Are RF and anti-CCP tests redone at subsequent visits?

Mat48

Got my 3rd rheum apt at the end of the week with a different consultant and was wondering if they routinely re-test for rheumatoid factor and anti CCP if you have an RA diagnosis and treatment but were borderline low positive / negative for these tests? And do they usually x-ray or ultrasound RA patients every few years or not?

scattered

They don't routinely redo RF and anti CCP tests. Sometimes they'll redo them if you move house and completely change rheumatology teams. X-rays and scans depend on how active your disease is. In theory you should have baseline X-rays at diagnosis, then once a year thereafter. In practise, maybe every four or five years if everything is generally ok. Ultrasound may be done to try and find out if there is any inflammation that's been missed in a physical examination, or to discover if a drug has really worked, but not regularly.

I've moved twice and had my RF redone once. Mine changes depending on if my disease is active. When it was first done I was seropositive, when I moved my RA was under some control and it was just seronegative. I had baseline X-rays done six years ago and none of my joints since. I get chest x-rays whenever I change drugs though! I had my hands ultrasounded three years a go to check that I was nearly in remission.

Things differ depending on the health authority. I hope that helps.

salamander

Hi Mat, mine checks for RF every now and then just to see. Rheumy does xrays or ultrasound if I express worry about my joints, otherwise not.

Mat48

Thanks Scattered and Salamander that's really helpful of you both. My consultant said it was time to get x-rays taken when I saw him by video link but then, at my last consultation in July he didn't mention it and nor did I. I would like to know if I'm in remission or not and whether I should just accept some changes to my hands and wrists as collateral or can a raise in dose of Methotrexate get me remitting even further. I will ask all this on Friday when I see the next chap. Mat x

salamander

Mat, I certainly wouldn't accept changes to my hands and wrists - it's totally avoidable with the right treatment. Was talking to eye specialist on Friday who has been told by eminent surgeon they are no longer having to do hand surgery due to drugs like anti tnfs/biologics. Sorry to be so forceful but don't think you should accept that. all the best on Friday. xx

Mat48

Thanks Salamander. It's funny the things we just get used to and put up with isn't it? Because my anti-CCP was negative and because my rheum advised me to keep an open mind - "things could change" when he diagnosed me with RA 14 months ago - I have done just that. But I had finally decided that my RA must be quite mild and that was probably why my tests were negative/ weak positive. Then someone I know said something about spondyloarthritis being negative this morning and commented on back pain being common symptom plus hands and wrists too and that's made me rethink.

But from looking things up today I realise that the rheumy wouldn't have put me on as much MTX as I would tolerate - plus Hydroxy - if he hadn't thought that something worrying was going on. And now my Sacroilliac joints are aching so much I have been researching and realise that he actually meant that my diagnosis might be changed to PsA or another type of inflammatory Arthritis - not just go away or be Palindromic as I'd really hoped. I'm consoling myself that I have no family history of PsA and no Psoriasis to date - although I did suffer from chronic eczema everywhere until about five years ago when it vanished so maybe there is a connection?

Ah well detective work for the day is over because my husband has lost the car keys to the courtesy car garage lent us while ours is being fixed and also I can't sit down for another second as back is killing me! Mat x

salamander

I'm sero neg and there is nothing mild about my RA. Not worth trying to diagnose yourself, IMHO, as it's hard enough for the experts to do so Hope you have a good appointment and get some answers and a proper discussion about where to go from here.
take care.

Mat48

Thanks Salamander. Until yesterday I was of the mindset that it didn't really matter as long as we are under a rheumy and being treated for inflammatory arthritis that was the main thing. What I hadn't appreciated is that sero-negative only relates to a person who has no rheumatoid factor - it doesn't refer to people who are positive for anti-ccp - which is the more specific test of the two for RA by far. So I think most people with RA - whether sero neg or positive are usually positive for anti-CCP even if not for RF.

I maybe wrong about this and it would be interesting to learn from others if this is so. I had just assumed if you were sero negative that would be for both blood tests but it isn't apparently.

And of course it's a really complicated business diagnosing these arthritic diseases but it is important to distinguish in that they have differing disease activity scores. So people with spondyloarthritis often have to be put on the anti-tnf/ biologic drugs before they seen an improvement to their disease activity because DMARDs are often not an effective enough treatment for them. And because anti-tnf drugs are so expensive therein lies the problem!

End of my research - got a job to do and a sore back to pamper. Can't seem to get comfy today. Mat x