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Rheumatoid arthritis (RA) is an autoimmune disease that can lead to the destruction of joints and loss of mobility.1,2 The intra-articular bone erosion usually occurs early during disease progression with 30 percent of RA patients having radiographically confirmed erosions at diagnosis and 70 percent three years later.2 The early differential diagnosis of RA from clinically similar diseases (e.g., osteoarthritis) is needed for the initiation of adequate treatment that can slow down the disease progression, prevent bone erosion, and improve the patient’s quality of life.1-3 The median time for a patient to start disease-modifying-antirheumatic drugs (DMARD), from onset of symptoms, is almost 12 months.4
In combination with other clinical information, serological tests for anti-citrullinated protein antibodies/anti-cyclic citrullinated peptide antibodies (ACPA/anti-CCP) and rheumatoid factor (RF) IgM, which are included in the 2010 ACR/EULAR classification guidelines, as well as RF IgA enable the clinician to come to a well-informed patient diagnosis.1,5,6