Hi,

My wife was recently dignosed as having reactive arthritis for the past 30 years or so. She is HLA-B27 positive, but (at least in the last few years) she has not had an appreciable sedimentation rate or C-reactive protein level. He rheumatologist maintains that reactive arthritis can be present (certainly in its chronic form) with negative sedimentation rate and CRP. The diagnosis was based on the fact that my wife has inflammed joints in her hands and wrists (by X-ray and examination), the absence of osteoarthrits (osteophytes) and the fact that she is HLA-B27 positive. I, on the other hand, am not that sure. Dr.'s sometimes feel compelled to a diagnosis when there may not be one.

My wife is in her mid 50's, has pain flares (especially in the last few months) of many joints - which she describes as "hot" and achy. She has had a lifelong spinal condition leading to degenretive disc disease which is felt due to scoliosis that she had as a teenager.

Has anyone heard of someone having reactive arthritis but not showing any elevated sedimentaion rate or c-reactive protein? Any help would be greatly appreciated. Thanks.

I have psoriatic arthritis, another inflammatory type of arthritis. At present my ESR and CRP are in the normal range ( I didn't know they could be negative figures, so am assuming at this point that you mean they are normal). This set of circumstances is normal and somewhat frustrating. One can be in a lot of pain, with plenty of inflammation ( believe me, I know from personal experience), but it doesn't show up in the blood work.

At this point I would tend to go along with what the rheumatologist says. You would be amazed at how many people have had doctors say they can't possibly be in pain when their ESR and CRP are normal, yet those doctors are way off base. Unfortunately little seems to be known about these conditions and how they show up in blood work.

Could your wife possibly have ankylosing spondylitis, rather than reactive arthritis? Just wondering, but I'm sure the rheumy has been thorough.

Meantime, please support your wife thru this difficult time, she needs all the help you can give her. Arthritis is a very painful condition, and she needs treatment, usually in the form of DMARDs to try to halt the progression of the disease. If she is happy with the rheumy's competency, I'd support her all the way.

Cheers
Lesley