My Rheumatologist treated my RA when I was first diagnosed based on my blood tests. He ordered xray too to see if there was any damage that could be seen on imaging. After that he has treated my RA based off my symptoms. I even got to the point of taking pics of my flares so I could show him when I felt I needed my meds adjusted or changed. It gave him a better idea of what I was experiencing.

Yes, the think the blood tests tell them a lot about what's going on in your body.

My rheumatologist listens. All my blood work is normal, but I have bone erosion and MRIs from multiple joint that show large joint effusions. My podiatrist told me that just a small amount of inflammation can be enough to cause a significant amount of pain.

If I had listened to my primary care doctor, who usually looks at only tests, I would have seen a hand surgeon for my erosion even though the radiology report said I should be evaluated for inflammatory arthritis. My rheumatologist diagnosed me on the first visit.

Since inflammatory disease is not diagnosed by blood tests alone, it is my opinion that a good doctor should also listen to you.

I have blood tests every two months and see my rheumy every 3 months. Whenever I go in for a visit she has a questionaire I fill out that asks how I've been doing for the last week. It goes into great detail and has scales from 0-10 on how you're doing. Then they total it up and it gives her an idea of how I've been doing. In addition to that she always asks how things have been and examines my hands and feet. She will also use the blood test results to see if anything has changed since the last one.
So - to answer your question, no she doesn't go by just the blood test. You might ask your rheumy for a Vectra DAblood test.
https://vectrada.com/patients/?gclid=EAIaIQobCh...

I agree with Atypical.... I have a negative RA factor BUT my Anti-CCP was moderate and I have ANA findings indicative of an autoimmune disease. You don't need to have those tests done again - if your tests state you have RA, then you have it. The RA factor is not accurate. (per 2 RA drs I saw). Xray will show any joint erosion. Blood work can show your inflammatory status which will include (CRP) C-Reactive Protein and your Sed Rate. One RA dr I recently saw told me there is a Vector Test >.. I'm unsure exactly what this is but will ask - search it online. I believe it shows your inflammatory stage or status.