Autoimmune diseases are notoriously hard to diagnose. It takes several steps to figure out whether you have an autoimmune disease, and, if so, which one. Getting the diagnosis right is key to effective treatment, so it's worth the time and effort it takes to get to the bottom of things. Whatever diagnosis you end up with, the process will likely start with a detailed description of your symptoms, family medical history, and a physical exam.
From there, the healthcare provider will decide what tests and imaging to order. Because RA and lupus are both inflammatory, several tests that measure inflammatory markers in your blood are common parts of both diagnoses. The results simply tell the practitioner whether you do or don't have significant inflammation.
These tests include:. Other tests look for specific antibodies in your blood. You may have any combination of these tests, depending on what your healthcare provider suspects at this point in the process:.
Your healthcare provider may order a number of other antibody tests, as well. And if you're suspected of having lupus, a urinalysis and a tissue biopsy may be performed to gauge organ involvement. Imaging tests that may be part of the diagnostic process for both conditions include:.
Again, additional imaging may be done to look for organ involvement in lupus, such as:. Because these diseases are so hard to diagnose, you may have any of these tests and even more before you receive a firm diagnosis.
Neither RA nor lupus can be cured. The goals of treatment are to minimize symptoms and prevent damage, with long-term remission being the best-case scenario. Both of these conditions are typically treated by rheumatologists —healthcare providers who specialize in musculoskeletal diseases and certain autoimmune conditions.
Classes of medications that may be used to treat both RA and lupus include:. People with lupus or RA may also be treated with antimalarial drugs chloroquine , hydroxychloroquine. Other treatment approaches can be similar for both conditions, such as:. Surgery may become necessary in severe cases of either disease, but such procedures are considered last-resort treatment options. With RA, you may need a joint replacement , depending on which joints are affected and to what degree.
Joint replacement is less common in lupus. It may become necessary due to damage from the disease itself or from some of the drugs used to treat it. Some people with lupus nephritis may eventually need dialysis or a kidney transplant. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Genetic and environmental risk factors for rheumatoid arthritis. Best Pract Res Clin Rheumatol. Lupus Foundation of America.
What causes lupus? Updated November 28, Francis L, Perl A. Infection in systemic lupus erythematosus: friend or foe? Int J Clin Rheumtol. Centers for Disease Control and Prevention. Systemic lupus erythematosus SLE. Updated October 17, Additionally, the FM group reported more tenderness than pain 6. The healthy control values are provided for background comparison.
HLTH, healthy controls. This demonstrates that while SIQR pain predicts pain sites in both groups, tenderness to touch predicts pain sites only in the FM group. Along with the regression analyses, the latter analyses point to several conclusions. These findings indicate that variables predicting between-group identification do so in a different way than they do in predicting within-group severity differences. While the classification criteria for RA, SLE and FM all require a physical examination, epidemiological surveys seldom provide for patient examination, thus the development of discriminatory questionnaires is problematical.
One might logically surmise that the symptom of tenderness to touch that is "whole body," as in FM, would be more severe than focal joint tenderness in RA, which is what we found in this analysis. Although the finding of inflammatory arthritis in two or more joints is one of the eleven criteria used in SLE classification [ 14 ], tenderness per se is not part of these criteria.
Overall the combination of seven pain sites and eight SIQR items together produced a multiple R of 0. But neither pain sites nor SIQR variables alone seem sufficient to differentiate patient groups. The role of SIQR pain was different and also significant when examining within-group correlations rather than correlations across groups pooled across groups as described above. A notable finding in this study was that the SIQR question on tenderness to touch, along with neck pain, arm pain and hand pain, were important symptoms to consider when developing questionnaires to distinguish FM from RA or SLE.
This notion is supported by the observation that tenderness was correlated with pain 0. Nevertheless, while pain and tenderness uniquely predicted pain sites, they did not account for much variance in pain site. A more refined measure of pain locations, such as a pain VAS, one that specified the nature or quality of the pain in greater detail or one which included axial, distal and proximal subscale scores, might provide more useful information than a simple count of presence or absence of pain.
We are not aware of other survey questionnaires that ask about "tenderness to touch. It seems possible that the "tenderness to touch" variable may be a useful surrogate for a tender point evaluation in musculoskeletal pain surveys without a physical examination. It is also worthy of comment that "tenderness to touch" was associated with a diagnosis of FM even when psychological variables such as depression, anxiety and "feeling overwhelmed" were controlled for in multivariate regression analyses, thus challenging the still common notion that tenderness in FM can be explained in terms of a psychiatric condition or a psychosomatic reaction.
Looking backward to the ACR study, the finding of "tenderness to touch" is redolent of the "skin-fold tenderness" test, which provided odds ratios of 8. We surmised that this was due to pain locations being a better discriminator. The SIQR only asks about pain in the general sense, and maybe more specific questions would be useful in epidemiological surveys.
For instance, Perrot et al. There are several limitations of the present study. The pain locations were designed to reflect a composite of widespread pain and peripheral pain.
In this respect, it may have been useful to include the wrists and ankles, joints that are commonly involved in RA. The RA and SLE patients were specifically screened for not having concomitant FM, and thus this study does not provide any useful information on that common combination, which is now known to skew the results of questionnaires such as the DAS [ 15 ]. While researching background information for this paper, it became apparent that very little information has been published regarding musculoskeletal pain in SLE patients.
A typical description is, "Joint involvement in SLE is similar to that of rheumatoid arthritis, primarily affecting the small joint of the hands, wrists and knees An inconsistency of symptoms and objective findings is always suggestive of central sensitization, as exemplified by FM. These differences may be due to the relatively small number of RA and SLE patients, but if confirmed in a larger data set, these differences could point to differences in the musculoskeletal symptoms of SLE and RA that have hitherto been opaque.
Overall, this report provides some pointers for distinguishing FM patients from patients with RA or SLE in clinical questionnaires and raises some potentially novel issues regarding musculoskeletal symptoms in SLE patients.
J Rheumatol. Z Rheumatol. Article PubMed Google Scholar. Arthritis Care Res Hoboken. Article Google Scholar. Arthritis Rheum. Arthritis ResTher. Google Scholar. Ann Rheum Dis. Some medications are helpful for treating the two diseases, including NSAIDs, corticosteroids, anti-malarial drugs such as Plaquenil, and immunosuppressive medications like methotrexate.
Treatment varies more when RA and lupus are more severe: A person with RA may be treated with biologics, while someone with lupus would likely be treated with stronger immunosuppressive drugs, Dr.
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Only fill in if you are not human. Lupus often causes a rash. Lupus is more likely to cause chest pain and shortness of breath Lupus can also attack other organs, such as the heart, lungs, and kidneys more on kidneys below.
Lupus vs. The Role of Imaging Tests Imaging tests such as X-rays can be very helpful in determining the correct diagnosis of lupus vs. Keep Reading Lupus or Rheumatoid Arthritis? Subscribe to CreakyJoints Get the latest arthritis news in your inbox. Was This Helpful?
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