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Symptoms of Arthritis but nothing in blood test

mraakmraak Posts: 2
edited 8. Nov 2019, 18:01 in Say hello
Hello!

I am new here and posting on behalf of my wife.

She has been experiencing joint pain, mainly in her hands, shoulder, knee and ankles. The pain usually gets worse in the morning and she also has some stiffness in her hands, you can clearly see the redness and swelling in her hand joints. This has been going on for about one month now, and all she has been taking are painkiller (NSAIDs) and tumeric, but its not helping much.

I suspected RA but I also got opinion from my brother, who is an orthopedist surgeon, and he also confirmed these seem to be symptoms of Rheumatoid arthritis. Recently she has been having chest pain in addition to the joint pain and i am not sure if this is a typical symptom of Rheumatoid arthritis. The pain is in upper chest around the sternum, and sometimes it gets quite sever.

I got her blood tests done and apparently, every thing was normal, her CRP is 1.7mg/l, ESR is 18mm/h, Rheumatoid Factor is less than 8.4 and her uric acid is also within the limits. I know there are some cases of sero-nagative RA, but i am not sure if even the inflammation does not show up in the tests? I mean the redness and inflammation can clearly be seen visually? Just last night when she woke up her hands were so stiff and painful that she was not able to close her hand. Need some advise as to what it could be.

We will also be seeing a rheumatologist next week., but just wanted an advise from you all.

Thanks and best regards,

Comments

  • moderatormoderator Posts: 4,082 mod
    edited 30. Nov -1, 00:00
    Hello and welcome mraak to Versus Arthritis Community Forum

    I'm sorry to read of your wife's condition with possibly RA, it can be quite a debilitating illness and from what you are saying she going is through it at the moment. You have sought advice from others but the Rheumatoid Consultant appointment is the right direction to go, taking the various test will help your wife get the appropriate help and treatment.

    We have many of our forum users who have RA and are in a position to offer help, advice and support.

    I have found a link that may be of help to you:-
    https://www.versusarthritis.org/about-arthritis/conditions/rheumatoid-arthritis/

    Also, feel free to phone our experienced Versus Arthritis Helpline 0800 520 0520

    Enjoy the forum

    John
  • daffy2daffy2 Posts: 1,713
    edited 30. Nov -1, 00:00
    Sorry to hear of your wife's joint pain. My own experience is that OA can cause quite impressive redness and swelling as well, in fact a couple of years ago I was able to get a GP appointment at a time when my hands were looking bad enough that they made my friends wince, let alone me who was feeling them! She was quite unimpressed and said that OA can do that and looking at the other tests done there was no reason to consider changing the OA diagnosis. Advice was pain relief and hot/cold depending on what helped. It did settle down after a few days.
    Stiffness will tend to be worse in the morning as the joints have been immobile and will have 'set'(as someone said, like a jelly left in the fridge!)
    The chest pain could be costochondritis?
    I hope you will get some answers when you see the rheumatologist, but it can sometimes take a while to sort out a diagnosis.
  • stickywicketstickywicket Posts: 25,993 ✭✭✭
    edited 30. Nov -1, 00:00
    Hi and welcome from me too. Your wife is seeing a rheumatologist which is exactly what she needs right now. We are not qualified to diagnose. I have both RA and OA and, from what you have said, it could be either. The big difference for me is the overwhelming fatigue when RA is flaring.

    Just a word of caution. I think turmeric can interact with NSAIDS which, as the name implies, are anti - inflammatories rather than straight painkillers. Also, if she is taking regular NSAIDS, she should also be prescribed a stomach-protecting med. Daffy is right in that RA can cause costochondritis but that is rare. Much more common is stomach/oesophageal problems caused by NSAIDS. As someone who gets these, it all sounds right to me.

    My advice would be to give the rheumatologist all the info you can but be prepared to hear that it might not be RA or any other autoimmune arthritis. (Any autoimmune diseases in your wife's family?) I think the essential difference between OA and autoimmune forms of arthritis is that, with OA, the inflammation is localised to the affected joints: with RA etc it is systemic.
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • BouveBouve Posts: 3
    edited 30. Nov -1, 00:00
    Hi mraak :)
    I'm so sorry that your wife is suffering. I recently found out that there are many conditions that mimic rheumatoid arthritis or inflammatory arthritis, but unfortunately our NHS system doesn't tend to investigate, they just tend to throw medication at people. Personally my arthritis gives me all the symptoms of several other conditions including; vitamin B12 deficiency, lymes disease (one to pay attention to if your wife has ever been exposed to insects), leaky gut due to mold exposure, lupus and hypothyroidism, although I believe there are several other pathogens that an cause the same symptoms, and a severe physical or mental trauma can also cause the bodies immune system to flip on itself. Obviously I'm not a medical professional, but at a mere 29 I have a lot of experience with getting blood out of the NHS stone.
    If there are no inflammatory markers in the blood results I would strongly reccomend pushing your GP (gently) for tests on some of these other conditions, as they can also lie dormant in the body for some time and cause the same symptoms without the inflammatory markers.

    I hope this helped or was informative in some way :)
    Regards, Kat
  • MrFredericksonMrFrederickson Posts: 2
    edited 30. Nov -1, 00:00
    Hi. I'm sorry to hear about your wife's condition. My pain started in my feet. Bunions I was told and so had cortisone injections in both big toes; This was 2011. Then my hands started to give me problems. Just a few joints (distal interphalangeal Joints) at first. So had cortisone injections here too.
    I've had numerous surgeries for this now since 2011 as my hands have got progressively worse. Last year I also had pains in my chest bones and was told I had costochondritis and was told to rest (ie no lifting etc). This helped a lot. I had my forefinger fused last year and no pain now. That's one good thing I'm grateful for.
    My hands are so bad now and a few months ago I had an appointment with Rheumatology where they tested me (physical, x-rays and bloods) and to be told that I don't have RA or Fibromyalgia (I was a few points off apparently). I mean how much pain does one need to be in before someone can help? Can anyone help? They were to refer me to Hand Therapy. Two missed calls and now forgotten.
    Spoke with doctor this week and he is now following things up for me.
    At the moment I can't move my thumb as it is stuck and extremely painful. I can't grip my hands as they are painful and stiff (particularly in the mornings). I'm finding it really difficult to get dressed, brush my hair, grip a cup, so on and so on. Really getting me down now.
    I wish you wife all the best as this is just so debilitating and only you, the person with the pain, can see it.
  • moderatormoderator Posts: 4,082 mod
    edited 30. Nov -1, 00:00
    Hi MrFrederickson & welcome to the forums.

    I’m sorry to hear that you have had such extensive problems with your hands & previous surgeries. As each new problem arises it must be so wearing to have to go through another set of diagnosis procedures before any solution is attempted.

    It’s good that your doctor is now following up the referral to Hand Therapy. Our website has a range of information about hand pain here

    https://www.versusarthritis.org/about-arthritis/conditions/hand-and-wrist-pain/

    It is also worth searching the site for more in depth information that may help you.

    Brynmor
  • MrFredericksonMrFrederickson Posts: 2
    edited 30. Nov -1, 00:00
    moderator wrote:
    Hi MrFrederickson & welcome to the forums.

    I’m sorry to hear that you have had such extensive problems with your hands & previous surgeries. As each new problem arises it must be so wearing to have to go through another set of diagnosis procedures before any solution is attempted.

    It’s good that your doctor is now following up the referral to Hand Therapy. Our website has a range of information about hand pain here

    https://www.versusarthritis.org/about-arthritis/conditions/hand-and-wrist-pain/

    It is also worth searching the site for more in depth information that may help you.

    Brynmor

    Thank you very much. It's challenging. I will certainly look into the website more and read some more. It's 'nice' to know that I'm not alone with this mostly invisible pain. You do feel sometimes that no one believes you can be in so much pain without any visible evidence. Sadly my eldest Son has Addison's Disease (plus Asthma and Alopecia, which I think is under control for the moment) and my youngest has fairly bad Psoriasis, both of which have potential to attract other autoimmune conditions and I'm praying they don't.
    Thanks once again. Best wishes to everyone here.
  • stickywicketstickywicket Posts: 25,993 ✭✭✭
    edited 30. Nov -1, 00:00
    Hello from me too. I read your first post last night (when I was too flaked out to reply :roll: ) and wondered why you seemed disappointed not to have a diagnosis of RA. I now see why. With your sons having autoimmune problems it might seem logical that yours was too.

    I guess this was not a definitive reply. Our inflammatory levels do keep changing but they, alone, don't determine what is OA and what is autoimmune. X-ray damage is different, though so x-rays are usually quite reliable. And, although some people's OA can be explained by trauma to a single joint which, possibly, then sets others out of kilter, others do seem to get it in multiple places for no clear reason. Sadly, arthritis of any kind is an 'unglamorous' disease which doesn't attract huge amounts of funding so there is still a lot of mystery about all knds.

    I have RA virtually everywhere and, because there were no modern DMARDS on offer when I was first diagnosed back in the arthritic Dark Ages of 1961, I also have OA too in most joints apart from the replaced ones. My method of dealing with it has always been (i)distraction and (ii)exercise(s). Finally, when all else fails, 'painkillers'. (What a misnomer!) You seem to have had a fair bit of surgery but you write “ I can't grip my hands as they are painful and stiff (particularly in the mornings). I'm finding it really difficult to get dressed, brush my hair, grip a cup, so on and so on.“ which sounds as if you've not yet made many adaptions to daily living. Believe me, they make a difference. I have virtually no grip so mugs, pans etc are lightweight, cutlery and pens are thick-handled and, basically, improvisation rules. I invariably wear trousers as they're easier. I have a sock aid, dressing stick, pick-up stick, long-handled comb (long hair was cut short years back) and, best of all, a walk-in shower. My vac is a lightweight cordless, my washing line low enough to throttle the unwary :lol: and my lightweight iron is....er....somewhere :oops: We adapt and survive. Check out disability stores online for ideas.

    You have already made the unfortunate but important discovery that, with the NHS in such dire straits, we have to do our own admin – follow up appointments, ensure messages are passed on. It's a chore we don't need but must take on. Ask for physio and, if it seems appropriate, ask to see an Occupational Therapist who could advise about adaptions to your home. An orthotist could provide splints for when your hands are at rest. There is stuff out there to make our lives easier and I hope you can find some.

    By the way, 'autoimmunity' is not always passed on. One of my sons just has hay fever: the other has coeliac but is fine as long as he doesn't eat gluten – so he doesn't. They are now nearing 50 and neither has arthritis of any kind.
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 30. Nov -1, 00:00
    Hello, I have psoriatic arthritis (PsA) without much of the skin trouble but, after being born with eczema, it came as no great surprise. Both parents had auto-immune issues in their respective families but were fortunate to dodge the genetic bullets they happily fired into me.

    I began the arthritis back in 1997 when I was 37 but was not accurately diagnosed until 2006 which changed absolutely nothing: I have also aquired osteoarthritis and fibromyalgia. Over the years I have followed the arthritis ABC, viz. adapt, believe, compromise: adapt includes changing household kit, using aids, how I dress and pacing myself, believe means believing in myself and my abilities to do what I can with what I have and compromise includes prioritising events and breaking tasks down into manageable chunks punctuated by rest.

    There are around three hundred auto-immune inflammatory conditions so diagnosis can be tricky. PsA is a sero-negative form of auto-immune arthrtitis so docs not in the know, on receiving test results which are negative for rheumatoid factor, incorrectly conclude auto-immune arthritis is not a possibility.

    I apologise, I am very tired and have to go. I hope I haven't muddied your waters too much. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • felicityhfelicityh Posts: 25
    edited 30. Nov -1, 00:00
    Psoriatic arthritis often shows nothing in the blood so CRP, ESR and autoantibodies are all normal in at least half of the people that have it. It's symptoms can be very similar, if not identical, to rheumatoid arthritis. I saw you mentioned that someone in her family has psoriasis so that also makes it more likely that this could be the cause of your wife's problems. Definitely ask her doctors about this if you haven't already. Best of luck.
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