Need some help????

dobbie59 Member Posts: 4
I have been treated for RA/OA and gout for the last three years, Pain treatment of Tramadol and Patch's only as I am a renal transplant patient.
Usual symptoms of stiffness in morning easing in some joints but not in others, Pain in numerous joints( hands, feet, shoulders knee's everywhere really.

I seen a different consultant recently and was informed that he believes that I don't have RA /OA but have a chronic form of gout,
My blood tests show that my uric acid levels have been off the chart for the last 2years but doesn't show I have RA??

Is it possible that two consults read my results so different?? and is it possible to have RA/OA without it showing in my blood.(My last ESR was 74_

Looking forward to hearing from you.



  • helpline_team
    helpline_team Posts: 2,691
    edited 30. Nov -1, 00:00
    Dear Dobbie,

    Thank you for your enquiry to Arthritis Care. We are not medically qualified so can only give you general information rather than medical opinion or advice.

    As you have a complicated medical history on top of some conflicting medical opinions I'm not surprised that this situation must be dismaying and difficult.

    In the first instance you may need to go over the information that's been given to your GP - which may help to clarify things somewhat, but even then your GP may want to refer you for a second (third?) opinion.

    Normally to get a diagnosis of rheumatoid arthritis (ra) the following results would be the ones that they are watching
    Rheumatoid factor, ESR, CRP, and your blood count.
    Just one test alone like ESR would not be enough to talk about.

    We on the helpline are not qualified to interpret these results, but your rheumatology nurse obviously is and could go through your results with you if you got an appointment with them perhaps?

    Because of your medical history (the kidney disease etc) you may not have been using the rheumatology drugs that most people with ra, or gout?get - i.e. the disease modifying drugs or anti gout ones. Without those treatments the rheumatology team may be a bit limited. But if that is the case you might want to know in the fullest possible detail what treatment options may exist. You should be able to get that spelt out to you. Certainly pain patches and trammadol are only pain killers.

    If you would like some support please do get back to us, but for the medical side we are not going to be able to say a lot more.

    I hope that's helpful

  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    Oh poor you, what a muddle. I don't know if I can add anything to what Guy has told you but hey, when has that ever stopped me, helpline peeps? :smile:

    OA cannot be diagnosed by a blood test as it is a different beast to the auto-immune versions of this dross. OA will be shown in Xrays and scans, have you ever had any of those done? OA can cause one to lose bone and grow bone, one would think the latter would be a good thing but it's what grows and where that causes all the trouble. It is painful, debilitating and is treated by GPs with pain dullers and perhaps anti-inflammatories.

    RA can be diagnosed by blood tests in a number of ways. High CRP and ESR are good indicators of inflammation, and one can also have a positive RF factor (rheumatoid factor). One can have raised inflammatory markers and not have the positive factor, a sero-negative arthritis. One can also be sero-negative and without raised ESR or CRP. I suspect you can begin to see just how confusing this all is and why doctors sometimes don't appear to be too helpful in trying to diagnose. RA is caused by an over-active immune system and it is treated by drugs that reduce the activity of said immune system.

    So, in short, yes, it is entirely possible for two people to take a completely different view of what is ailing you. We are all at the mercy of our doctors' personal opinions about diagnosis, treatments and theories, which can at times just add a whole new level of frustration to this malarkey. It is possible to have OA and an auto-immune arthritis at the same time, quite how the gout fits in I do not know but the high uric acid reading must be a cause for concern. Perhaps it's time to settle down with a notepad and start compiling a list of questions to be asked at your next appointment. The renal complications are not going to help much either, are they? I am so sorry, I hope you can get some proper, definitive answers soon about what exactly is going on with you and that some helpful treatment can be instigated. I wish you well. DD
  • dobbie59
    dobbie59 Member Posts: 4
    edited 30. Nov -1, 00:00
    Thank you both for your replies,
    I have done quite a lot of research over the last three years, since being diagonised with RA/OA and gout.
    I am currently waiting for a 2nd Total knee review due in next 16 weeks, have had numerous xrays of Feet,Hands, Elbows knees,shoulders etc.

    The problemis that this is not my primary illness, I had a renal transplant some 18yrs ago, and a major operation three years ago to re-implant my native urtera into my transplanted kidney. Since then I have had Diverticular disease and a DVT so have rely had a crap couple of years.

    Once again thanks for the info, a lot more to reseach me thinks before seeing the rhumie in 9mths time

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