Should GP’s be using Rheumatoid Factor in the diagnosis of Rheumatoid Arthritis?

RAEarly diagnosis and treatment of rheumatoid arthritis (RA) is important in preventing long-term damage and disability. RA should be suspected largely on the basis of clinical findings, such as persistent joint pain, swelling, and stiffness. Further investigations, particularly in primary care, may contribute to the diagnosis. Rheumatoid factor (RF) is an autoantibody associated with RA and its presence has traditionally been used to support the diagnosis. However, RF has a low specificity in primary care and cannot be used to rule in or rule out disease.
Currently GPs should base diagnostic and referral decisions on clinical features; number and site of involved joints and elevated acute phase response, rather than serological tests.

This body of work is in collaboration with members of the Nuffield Orthopaedic Center, Oxford University Hospitals NHS Trust.

Impact
The ongoing work is building a body of evidence around the role (if any) for RF in the diagnosis of RA  in primary care. Several further pieces of work are currently in process and we envisage these, collectively, to inform future practice on the diagnostic value of the RF in primary care.

Publications

Associated media
PulseToday News – No need for rheumatoid factor testing, GPs told
News GPonline.com – Rheumatoid arthritis diagnosis delayed by reliance on key test, GPs told