Patient's Query
Hello doctor,
Ten years ago, I started experiencing swelling and stiffness in my right ankle. A couple of years later, it affected both ankles and then both knees. Now, I have swelling, stiffness, limited range of motion, and discomfort in both ankles, both knees, both wrists (to a lesser degree), and one index finger and one thumb. I received a high ANA blood test result last year. Is it safe to say this is rheumatoid arthritis?
Kindly help.
Hello,
Welcome to icliniq.com.
I read your query and understood your concern.
A positive antinuclear antibody (ANA) test is not a sign of rheumatoid arthritis. Yes, single joint pain, swelling, and stiffness can occur due to many reasons, and systemic lupus erythematosus (lupus) is one of them. However, a positive ANA test does not always mean lupus. Further workup is required, so I suggest you undergo the following investigations:
Complete blood count with erythrocyte sedimentation rate (ESR).
Rheumatoid factor.
C-reactive protein (CRP).
Thyroid profile.
Blood glucose levels.
Anti-double-stranded deoxyribonucleic acid (anti-DS DNA).
Serum uric acid levels.
I suggest you get these tests done and write back to me with the reports.
I hope this has helped you.
Kindly follow up if you have more doubts.
Thank you.
Patient's Query
Thank you for your reply doctor.
Do you have any thoughts on what the symptoms may be leading to if not rheumatoid arthritis (RA)? I have started to notice bone deformities in one wrist, two fingers, and my feet. Also, the ANA test was homogeneous, for your information. The rheumatoid factor was normal this time but high in previous years. C-reactive protein (CRP) was normal. Also, I was reading about seronegative rheumatoid arthritis. Could this be possible? After researching my symptoms, it seems more likely to be RA than lupus.
Please help.
Hello,
Welcome back to icliniq.com.
I read your query and understood your concern.
Yes, seronegative rheumatoid arthritis (RA) is a possibility. However, it is usually associated with high erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and joint deformities. Please ask your doctor to have your anti-cyclic citrullinated peptide (anti-CCP) antibody test done.
I hope this has helped you.
Kindly follow up if you have more doubts.
Thank you.
Patient's Query
Thank you doctor for your reply.
My CCP test was negative.
Please guide.
Hello,
Welcome back to icliniq.com.
I read your query and understood your concern.
In that case, clinical judgment would be required to initiate treatment for seronegative rheumatoid arthritis. There is no harm in giving a trial of disease-modifying antirheumatic drugs (DMARDs) and observing the response.
I hope this has helped you.
Kindly follow up if you have more doubts.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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