It is possible to have seronegative rheumatoid-arthritis. Seronegative testing for rheumatoid arthritis means that the person is negative for both rheumatoid factors (RF) or cyclic citrullinated proges (CCP). This answer is complicated and requires some background. Rheumatoid arthritis is a condition that causes painful, swollen joints. It is different than osteoarthritis which causes joint damage due to aging.
When your immune system attacks your joints’ lining, you get RA. This is a complex phenomenon. RA can happen to anyone, but is most common in middle-aged women.
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What is the best way to diagnose RA?
No single test can confirm that you have RA. The diagnosis includes a thorough examination of your joints, including blood tests and X-rays. Your doctor will likely refer you to a specialist, known as a rheumatologist, if they suspect you may have RA.
The RF test, which can be used to confirm RA, is one of the blood tests. Your immune system makes RF, a protein (antibody), that binds to a normal antibody. This can lead to tissue inflammation. Elevated levels RF are common in autoimmune diseases such as RA or Sjogren’s Syndrome, and can also be caused by infections like parvovirus and hepatitis C.
However, RF testing does not provide a definitive diagnosis. Even though there are no autoimmune conditions, healthy people may have elevated blood RF levels with advanced age. People with RA may have normal levels of RF, which can further complicate matters. Some people may test positive for an antibody that is directed against cyclic citrullinated progesterones (CCP). Anti-CCP antibody (also known as CCP antibody) is more sensitive than RF and can be detected before RF.
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A person with RA symptoms but normal RF/anti–CCP levels might not have RA. Spondyloarthritis is another inflammatory autoimmune disorder. This is particularly true if your spine or sacroiliac joints are involved, or both.
Spondyloarthritis: The Disorders
Many of the conditions that fall under the umbrella of spondyloarthritis were thought to once be variants on RA. These include:
- Psoriatic arthritis
- reactive arthritis
- Ankylosing Spondylitis
- Enteropathic arthritis
- Whipple’s Disease
Non-radiographic axial spine spondyloarthritis
Although each disorder is different, they all share the same root. All of them are inflammatory autoimmune diseases that can cause arthritis in different parts of the body, especially the spine.
What is the difference between RA and spondyloarthritis?
Although these conditions may share arthritis, there are significant differences between RA (and the class of disease called spondyloarthritis). First, spondyloarthritis tends to be more common in men than in women.
Second, most spondyloarthritis cases include other complications, such as:
- IBD (inflammatory bowel disease)
- Inflammatory eye diseases
- Aphthous ulcer
The way arthritis is felt in RA and spondyloarthritis are different. Arthritis in RA can occur in the same joints on both the left and right sides of the body. Arthritis is not experienced in the same way in spondyloarthritis. It also affects tendons (tenosynovitis).
Inflammation is a common symptom of spondyloarthritis. It can often be found in the feet or ankles. Enthesitis can also occur in the spine, where the ligaments and tendons attach to the bones.
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Treatments for spondyloarthritis
Unfortunately, spondyloarthritis, just like RA, has no cure. There are treatments that can help manage symptoms and prevent damage.
- Nonsteroidal anti-inflammatory drug (NSAIDs),
- Biologics and disease-modifying antirheumatic drug (DMARDs).
- Topical creams to treat psoriasis
- Eye inflammation can be treated with NSAID and steroid drops
- Dietary changes to treat inflammatory bowel diseases (IBDs).
- Janus-kinase inhibitors (JAK inhibitors)