At 50, how can I monitor my rheumatoid joint damage?

Question

Hello, Doctor,

I have rheumatoid arthritis at 50. My symptoms are mostly under control; I worry about silent joints. My hands sometimes feel stiff even on days when the pain is not too bad. I want to cure it permanent damage. I'm not sure what the usual follow-up plan should be. Please tell me,

Should I get regular X-rays to monitor joint damage at 50?
How often are imaging tests usually recommended for someone with stable rheumatoid arthritis?
Are ultrasounds or MRI sometimes better than X-rays for checking early damage?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

We do not follow up with X-rays, as they add little value when the disease is clinically controlled and there is no arthritis. In such cases, there is no need for repeat imaging or follow-up with laboratory reports.

Morning stiffness is the main feature of the disease and can sometimes be present even when the disease is controlled, but this does not mean your disease is active or damaging your bones. Occasional joint pain or stiffness does not always mean your disease is active.

A proper clinical examination is required to determine whether your joint pain and stiffness indicate current active arthritis that requires medicines such as biological agents. It might be degenerative changes or secondary fibromyalgia to rheumatoid arthritis and can be controlled by other medications. Inflammatory markers in investigations can also help clarify the situation.

But as long as the disease is controlled clinically, you do not need to worry about radiographic progression. Just stay regular on your management and follow-up plans.

You can follow the below-mentioned steps for betterment.

Tests like complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum creatinine.
Follow up every 3 months.
Physical therapy for flexibility.

I hope this information helps you.

Feel free to ask further questions.

Thank you.