Rf positive, but no inflammatory markers in my blood work. RA?

[MOUNTAINMAMA]

I was diagnosed with RF positive Rheumatoid Arthritis a year ago and began treatment. My Rheumatologist was rude and dismissive, so I found a new one recently. She did a new round of blood work, but since there were no inflammatory markers present..except RF of 40..she told me that I do not have RA or Psa. This is despite visual inflammation & constant infections. Has this happened to anyone else?

[medway-lady]

It's a puzzle some are negative and get it badly, some are posative and it never developes. I don't know what you can do because if they can see it it begs the question why are'nt they treating it ? might be worth a chat to your GP as he/she might be able to help. I hope so....

[wsjkcj1]

I don't think blood test always work correctly and it takes many times to get the right result. I have primary sjogren's but my hand is almost identical to yours in the way the pinkie is now curved out due to the knuckle swelling. I don't know if my blood work confirmed it but my Rheumy took xrays and told me it was RA.

[helixhelix]

Your hand does look uncomfortable/painful so did the new rheumatologist suggest what else could be causing this? As osteoarthritis is also extremely painful. And having a positive RF is only a vague indicator as many people are positive and don't have RA at all. But looks like you definitely have something!

And did the treatment you were given by the first rheumatologist make any difference? As sometimes when the blood work isn't showing anything obvious then how you respond to different treatment can be used as part of the diagnosis.

Keep asking questions and pushing your doctors and I hope you get answers soon.

[Hidden]

I think ultrasound and other imaging eg x-ray would be the most reliable indicator of whether you might have RA or PsA of OA. Did she discharge you back to your GP?

I have primary Sjögren’s, originally diagnosed as RA, and my pinky finger sticks out too but my joints no longer swell up like yours so inflammatory arthritis is now a historic diagnosis for me.

I think you need to gather yourself up and persevere in order to get clarification. Neither RA, PsA nor other causes of inflamed joints caused by diseases such as Sjögren’s, Lupus etc can be diagnosed by bloods alone.

Also some people have immune deficiencies (low IgG) which mean their bloods don’t reflect their autoimmune conditions at all.

[Cheylann in reply to Hidden]

I've had ultrasound and still don't know what I've got whether it's RA, osteoarthritis, PSA as slightly swollen bursar is all that showed. They have put me on MTX injections and said it's the only way to find out exactly what it is. Hit and miss! It's scary as I don't really want to try MTX just in case I get a positive response.

[Hidden in reply to Cheylann]

Yes I know it’s scary when there is uncertainty of what they are treating. But many of us are in the same boat. I’ve tried 5 DMARDs, including MTX injections, without any clear certainty of the benefits each might bring.

Now I’ve been off everything for 8 months and am in so much pain - but couldn’t specify where as not in my joints. Vasculitis? Nerves? Sjögren’s connective tissue? No idea at all and nor have my doctors. This is often the nature of the beast with autoimmunity I’m afraid - it’s evil!

At least RA usually shows in synovial swelling in ultrasound so it’s easier to diagnose than the others. Maybe you have one of the others - there are many and at least you are being taken seriously.

[Stephs311]

My Rheumatologist told me it's a combination of blood work and symptoms, some people show normal bloodwork and have symptoms and some have no symptoms with abnormal bloodwork. It would seem your Rheumatologist only looks at one facet. I'd keep going until I found a doc who listens. You need to ask them, if it's not RA or PsA what is causing such severe symptoms. Make them give you an answer and they'll keep looking.

[Luci22]

My rheumatologist confirmed mine with an ultrasound of the hands, feet and wrists. That is what indicated to her that it was RA. Otherwise my RA factor was only 15 and I'm seronegative. So, you may want to seek more testing. Blood should not be the only test I think. Especially if you show some kind of physical symptoms .