Non symmetrical RA

[Bandido]

After about 15 years with RA on MTX some of the doctors I see are surprised that my Sero Positive RA is not symmetrical.

I Really don't know why or what the significance is. Any Ideas?

[Hidden]

No ideas. I’m s - negative and rarely does it effect symmetrical joints . It’s always my right ankle only or mr right elbow etc .. it’s still RA .

[oldtimer]

It's because the 'classical' presentation is described as being symmetrical and mainly affecting the metacarpal/phalangeal joints of the hands . But WE all know that it can come in all sorts of strange forms in all sorts of places. As rheumatologists become more experienced (if they are also paying attention and learning) they recognise that many other presentations occur.

[Mmrr]

The text books say RA is usually symmetrical, but modern thinking would not rely on symmetry or non symmetry as a diagnostic tool. An interesting observation perhaps that the rheumatologist would keep an eye on ?

My seronegative RA is not symmetrical either, but no one has ever commented on it (although I'm not convinced I have seronegative RA, but that's another story)

[ketiv74]

Mine is sero positive and it has never been symmetrical. It was always moving from joint to joint but I never had both knees or both wrists or any other joint pair hurting at the same time.

[Brushwork]

My sero-positive is not symmetrical. My ESR & CRP are rarely elevated even when I have a significant and obvious flare. I am not a text book case.

They should re-write the criteria perhaps.

[Bandido in reply to Brushwork]

So glad to hear I'm normal. When they make bland statements that don't include you it starts the thinking that they got it wrong. The exceptions seem to be plentiful so we are not all that much of an exclusive group

[rounder]

My sero neg RD isn't symmetrical either, and like brushwork my bloods don't reflect when I have a flare. My original rheumy was only interested in blood results and didn't care about pain, swelling etc. When I changed consultant it was brilliant, he listened and responded to my experience of the disease and it's been so much better. That said I haven't seem anyone from rheumatoid about 2 years, had one short phone consultation and am struggling now and trying to gather the energy to try and get through to the helpline.

[medway-lady]

Only my right hand and left foot are affected apart from the fatigue etc. I'm sero positive and told classic but its in remission and in 20 or so years I've only ever had two bad flares and one was after the covid jab. It's a strange disease. But I do think that being treated aggressively from the start might have helped and it being caught early. My joints look normal but I've had my left foot straightened and that was down to RA its been normal feet now for about 4 years.