Pain-Free Living

Rheumatoid Arthritis Can Go Undetected

By Joseph Gustaitis

It’s obviously possible to have arthritis and not know it. You can have an ache or a stiff joint and assume it’s nothing serious. But can you have rheumatoid arthritis without your doctor knowing it? You certainly can.

The classic symptoms of rheumatoid arthritis (RA) include fatigue, joint pain and swelling, joint tenderness and stiffness. It’s usually symmetric—that is, both sides of the body are affected. However, Rheumatoid arthritis can be difficult to diagnose because the symptoms can mimic other conditions, or the symptoms can flare up, go away and then flare up again in a different body part.

To really diagnose RA, clinicians normally rely on a blood test. When arthritis attacks the body, the body responds by producing certain antibodies that are detectable by a blood test. The antibodies are called rheumatoid factor.

Yet there have been many cases of patients visiting their doctors with all the symptoms of RA, only to have their blood tests come back negative. These patients have what is called seronegative rheumatoid arthritis. They might have such low levels of rheumatoid factor that they can’t be detected by a blood test, or they might have forms of arthritis that are not associated with the rheumatoid factor blood test. According to medicinenet.com, in addition to seronegative RA, some of these forms include psoriatic arthritis, ankylosing spondylitis, reactive arthritis and the arthritis that sometimes accompanies inflammatory bowel disease.

The problem is that if a person does, in fact, test negative for RA but has the disease, that person might not receive treatment. Early treatment is important in RA because it can prevent the nerve damage that might occur if treatment is delayed. A study recently conducted in Great Britain of 1,800 RA patients found almost half of them—800—waited an extra 45 days to get a referral for arthritis treatment.

For that reason, a physician can’t rely on only a blood test to detect RA. In fact, some people have high levels of rheumatoid factor and don’t have RA at all. For this reason, besides ordering a blood test, many arthritis specialists rely on additional methods of diagnosis such as X-rays, MRI scans and ultrasound to determine whether a patient has Rheumatoid arthritis.

Last Reviewed 12/16/15

Joseph Gustaitis is a freelance writer and editor based in the Chicago area.

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