What are the determining factors for a diagnosis?

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alli sunshine
Regular Member

Date Joined May 2009
Total Posts : 40
   Posted 10/26/2009 5:30 PM (GMT -7)   
I have been having issues with my health for over a year. Last winter, I was found to be extremely anemic. Was treated for that and had a uterine ablation. Also, very, very low vitamin D levels, so I've been taking supplements to help that. I was having a lot of joint pain last spring, and generally not feeling well. I have a family history of RA (mom and 2 aunts), so my doc did some blood work. I came back negative for sed rate, but had a very high ANA test. She sent me to a rheumatologist. He was not convinced that my foot pain was from a disease, but thought it might be from a gait problem due to spine issues (fused T3-L2). He wanted me to go to a podiatrist, which I haven't done yet. He didn't really address my other joint pain, in my hands and elbow, which was not as bad as my feet, but still bad.

Fast forward to now. I am feeling exhausted again. I don't think the ablation fixed my anemia problem. I am also having terrible shoulder pain, since July. Still having foot issues, and now occasionally knee and hand problems. Also wanted to add that I have had Raynauds for many years. Additionally, when I went for an EGD to try to get an answer to the anemia, I was found to have chronic stomach inflamation and have been diagnosed with gastroparesis.

I am headed back to my GP Wednesday to check for anemia again and to have her take a look at my shoulder. My question is this. Can I have RA if I don't have a sed rate issue show up on my bloodwork? Rheumy did do DNA lupus tests that came back negative. I am just thinking that all the crap I am dealing with must be related somehow. Crimeny, when I read all I posted above, I sound like someone who is older than I am at 42. Just wondered if anyone here could shed any light on all this.


Veteran Member

Date Joined Jun 2006
Total Posts : 909
   Posted 10/26/2009 6:42 PM (GMT -7)   
The short answer is that yes, you can have RA even if your sed rate is in the normal range. As for the long answer, I'm not sure myself. My rheumy isn't even going to run any of the standard tests until I am off prednisone, as that can mask inflammation. All the tests I've had over the past few months (sed rate, CRP, CMP) have all been in normal ranges even though I have been experiencing classic flare symptoms.

I know how frustrating it is to not have any answers. If the rheumy you previously saw isn't addressing your other joint issues beside your feet, you may want to get a second opinion. That said, you might also want to see a podiatrist per his recommendation.

I also can sympathize with feeling far older than you really are. In fact, I think we've all been there! Good luck and keep us updated.
29f, PhD student, originally diagnosed with Crohn's in 2/06
10/09: Prometheus test shows results consistent with UC
10/12/09: beginning treatment for arthritis
Currently taking: 7.5mg methotrexate weekly (pills), 2g Pentasa, tapering from 20mg prednisone, 150mg Trazadone, multivitamin, vitamin D, magnesium, probiotics, folic acid

Veteran Member

Date Joined Sep 2008
Total Posts : 1670
   Posted 10/26/2009 11:16 PM (GMT -7)   
I agree with Vitak, you can have RA without the RF. Is your pain symmetrical? Classic RA affects both joints, feet elbows, knees, hips, hands, wrists all the favourite flare sites for RA. Not sure about shoulders? get another opinion. A podiatrist can help with your gait and relieve some of your pain, helps with your knees too, so I'd defiantely go, but seek out someone more caring and sympathetic. Its a horrible disease, you want to ultimately trust the rheumy you're dealing with and not feel ignored or not listened too.
Best of luck on your search. Let us know how you're going, golitho

Veteran Member

Date Joined Nov 2006
Total Posts : 1331
   Posted 10/27/2009 9:05 AM (GMT -7)   
Yes, you can have a negative sed rate, I have had a negative as well, even at my worst flare and off of my methotrexate. As far as your anemia that you mentioned, what type did you have?  I have a low red cell count and even after 6 rounds of vitamin b 12 injections, it is still too low, and I'm still exhausted (megaloblastic anemia) so sometimes it can be difficult to treat.  I would get another opinion from another rheumy, sometimes a second opinion is needed.
Good luck!
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