Re: SED rate
The sed rate(ESR), measures how fast the red blood cells settle in a tube of blood...erythrocyte sedimentation rate. It has traditionally been a measure of inflammation somewhere in the body but even stress can make it go up to 20 and even higher.
But as more and more people are seen as having RA, it is being questioned, as are many other tests. The Rheumatoid Factor is positive in about 5% of the population who don't have RA and about 25% of those who do have RA, don't test positive for the RF. The Anti-CCP is another test for RA but it tends to be better at figuring out who has RA and who has Lupus...another disorder, rather than who does and doesn't have RA.
Where it really gets confusing is when you have OA but symptoms similar to RA but you test negative for everything....what I had for years and years. Like you, I had the toes and fingers with bumps(OA can do that too) and ankles and elbows and just about everywhere but all I ever had was my sed rate in the high 20's...for years....like 25 years. My doc was steadfast that I didn't have RA....yet. I thought I did.
Then all of a sudden, my sed rate went up further(50's) and my CRP(another one that shows inflammation "somewhere")went up. On top of that, my white blood cells went up and my hemoglobin and hematocrit went down showing anemia. My fingers looked like sausages and my knuckles disappeared under hand swelling. He started me on Plaquenil as something was happening. Then I got the hot, red wrist joint....so hot and red it almost looked like the joint was infected....nope...but it did signal RA was beginning.
This didn't happen fast but over a period of 2 years. Still, he didn't up the meds but waited another 6 months and then did an MRI of that same wrist to see what had happened inside...and that is how he decided it was definitely RA....it showed swelling of the synovial lining and the beginning of the bone erosions of RA. He then began to crank up the RA drugs.
So how I see it is this way. If it's RA, sooner or later you will show something with the blood work but the MRI was the test that clinched it. It can show the actual inflammation of RA inside an affected joint and the telltale sign of erosion of the bone instead of the building of bone you get with OA. So as far as I'm concerned, forget the blood work and look to an MRI to tell you what is going on.
The fact is, the drugs for RA can have life threatening side effects...like cancer....so you need to make sure you have it before you venture into those drugs. Otherwise, the drugs are very similar to those for OA.
OA is the most crippling disease out there and the chronic pain can drive you insane for sure. All of my 23 ortho surgeries have had to do with OA, not RA. But OA will never kill you, just make you feel like killing yourself......but it doesn't justify giving you potentially lethal drugs. But RA can kill you and very fast if it's aggressive. Attacks organs and not just joints. That justifies the potentially lethal drugs.
The diagnosis of RA has more to do with whether or not they can justify giving you drugs that might kill you than whether or not you have OA or RA or something in between. If you are going to give a patient a drug that can permanently harm them or even kill them, you have to make sure they have a disease that can do the same. OA won't kill you so it doesn't justify the use of those powerful drugs.
So keep whatever you have, keep it under watch and see if it develops into anything. But if you get a hot, red joint, then ask about having an MRI done after it settles down to look for signs of synovitis and bone erosions. That will tell you more than blood work.
Jenny(OA for 40 years and RA for 6)