New member here, With questions!! (scared)

Posted May 15, 2002 · May 15, 2002

Hi, My name is Daren, I am 37 and I believe I may have RA, and I am

scared, I have severe pain in my hands and wrists I have been tested

for Carpel Tunnel which came back negative, I don't have the symptoms

of Fibromyalgia, my pain has been going on since November I have had

2 blood tests done both came back negative for RA but my Doc says it

may not show in the blood right away. I am on Naproxen for the pain,

I have a 3 year old son and i want to be around for him for many

years to come, If I have RA how do I deal with it? and how will it

affect my life? any suggestions? at this point anything would really

be helpfull!!!

The way I wrote that may seem stupid but I didn't want to go on about

things and wanted to get to the point.

Daren

Posted May 16, 2002 · May 16, 2002

Hi Daren

Welcome….

Both my

husband and I are sero negative rheumatoid arthritis….the blood work is

normal….so it gets confusing for the doctors…other than one reading

where I had a high normal sed rate reading..

perhaps

push your doctor for a bone scan to make a true diagnosis of inflammatory

processes and bone disturbance…

if you

get aggressive early treatment it can help you a whole lot

Good luck

and maybe something in the article will help you

sincerely

Diagnosis of RA can be difficult, because there is no one particular test that

definitively confirms RA. Symptoms and lab findings of RA can be similar

to those of other diseases. Therefore, the patient's family history,

symptoms and signs along with lab results are used in diagnosing RA.

X-rays are not really diagnostic in early stages of the disease because of the

absence of apparent bone damage. However, X-rays can be used in later

stages of the disease to help the doctor monitor disease progression. According

to the American Rheumatism Association, there are eleven criteria for

diagnosing RA. Seven of the eleven are required for diagnosis of classic

RA, five for definitive RA, three for probable RA. Four laboratory

findings included in these criteria are positive serum tests for rheumatoid factor,

poor mucin clotting of synovial fluid, characteristic histologic changes in synovium,

and characteristic histologic changes in rheumatoid nodules [3]. Synovial fluid

can have a turbid appearance which reflects an increase white blood cell

count. The white blood cell count reflects the degree of

inflammation. An elevated erythrocyte sedimentation rate and an increase

in serum levels of C-reactive protein (CRP) also indicate the presence of an

inflammatory response [4]. People with RA have increased levels of alpha-1 and

alpha-2 globulins which are acute phase reactants involved in the inflammatory

response. Mucin clots in the synovial fluid can have decreased viscosity

due to a decrease in hyaluronic acid [1]. Also, patients may have moderate normocytic

hypochromic anemia with decreased serum iron, normal total iron-binding

capacity, and normal iron stores [3]. Another important test is the detection

of rheumatoid factor. Rheumatoid factor is usually detected

serologically. The slide agglutination test is used only for screening,

and positives should be confirmed using nephelometry or the ELISA method to

measure rheumatoid factor titers. In RA, titers are often 1:640 to

1:5120. Titers in conditions other than RA are usually <1:80 [4].

However, the absence of rheumatoid factor does not rule out the presence of

RA. Rheumatoid factor can also be present in people with syphilis,

leprosy, and other inflammatory conditions. Approximately 10-50% of

patients with RA also have low titers of antinuclear antibodies (ANAs) [1].

Rheumatoid Arthritis

We have met the enemy...

Most

people know this form of arthritis as the 'crippling disease' because it does

just that - cripples the joints. However, rheumatoid arthritis does not affect

just the joints, it attacks other body systems as well, including the heart,

nervous system, blood and even the lungs.

Why should an arthritic disease attack other areas of the body? The answer lies

in the process that causes the joint problem - the body suddenly does not recognize

itself and forms 'antibodies' against itself. These antibodies attack the

foreign invaders (the body's own tissues) and pretty soon the internal systems

begin to crumble under the weight of the immune attack. In essence, this is the

Pogo legacy: 'We have met the enemy and he is us.'

Joints seem to be the predominant focus of this disease. The joints most often

affected include the wrists, knees, elbows, shoulders, ankles, and 'knuckles'.

Joint destruction is an early manifestation of this disease and there is

usually X-ray evidence of damage within 3 years of onset of symptoms.

Since rheumatoid arthritis (RA) is a whole body disease, it is not unusual for

the patient to feel general fatigue, loss of appetite, weight loss and

depression. Indeed, these symptoms, along with some initial joint pains, may be

the only sign of RA's presence. Most patients go for an average of 36 weeks

before a diagnosis is made.

Mimickers

Other

diseases may mimic RA and this makes it more difficult for the physician to

correctly diagnose subtle cases. Osteoarthritis, Lyme disease, gout, even some

forms of cancer can present just like RA. It is helpful at times to be able to

exclude osteoarthritis quickly. This can sometimes be done on the first visit

by the type of joint involved. Osteoarthritis, for example, does not attack the

wrists or the knuckles, as does RA.

Diagnosis, for the most part, hinges upon common lab tests. Some components of

the blood count are deranged (mild anemia, elevated sedimentation rate or the rate

that blood sediments on standing) and finally a rheumatoid 'factor' test

(titer). While some true RA patients will not show a positive rheumatoid factor

at all, at least 70% will show some reactivity of a significant level. This

factor is actually a test for an immunoglobulin made by the body against its

own tissues.

Sometimes the joint involvement is so severe during 'flare' attacks that

physicians can obtain a sample of joint fluid for analysis that will assist in

making the diagnosis (or 'ruling out' other mimickers).

X-rays, while helpful to establish or follow joint involvement, cannot be used

to confirm this diagnosis.

*Criteria

for diagnosing Rheumatoid Arthritis (after the American College of

Rheumatology)

1. Morning stiffness > 1 hour's duration

2. Arthritis of at least three joint groups with soft tissue swelling or fluid

3. Swelling involving at least one of the following joint groups: proximal interphalangeal,

metacarpophalangeal, or wrists

4. Symmetrical joint swelling

5. Subcutaneous nodules

6. Positive rheumatoid factor test

7. Radiographic changes consistent with RA

*5 of the 7 criteria are needed to confirm the

diagnosis

Hope this helps

Sincerely

Sam

-----Original Message-----

From: Dot.Com [mailto:dot.communicator@...]

Sent: Thursday, May 16, 2002 6:44

AM

'arthritis '

Subject: RE: [arthritis]

Rheumatoid Factor/Numbers?/links/

Importance: High

Hi …

this little blurb might

help you find some answers….

Diagnosis of RA can be difficult,

because there is no one particular test that definitively confirms RA.

Symptoms and lab findings of RA can be similar to those of other

diseases. Therefore, the patient's family history, symptoms and signs along

with lab results are used in diagnosing RA.

X-rays are not really diagnostic in

early stages of the disease because of the absence of apparent bone

damage. However, X-rays can be used in later stages of the disease to

help the doctor monitor disease progression. According to the American

Rheumatism Association, there are eleven criteria for diagnosing RA.

Seven of the eleven are required for diagnosis of classic RA, five for

definitive RA, three for probable RA. Four laboratory findings included

in these criteria are positive serum tests for rheumatoid factor, poor mucin

clotting of synovial fluid, characteristic histologic changes in synovium, and

characteristic histologic changes in rheumatoid nodules [3]. Synovial fluid can

have a turbid appearance which reflects an increase white blood cell