RA with low CRP and normal blood tests?: I've had... - NRAS

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RA with low CRP and normal blood tests?


I've had inflammation and swelling in all of my finger joints and in both wrists for 11 weeks, but all the blood tests are normal. The inflammation marker CRP is very low, only 0.60. Anti-CCP, RA factor, ESR are normal too. My GP says I'm too young to have osteoarthritis. It will take a couple of months to see a rheumatologist on NHS, I know that there is such a thing as seronegative RA, but the CRP would still be increased I suppose? Any ideas if this could be seronegative RA when the CRP is low? Thank you.

20 Replies

i dont know enough but if you have had it for 11 weeks you should need an urgent request to see them and get more test done thats not right to me

Hi Linda...how frustrating for you when your blood tests show as normal and you have the symptoms and signs! My bloods always came back as normal apart from a slightly raised RF, however as I was presenting with classic and visual signs of RA I was diagnosed at my first appointment with a Rhematolagist. I didn’t have a Anti CCP done until I was about 2.5 years into my diagnosis and it was very high about 185 I think but I had got worse by that point.

I hope for your sake you don’t have this condition but blood tests are only one part of the diagnosis but a good sign that your ANTI CCP is showing as normal as this is normally a more accurate way of testing...however obviously I’m not medically trained! A lot of us have had the you’re too young for Arthritis but it doesn’t discriminate. Good luck and hope it settles down for you 😊


I'm seronegative . I have psoriatic arthritis. Sometimes my bloods come back OK even when I'm in agony! They were negative for quite a while until my inflammatory markers suddenly shot up to 78, and I sometimes become anaemic. They have never been that high since, but if mine even go up as 6 I'm in agony.

Anyway...negative in the early days, then not.

in reply to Hidden

Exactly Nettie...Whwn I’m literally in sobbing awful pain my CRP is 4...no wonder sometimes we don’t get taken seriously until we get visual signs!

in reply to Hidden

Hi Nettienet, can it be PsA without any major skin issues? I've had a couple spots with dry skin on my body, one of them for some 20 years and other two for a couple of years, they sometimes turn red but I have had no major issues for a while, they are almost invisible. Nails are fine too, just a couple of them have vertical lines that might split, but holding together well. Skin around the finger joints is red and maybe slightly itchy though, but that's a recent development.

PS I saw in your profile that the person you looked after passed away last night, so sorry... xx

I have had low levels of CRP and ESR when I have been in flare but luckily my nurse has seen me in flare and knows now that I don't show high inflammation markers.

I have PSA and my blood doesn't show inflammation markers. I have seen my consultant when I have been in a flare. A scan has shown high inflammation in my joints but not in blood tests.

Yes, same for me - high inflammation in joints but not in blood tests.

I had this. Took a blood test - Cerascreen, which indicated reactions to wheat, oats and egg yolk. Once I stopped eating those foods, symptoms improved. Also took a bunch of supplements, see my previous posts.

Hi, I have RA and the CRP almost never confirms the amount of pain, inflammation or swelling I have. Since you can get RA at any age (I was 17) I’d definitely let your doctor check for that.

Wish you all the best!


I have the same thing, but in my big toes. All the tests have come back OK, and my GP says it's osteo, but the stiffness and pain came on suddenly, in both feet, and it lasts most of the day. I don't want it to be RA, and the bloods say not, but the symptoms fit everything I've read.

Would love to know how you get on with the Rheumatologist - I've yet to persuade my GP to refer me.

Hi Spacey1, my first blood tests showed slightly increased CRP and I had pain in many joints, but there was no swelling then, yet. My GP did not refer me to a rheumatologist then, I was wrongly referred to a physio, but the physio further referred me to see a rheumatologist. It all has taken a while though, 6.5 weeks since I went to GP and still another 2-3 months left to wait. My second blood test results were normal in all ways, but there was visible swelling in the finger joints and I was re-referred again in a hope that things move on faster. But my GP made it clear that it's unlikely to be a priority to them because of the blood test results, I'll just have to wait. Maybe you should try again, even if you are referred to a physio they sometimes know more than GPs do. One of the criteria for rheumatology referral is that is has lasted for a couple of months I think - stiffness, pain, swelling etc., If you describe all the symptoms they should refer you with normal blood tests, too. Good luck, I really hope it is not RA for you, but you definitely need to see a specialist.

Thanks, Lindalinda11. I hope the Rheumys bring your apt forward. It's so hard to have to wait.

I have pain, stiffness and a little swelling - my feet don't look swollen, but I can't get most of my shoes on! It's been 10 weeks now.

50% of psa sufferers will have a normal crp and esr, which are inflammation markers but boy do they have inflammation . xx

Yes, I also wonder if pain and swelling in the tendons is more likely to be PsA than RA. I have had pain above the knee since Easter and it is getting worse by the day. The GP swore it was osteoarthritis so I asked for an x-ray, which came back perfect. The pain is in the quadriceps tendons above the knee. Previously it was in the suprasinatus tendon in the shoulder and also in the hand tendons which jammed some fingers and produced nodules when the tendon popped its sheath. RA was diagnosed on an MRI which showed many features of it, albeit the GP won't accept the rheumatologist's diagnosis. It is all such a wearing business. They have it fixated in their head that you have to abnormal blood tests or else there is nothing wrong.

Yes I agree some will only accept abnormal bloods and very frustrating. Do you have any skin issues ? bowel issues ? are you hla positive ? lOU XX

All of my blood work, including CRP, is also normal except the specialized inflammation tests that aren’t normally given. My dr says that everyone presents differently.

I have had raised RF 283 but low CRP 5 but it showed in my hands, wrists, toes on the scan and xrays

and my symptoms was in my jaw, toes, fingers

now its in my knees, elbows and shoulders too, and before didn't have any swelling but now that's changing too, I do now have swelling

Hi Lindalinda11,

i have seronegative RA and my CRP is never raised as a result. My bloods are within normal ranges (slightly higher LFT on MTX) and does not reflect anything when I am in agony. I have also just been diagnosed with fibromyalgia. So do get in touch and let me know what the Rhuemy doc says.

I have seronegative and my bloods are usually normal, they have been abnormal on occasion, but mostly normal, but I do have swelling, pain, stiffness etc so was diagnosed on symptoms. Now I'm having difficulty convincing rheumy I do, as I had very few symptoms when I saw him recently (2 weeks before had been in constant pain with swollen stiff fingers, knees, feet) Its all very frustrating.

I hope you get some answers soon.


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