Could it be RA even if blood tests say its not? - NRAS

25,833 members29,494 posts

Could it be RA even if blood tests say its not?

Rhuemy says its OA but its in my hands, wrists, toes and ankles. Could it be seronegative RA? How is that diagnosed? Would cortisone injections in wrists help? I had one in my thumb. It only lasted 4 days!

10 Replies

Hi, have you had an ultrasound scan on your hands? My consultant was discharging me as bloods were normal at first but luckily he noticed swelling and performed a scan at his desk. The diagnosis was definite as soon as he saw what

was showing on the screen. Sorry I can't advise on injections but hope you get sorted very soon


I have seronegative RA. My diagnosis was based on swollen joints, high inflammation levels (ESR & CRP in blood tests), pain and 'systemic' symptoms i.e. feeling very tired and grotty 24/7.

There are people who are diagnosed with RA even though their inflammation levels are within the normal range according to blood tests & who have no other RA blood indicators either.

X-rays can show differences between OA and RA too.

If you think there is more to your problems than OA then try to get a second opinion. Doctors are wrong sometimes, of course they are, so it's up to you to keep up the pressure for a re-think - perhaps talk it over with your GP?

I'm no expert but I think that you can get OA relatively quickly in various joints .... and steroid injections do seem to vary in how long they last. If you're not happy with the treatment you've had or the diagnosis keep pushing - it's so easy to feel that you are being a nuisance but every time I steel myself to ask for what I need then things start moving.

Good luck,

Luce x


X-rays don't normally show up RA erosion until its quite advanced Luce especially in hands - but scans do show inflammation much more efficiently. X


I was assuming that rowantree's joints are already showing changes if OA has been diagnosed .... i.e. some degeneration even if (hopefully) not erosion? But I see what you mean ....... the word 'scan' is never mentioned at my hospital, it's like the Scottish play or something ....... x


Same in my health authority re RA although my gallbladder and womb have been scanned often enough so I can't see why they don't routinely scan joints up here as well using ultrasound? Its supposed to be far more reliable and safer too? It would be by far the best way to differentiate between OA and RA surely? But I was just reading about MCP joints (knuckles) because two of mine are now big bony things and read that OA doesn't affect these joints - if they are swollen for any length of time it almost certainly means RA so that may help Rowantree's understanding of her rheumy's decision perhaps?

I love a Rowan trees - my favourite so lovely name! Xx


Hi Rowantree, This time last year all my bloods came back negative then in January it was the same till the following day one of the blooods changed which confirmed that i had RA and because the symptoms i had through the year they agreed i probably had RA from the 1st blood tests, please ask them to recheck your bloods,good luck.Mattcass


A good rheumatologist would normally know the difference between RA and OA whatever the bloods say - they are used to looking at people with sero-negative blood results, although, in common with all specialists, I'm sure they do occasionally get it wrong. OA looks very different to RA - especially in the hands. OA can affect the same areas snd is sometimes very aggressive and painful too. Tilda x


Thank you to you all. back to rhuemy this week. hes just focusing on the sesamoiditis in my thumbs at the moment. but my wrists are usually worse than my thumbs and my feet hurt so much too. im waiting for better insoles as i have cavus feet. ive asked for a neuro referral to see if it CMT, but GP wants to do a full neuro exam herself first. which i guess is good. rhuemy mentioned fibromyalgia too, but i dont get the other symptoms, except extreme tiredness. its difficult when the symptoms overlap so much isnt it. Does anyone get shooting pain in ankle too?


The first GP I went to with fingers, wrists and toes took a blood test, which came back negative, and I was told it was OA. I then moved house and as my symptoms had gradually, but fairly quickly, got worse (with a little bit of swelling), I went to my new doctor and he took one look at my hands and referred me to a Rheumy. The blood tests still showed negative, but the rheumy diagnosed RA through joint examination and xray. We are very lucky with our Rheumy's up here (Cumbria), but my experience shows that Doctor's can vary!!!!!!! As OA is more a wearing out of joints - your pattern of joints affected does seem strange. Helen.


I'm also sero-negative and my blood shows that I am the healthiest person walking on this planet!!

Except, that when I flare up, I feel a general sense of being ill, I'm very stiff on getting up, the stiffness last a good hour or 2 getting better in late afternoon. I'm very tired and feel ill. I also have OA in many joints but when I get a Kenalog injection, I feel on the top of the world for a good 4 to 5 weeks.

According to my Rheumy, this is inflammation. I'm now on Leflunomide but I still require a Kenalog injection every now and then. This is when I can't manage with my pain management.

I understand that when the blood don't show any inflammation, it is VERY frustrating and confusing. It took me a good 3 years to come to term with it.

I hope that this will help you.


You may also like...