RA ….

[Barbs22]

My bloods have been positive RA but inflammatory markers normal

I am in so much pain and RA consultant just said no action my doctor is wanting more information and dosnt agree with her

[Runrig01]

Are you already diagnosed with RA, and on any meds?. Most of the medication for RA, unfortunately takes time to take effect, most are 12 weeks +. Is it maybe the case that they feel it’s too early to change meds. Most rheumatologists unfortunately won’t administer steroid injections, if your inflammatory markers are normal. Your GP though if they disagree, could try a short course of steroids to see how you respond. You also have the right to a second opinion if you’re not happy with their treatment plan.

[Barbs22 in reply to Runrig01]

Hi I was recommended methatexrate 6years ago and I asked could I keep on the naproxen… but then they were saying it could be a positive/negative so was told probably osteoarthritis I have just had a knee replacement and surgeon commented on my bones being like butter and to get a dexa test which came back as osteoporosis.. but my joints are really bad and pain team have recommended tramadol and amtripline, I am due a cortisone injection in the other knee on Monday but really not to sure in having it

[Runrig01 in reply to Barbs22]

If your other knee is causing you pain, it would be worth having. Otherwise you risk your new joint taking the burden as you’ll be reluctant to out full weight through it. If you and your gp disagree, then get a second opinion. It is also possible to have both RA & OA in the same joint.

[Jillyanne in reply to Runrig01]

I have RA and OA, definitely get a second opinion

[Barbs22 in reply to Jillyanne]

Thank you I will

[Jillyanne in reply to Barbs22]

Naproxen, I thought was not good, long term ?

[Barbs22 in reply to Jillyanne]

Yes I went to see a pain clinic and now they have prescribed tramadol and amptripline my CCP and RHF are high not normal ESR CRP

[AgedCrone in reply to Barbs22]

Have a word with one of the nurses on the .Royal Osteoporosis society helpline. I got more information from that nurse than I ever got from my rheumy team.

[helixhelix]

the cortisone in your knee can help your knee and also make the rest of you feel better. And if it does you can argue that if this works then there must be inflammation despite low markers.

I never have high inflammation markers even when joints are hot and swollen I might get up to 20 (my lab norm is that under 20 is normal). Most times it’s 1 or 2. Luckily (!) I am anti-CCP positive so my rheumy accepts that this is how I am and looks at me, not the blood test results.

[Barbs22 in reply to helixhelix]

Can I ask you what is your rheumatoid score

[helixhelix in reply to Barbs22]

I was negative for the rheumatoid factor - which isn’t specific to RA anyway. But positive for anti-ccp at around 320

[CCL_JMFAN]

You may be, like me, "sero negative" but have RA - keep going back, make a nuisance of yourself until someone takes you seriously.

[Barbs22 in reply to CCL_JMFAN]

Can I ask you your RA number is

[bpeal1 in reply to Barbs22]

Sero-negative means that they don’t test positive for the rheumatoid factor, I assume that’s what you mean by RA number. Rheumatoid factor isn’t a reliable test for RA. Many people have RA and and don’t have a positive rheumatoid factor and about 10% of the general population are positive but will never develop RA. It is often checked when diagnosing RA as it can be an indicator but it is always looked at along side presenting symptoms. Some medications are thought to work better in either sero-positive (with rheumatoid factor) or sero-negative (without rheumatoid factor) so it’s useful to know which you are. Once diagnosed it is not routinely measured as it doesn’t give any extra useful information.

A more useful blood test is the anti-CPP test. It’s still not infallible but seems to be more reliable than rheumatoid factor. Maybe ask if you can have this test done?

[Barbs22 in reply to bpeal1]

My CCP AND RHF are high but because my ESR and CRP are normal the consultant said it’s mor Osteo