Have I got seronegative arthritis or something else?

I have been reading the internet for symptoms of seronegative arthritis and it doesn't fit with what I have. I have no joint swelling and no stiffness in any particular joint. My stiffness comes and goes, mainly in my neck. I have really bad toothe ache pains i n my hands which start when I wake up. They ease off through the day. Some days I can't grip things because my wrists hurt too much but that improves with the day. I take prednislone for pmr but I have been told these pains I get are not that. Still as I lower my steroids my ESR goes up. My Dr didn't know if you get a raised ESR with seronegative arthritis does anyone on here?. I take Hydroychloroquine and have been taking it for over three months, I'm not sure it is working. I really don't want to start Methotrexate when I have my doubts about my diagnosis.Does anyone have similar symptoms and what were you diagnosed with?

7 Replies

  • You certainly can have raised ESR with seronegative RA. The 'seronegative' bit is nothing to do with ESR but refers to rheumatoid factor (RF). If RF does show up in your blood you are diagnosed with seropositive RA. Just to confuse matters, plenty of perfectly healthy people have rheumatoid factor too!

    I have Psoriatic Arthritis which can be a complete swine to diagnose as there's nothing in blood tests that distinguishes it from other forms of inflammatory arthritis. And people with PsA often won't have raised inflammatory markers - that's ESR and / or CRP.

    Raised ESR & CRP show systemic inflammation. I believe that can occur with infections as well as inflammatory diseases so it doesn't clinch a diagnosis of inflammatory arthritis, but makes it a great deal more likely if it is accompanied by things like swollen joints, stiffness and fatigue.

    Just looking at a description of PMR on the Arthritis Research site, which is a reliable source of info, it seems that you will have raised ESR with that & I personally thought your symptoms seemed to fit but you need a rheumatologist's view. It sounds as if you're seeing your GP for all this, is that right? If so, ask for a referral to rheumatology as GPs aren't necessarily well-versed in these conditions.

  • I have seen four different rheumatologists and they all have different ideas. The hand pains only started after christmas. To start with I had pmr symptoms which responded almost straight away to being on pred. I was never able to get very low on it and ended up a year later higher than when I started, The drs think I should be down to 5mg by now but although I have been reducing it is not as fast as I was told to.If I go much lower than 15mg I know my legs will become like jelly and very weak.

  • I know my friend has tried to tapper down twice on pred for pmr but then has had to raise it again. He was advised not to go below 7.5 mg for now. My aunt took pred for a number of years but is off it now, again for pmr. Think everyone is different. Have you seen a rheumy who has a special interest/knowledge in either condition, may be worth a try. My bloods were fine and saw quiet a few consultants before my inflam arthritis diagnosed. Not easy sometimes. x

  • I don't know what special interest my rheumy has as until i get an appointment I have no idea who I will be seeing. Also You have an appointment to Dr so and so's clinic but when you get there it is to see a registrar of his.

  • Gosh, you are evidently a puzzling case! My rheumy's profile says he has a special interest in puzzling cases (can't remember the exact phrase, but that is the upshot.) Perhaps you should go for number 5 - though I bet you're sick of this journey by now - looking for a rheumy who states that they like a challenge and / or, as louise suggests, one who has a special interest in pmr and ...... what is the other most likely diagnosis .... seroneg RA?

    You know many of us have osteoarthritis as part of the fun package. And hands are prone to that. Sometimes OA is caused by inflammatory arthritis, sometimes it arises independently of the inflammatory condition. But it can muddy the water in terms of trying to work out what is happening.

  • Thanks for the link to your rheumatologist, however I don't drive and it would take 3 to 4 hours driving to get there.

  • PMR is a type of Vasculitis so you might get more specific advice by going on the Vasculitis UK HealthUnlocked. There are other types of Vasculitis which cause nerve pain but it is also a rheumatic disease - although many rheumies focus/ specialise in RA because it is more common and easier to identify because of synovial swelling. Vasculitis can affect the whole system too and GPs aren't usually seeing enough of it to recognise it unless there is obvious skin involvement. Tx

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