Can you have Rheumatoid arthritis with normal bloods?

Hi Folks, I have had Polmyalgia Rheumatica for 3 year. I am on a reducing dose of Prednisolone and currently taking 3.5mgs. In Feb my Rheumy added Azathioprine to help with the reductions. In the last 4-5 months I have had pains in fingers and feet. The fingers wax and wane, however the feet are more troublesome. I get pain on the bottom of heels when I first get up, which lasts about an hour. I also get ripping sensations to the sides of the heel. Both little toes are very painful with what appears like bunions, and the pads of my feet hurt in the evening. I cannot say there is any obvious swelling, although can no longer get any rings on,

My problem is that even during my PMR my bloods have never been raised and still aren't. My GP States hands are "rheumatoid" (haven't seen GP re feet), and told me to speak with my Rheumy and ordered RF and ANA bloods. Emailed my Rheumy nurse who states RF negative (it was 20), and therefore unlikely to be Rheumatoid. I don't see my Rheumy till end of Nov, but would like to kmow if it's possible for all bloods to be normal and still have RA? I apologise for the long winded question. Thanks Runrig

8 Replies

  • It certainly is possible to have various forms of inflammatory arthritis with normal bloods. I have Psoriatic Arthritis and many with this disease have normal ESR / CRP and of course no Rheumatoid Factor. I'm pretty sure many with Rheumatoid Arthritis have normal bloods too. I hope your rheumy comes up with some answers, waiting is hard I know. But at least it sounds as if your docs are on the case. I think it's best to keep an open mind because diagnosis is a bit of a detective job, but then you probably know that already!

  • It's entirely possible to have rheumatoid and be negative for the rheumatoid factor in your blood. There is another blood test - the anti-CCP test - which is a more reliable guide, but is also not 100% indication as you can be negative for both. GP's don't do the anti-CCP so might be worth asking rheumy for this.

  • Hi--- yep- my bloods are always normal- my rheumatologist dismissed my symptoms for years until I begged for a hand scan. That showed the inflammation. Good luck x

  • Get them to do ultrasound scans, I am negative bloods but sure do have RA!! The nurse spoke out of turn as the bloods do not always show RA xx

  • I'm sero negative & my bloods are always normal My rheumy dismisses them & looks at me It was a hand scan that proved beyond doubt that I have RA. I've been on DMARDS for the last few years but am about to go onto Biologics as the drugs aren't working. Keep persevering to get the correct diagnosis.

  • yes , my bloods are normal and have been diagnosed with seronegative RA , they should look at the whole picture not just the blood results x

  • Hello,two years ago I was diagnosed,but for 6 months before I wen to the dr and my RA and ANA was negative,but going by my symptoms my dr referred me to my rheumy,who did the anti ccp test which came back strong/positive,which diagnosed RA..hope this helps michelle x

  • RA isn't the only inflammatory arthritis - spondyloarthritis is also a form of inflammatory arthritis, and is always seronegative. One form of it, Psoriatic arthritis, can have hand and foot involvement just as bad as RA, and you don't always have to have very obvious psoriasis to get a PsA diagnosis - it can be as little as psoriatic nail changes, or small patches of psoriasis around the hairline.

    I think if I were you, I'd be asking the rheumatologist if they had considered other forms of inflammatory arthritis, rather than just focussing on RA (which seems to be the only thing most GPs consider, unless you happen to be a young male with severe and chronic lower back pain that isn't injury related).

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