoms and patient presenting, a referral should be made within 3 working days.