Dies RF and anti ccp positive definitely confirm RA diagnosis?

Bones, joints and muscles
1

Hi all! I'm now 6 weeks in with Methotrexate (up to 15mg now ) . I was told just prior to starting that I definately had RA. However, yesterday at my consultant appointment ( actually not set eyes on him yet, once saw a junior doc then other two times its been the nurse practitioner ) the nurse referred to my condition as 'inflammatory arthritis ' . When I queried this she said the consultant hadn't put 'a label' on it yet. She agreed that it was probable given my blood results but, as I don't seem to have any joint damage, she couldn't be sure!?!?

I'm now wondering why I'm on Methotrexate if there's a chance I don't have RA? I had a Kenalog injection before starting the meds , that made such a difference and almost alleviated all my symptoms so i'm not sure yet if the Methotrexate is working.

I left there yesterday totally confused, when I asked was there any other conditions possible with my blood results she just shrugged!

Anyone any suggestions? ? Thank you!

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There are several different forms of inflammatory arthritis and they look for more than "just" blood test results. The absolute factor in RA is when they see joint damage. Methotrexate is used in various inflammatory arthritides, not just in RA. If you have a raised anti-CCP result it is pretty much accepted that if you haven't got RA now, it may well develop in the future.

Kenalog is a steroid - steroids are wonderful for sorting out inflammation but not ideal for long term use because of their side effects. And nurses are not really meant to give that sort of information - that's the consultant's job - which is probably why she wasn't providing any answers.

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Thanks Eileen! Your reply makes sense, i've said from day one that I dont 'feel ' as if I have RA......although I do have general stiffness ( particularly in the morning ) and did have a prolonged 'flair ' which caused intense pain and swelling in my hands......the reason for attending the gp in December.

Unfortunately my RF and anti CCP are indeed raised so, hopefully by starting the Methotrexate early on, I will continue to keep RA at bay .

Thanks for taking the time to reply

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Hi Kaz,

My Anti CCP was positive 200 I think the correct reference range is 5, I also do not have any joint damage, but was told by consultant that RA was an autoimmune condition of the blood and can affect people differently I have weakness fatigue some joint pain but pain is not my worst symptom, I have been unable to tolerate any of the oral meds so they are looking at trying the biologics injection on me I see the RA nurse early in June. 

L.

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That is the point - the sooner you start medication the less damage gets done. And it has made a major difference to the long term effects.

Good luck 

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Thanks Linda, it's good to know that other people don't have major joint pain or damage either. ......I was beginning to feel like a fraud! !

I hope the injections work for you and you get some relief from your symptoms.

Good luck!

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Thank you!

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Do you have psorasis on your skin, you will know if you do, or maybe you have never been diagnosed with psorasis.

I have had psorasis my entire life, and have been using various cortizone creams to supress the worst of it on my face, not pretty I'm afraid on your face.

And about 12 years ago now, my hands were swollen, sausage fingers, stiffness of joints, and generally feeling unwell, rheumo told me I had psorasis arthirits, the first thing she always does when she sees me is hold out her hands and asks me to do the same, we have this little routine down pat now, we compare hands and knuckles or lack of knuckles in my case, due to swelling.

Had never heard of it, and even when i mention it to physio quite recently, they have to get out their text books.

Sounds like thats what you may have, my RA arthiritis comes back negative, as does genetic test for psorasis, but rheumo says that is not 100% a test, i just carry the genetic on differnet or other marker, my Dad had it also, had some really nasty flares during his life.

My ESR is usually about 77, and my CRP 36, anything below those figures is a real bonus.

I have asked my Rheumo where this sits on the RA scale, and she said number two, and for those that have never heard of Psorasis Arthritis its OK to call it RA, as exactly the same, with the same treatment.

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That's interesting Lyn, thank you for replying.

I don't have psoriasis; well, not so far anyway! My symptoms started suddenly in my hands, I now get some pain/swelling in my ankles, knees and chest bone. Also general stiffness, my elbows have been bad recently. Bit, in all honesty, since I had the injection things have massively improved, thankfully!

Each time I attend the clinic the ask about joint tenderness, and always ask me to make a fist......which I can do effortlessly. When I was 'flaring ' before the injection I told them I never really have joint pain, more like general 'boney ' pain particularly in the small bones of my hands and feet.

I do get swelling though and at its worst my hands looked at least double in size!

Since having the injection and starting on Methotrexate I have felt 90% better than I was. .....not sure if it's one or other (or both ) that's improved things, but hey I'm not complaining!

I hope you continue to keep well too!

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MTX has been alife saver for me too, Dr's have tried many other drugs with me, and my system does not like them at all, I have now been on MTX for about 12 years now, with no side effects, just the monthly blood tests which are a bug bear.

Sulfur drugs that work for many, for me are a nightmare, high blood pressure, extreme sweating, the annoying thing is they control my RA or PA, but the side effects for me make them a NO NO.

Best wishes to you as well.

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My first inclination was to tell you to find another rheumatologist! But, having re-read your post, I am confused by the difference between a doctor, a consultant and a nurse-practioner. So many layers of effort. 

I'm with you. I would be confused, too. 

But I can tell you that taking mtx early on in the disease is exactly right. Joint damage becomes much less likely with early aggressive treatment.

Hang in there, kaz. 

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Thank you Timothy!