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Old 06-26-2007, 12:46 PM   #1
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elisso HB User
What other tests are there apart from x-rays andblood tests for rheumatoid arthritis?

Hello everybody,

I've been suffering from joint pain for the past three years. The pain lasts for a few weeks each time that I get a flare and has to date affected almost all my joints. I've been also suffering from fatigue whenever I have a flare (it's as if my brain switches off)). The blood tests and x-rays I've had so far show nothing. I am thirty years old and I've been wondering whether I might have rheumatoid arthritis or any other form of arthritis.
Does anybody know what sort of tests there are for these kind of things?
Any ideas about any diseases with similar kind of symptoms?
thanks,

Elisso

 
Old 06-27-2007, 09:18 AM   #2
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Re: What other tests are there apart from x-rays andblood tests for rheumatoid arthri

Elisso,

Can you be more specific about your pain and the tests that have already been run? For example, is your pain worse in the morning and after periods of rest, or is it worse after activity?

There are many blood tests that can help diagnose, but you don't have to have positive tests to have RA. This would be called seronegative RA. There is also a condition called Palindromic Rheumatism that presents similar to RA and can have negative tests. People with Palindromic Rheumatism do not have damage. Some develop more traditional symptoms over time and can even become seropositive.

My RA was diagnosed mainly based on symptoms and a positive Anti-CCP test, as well as a positive ANA. I did have a positive RF, but it can be positive in other illnesses as well.

 
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Old 06-27-2007, 10:43 AM   #3
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Re: What other tests are there apart from x-rays andblood tests for rheumatoid arthri

Hi Creinha,

Thanks for responding. With regards to the pain: Itís definitely worse in the mornings Ėwhen itís really bad it even wakes me up. When I am simply resting (at a time when I am having a flare) it becomes difficult to move the affected parts (especially the legs) and it feels as if they get Ďlockedí in a certain position. In periods of mild pain I would say it becomes slightly better with swimming, but when the pain is bad, activity (even walking) makes it worse. It becomes worse with the cold, and whenever I am exposed to toxic stuff (alcohol, cigarettes, and infections I might have caught). It often starts off smoothly with the pain being imperceptible as if Iíve had too much exercise but then if I donít take anti-inflammatory it gets worse. When the pain is really bad I cannot touch the affected area because even that hurts and I have difficulty moving. The pain is usually accompanied with physical and mental fatigue and itís as if I have difficulty thinking straight. I havenít seen any swelling so far apart on the fingers; the rest (elbows, shoulders-upper arms, knees, feet, wrists etc) they donít seem swollen to me.
Sometimes the pain is triggered by a strenuous moment (lifting a window or carrying a bag).

My RA and my Anit-CCP were negative so far. My ANA was positive once (1:320). Iíve also had a positive Anti-Fcl0 and a positive Anti-ENA (or Anti-ONE ĖI donít know the English version of this last one). I donít really know what these different things stand forĖIíve just started looking at them.
Sorry if I put too much information Ė I am just trying to find out whatís wrong with my body.
Anyway, I really appreciate your help,

Elisso

 
Old 06-27-2007, 11:37 AM   #4
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creinha HB User
Re: What other tests are there apart from x-rays andblood tests for rheumatoid arthri

Iíve never had increased pain from exposure to toxic stuff, but the morning pain and stiffness sure sounds like RA to me. I hardly ever have what I would call visible swelling to me. Sometimes, my pain becomes excruciating in a matter of minutes and sometimes it remains a dull ache. I too have increased pain when I try to exert myself too much physically. I had a really bad winter this year Ė shoveling my driveway was almost too much!

A thyroid problem could also cause joint pain. You might want to have a thyroid panel. Also, you didnít mention if you had any inflammatory markers such as ESR (Sed rate) or the CRP? Those are usually, but not always, elevated in inflammatory diseases.

What was the normal range for your labs ANA? Most here are <1:40. If thatís true at your lab, then the ANA seems a significant number to me, and would likely be from an autoimmune condition. My original ANA was 1:320 as well, and my rheumatologist thought it was elevated because of my hypothyroidism. When tested two months later, it was 1:1280 and was then attributed to the RA because of the positive CCP and the negative Lupus panel.

Iím not familiar with the Anti-ENA or Anti-Fc10. What are those?

 
Old 06-28-2007, 11:29 AM   #5
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Re: What other tests are there apart from x-rays andblood tests for rheumatoid arthri

Hi Creinha,
Thanks for responding. I am unfamiliar with most of the markers and I havenít had the chance to have a rheumatologist yet although Iíve been having the problems for three years now. The health system here in the UK is falling apart and itís very difficult to find a general doctor who is willing to refer you. I just managed by some miracle though to be referred to a rheumatology department just now but it will take a few months before I am being seen. The problem so far has been that I hardly ever manage to get blood tests done when I am having a flare due to the long waiting lists over here Ėdo you know if that delay between the flare and the time of the tests could affect the results?

I donít know what the Anti-Ena and Anti-Fcl0 are either. The normal range for the ANA here is 1:80, my CRP was 0 which apparently is good and I donít seem to have been tested for the CCP and the Sed rate.
What I understand from what you said is that my symptoms look similar to yours, I donít necessarily have to have the swelling to suffer from RA and that maybe my ANA is significant too. Thanks for the suggestion to look into my thyroid ĖIíll try to do that.
Does RA get manageable with appropriate treatment? Is there any medication that blocks the progression of the illness?
Also would you by any chance know whether a department for arthritis is the same with a department for rheumatology? (I was given choice for one or the other and I donít know which one is relevant).
Sorry to bombard you with all these questions,
Thanks

Elisso

 
Old 06-28-2007, 12:52 PM   #6
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Re: What other tests are there apart from x-rays andblood tests for rheumatoid arthri

My referral took a few months too, though I don't think I could have put up with the pain for years before getting the referral. Wow.

Here in the US, the rheumatologists handle all the arthritis conditions, so they aren't separate fields. I would suggest the rheumatology department based on the ANA results. I say that based on my rheumatologist saying my lowest ANA of 1:320 was due to an autoimmune thyroid condition. I think you'd be safer going to someone who specializes in that field.

The CRP and ESR are elevated when the inflammation is "systemic". If it is confined to the joint area, then those tests can come back within normal limits. The CRP raises and lowers more quickly in response to inflammation. The ESR, however, raises after the inflammation has been present and slowly lowers after the inflammation has gone. I've had tests that came back elevated when I felt fine and tests that came back normal when I felt absolutely terrible. My very first tests were both elevated and I had them taken when I wasn't flaring, so don't worry about that. I'm thankfull that my rheumatologist pays more attention to how I feel than what my tests results are.

I think the whole "uncertainty" of what's going on can be really scary. Don't worry so much about your tests. Just be sure to tell the doc exactly how you feel. My rheumatologist is always most concerned with how long my morning stiffness lasts and how often I have flares. He never asks me if I have swelling, though he does mention it if I have swelling during an exam. Sometimes he can feel it when I can't see it.

There are many drugs that slow the progression of RA. These are called DMARDs (disease modifying antirheumetic drugs). I have been on Plaquenil for three years and still don't have any erosions, thank God. The drug worked great until the last few months. Just this morning, my doctor has added methotrexate. I'm hoping it will stop these horrible flares I've been having the last 5 months.

I just thought of something. Have you ever been prescribed prednisone during a flare? If you get relief from the prednisone, it's likely you have an inflammatory condition.

Hope this wasn't too long. I've been on prednisone for a while and it tends to make me a motor-mouth!

Hope I didn't miss any of your questions.

 
Old 06-29-2007, 01:38 AM   #7
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Re: What other tests are there apart from x-rays andblood tests for rheumatoid arthri

Hi Creinha,

Itís really really helpful having all this information. You seem very knowledgeable Ė in fact even more knowledgeable that some of the doctors Iíve seen so far (which makes me worry).
I think at this stage thatís as far as I can get, I would need to get to meet these rheumatologists first and start looking into the different markers etc. Good to hear that you havenít had any erosions whilst on that medication and I hope that it keeps on being like that.
Thanks again,

Elisso

 
Old 06-29-2007, 11:04 AM   #8
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Re: What other tests are there apart from x-rays andblood tests for rheumatoid arthri

I was diagnosed with RA in 2003. The RA came on suddenly during the heatwave August and my rheumatologist (I was so lucky to find someone to believe me) found my 'rheumatoid factor' high, thus positive, that November. She put me on Methotrexate (which I hated). I came off it two years later. Along with anti-inflams, glucosamine etc, I've since been for what they call here 'cures' in Aix les Bains. Most importantly, I don't eat red meat anymore !! I find if I'm careful with my diet, the pain decreases. (If I do eat meat, the pain is back within hours.) Avoid all that comes from the cow... But these are personal findings, not my doctor's. If anyone else has thoughts about diet, I'd be most interested.

 
Old 07-29-2007, 08:19 PM   #9
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bluebird8 HB User
Re: What other tests are there apart from x-rays andblood tests for rheumatoid arthri

About 10 months ago I was diagnosed with AS, Ankylosing Spondylitis. This is in the RA family. My doctor thought I might have AS from my symptoms and referred me to a Rheumatologist. I'm very grately my Dr. sent me to the RD and he said I did have AS. He started me on prednazone to make sure it was AS and then put me on Enbrel. The seemed to work very good at first. But then after a few months it wasn't helping as much and I got a rash, not necessarily from the Enbrel. I was taken off of Enbrel and lipitor that I also had started around the same time period. The more research I did on AS and Enbrel the more I was scared about going back on it. Their could be possible increased chance of getting major diseases because of the immune system getting so low. I also was reading about how food can play an important role in these autoimmune diseases. During this time, about 2 months ago I had 2 weeks of no pain. I was in shock and thought that maybe I didn't have AS or any disease. I was just learning about the Gluten free diet and tried it a little but can't really say why I had no pain for those 2 weeks. I thought at the time it was the gluten free diet. But after those 2 weeks I went back to having pain and it has gotten progressively but quickly worse.

I tried going back on Enbrel 3 weeks ago but have noticed no decrease in pain. The pain has now gone all over my body it seems and it is very frustrating. I have an appoinment with my RD on Tuesday. It keeps me up at night. I am constantly trying to find other solutions and also looking for solutions to cut the pain in daily life.

For example I have found a new mouse for my computer that I don't have to take my hands off of my computer and move my wrist to use the mouse. I'm still getting used to it but I think this will help my pain in my wrist. I am waiting for a new keyboard that I found online that splits in 2 and you can put the 2 parts of the keyboard on a platform closer to your body. This, I hope, will also help my wrists and elbows. I am still going to keep trying the gluten-free diet. I also heard a low to no starch diet and no red meat or animal food products at all could help. I am trying those but I have a problem with diet because I am bulemic.

 
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