Early Diagnosis - Newbie | Arthritis Information

Hello All,

I'm a newbie who just found out yesterday my anti-ccp count is 30. She indicated that the normal range should have been between 0-14. I've read that anything >60 is considered clinical RA. At the conclusion of her clinical exam, she indicated that my presentation is not typical RA at this point. I have no swelling or pain in any joints but rather popping sounds all over, foot pain during my first few steps out of bed and anytime I bump my arm/leg against something the pain hurts far more than it should.

I'm having my first appt with my rheumotologist tomorrow to discuss a treatment plan and am curious what types of questions I should ask. It does appear we have caught this early of which I am very thankful. The medicines available today seem to be working for many people on this board and I plan on using this board as a great resource.

As a father of 3 little girls and only 34 years old, I'm scared but hopeful. Thanks for any help.

Hey there-sorry you have to be here but you are correct that early diagnosis is key. What was your RF? I'm assuming it's positive since your CCP is, but it's probably not always the case.

I'm curious what meds your doc will prescribe since your not in terrible pain, yet your CCP is positive. There is a good chance the doc may just start you out on plaquinel for that reason. It's pretty mild. I was just diagnosed a year ago, my symptoms were pretty bad. My doc started me out on the plaq., then when the CCP came back a high positive he added Methotrexated (MTX). That's usually the first DMARD prescribed. In about a month I was already feeling near 100%.

I'm sorry I didn't give you questions to ask. I'm sure someone else will be along to help with that. Good-luck. La

Thanks TheLa....should get the RF count in my visit tomorrow and will keep you posted. I've got little "sharp" pains that come and go in my feet, hands, and hips but nothing is constant. I read about people getting "Hit by a wall" and I'm surprised that is not how mine has presented. The "popping" is probably the most odd symptom I have as I never hear much of it as a symptom of RA.

It is good to hear you are doing good and have had success with the medication! Will keep you posted!

Actually I do pop a lot. My theory is that our synovial fluid is just generally affected...it's my theory, and I'm sticking to it! Welcome Techzit.

Actually I have heard of people presenting in all kinds of ways and that being hit by a wall is an uncommon way to present. I was one hit by a wall and yet I am negative for RF and anti CCP. I was diagnosed by high inflammation markers in my blood, the number of symmetrical joints that were unbearably painful, severely swelled, hot joints. Morning stiffness that lasted til evening, etc. etc. etc.

I'm curious to know how they diagnose RA when things like that are not present. I have heard that you can test postive and not have RA either.

Good luck and maybe, hopefully you will find out you don't have RA at all. Wouldn't that be nice?

Got the lab results back today and here are the findings:

CRP - Normal (4 out of 5)

RA Factor - 30 (High)

Sedimentation Rate - Normal (7 out of 5)

CCP - Normal

When the doc left the message the other day all she said was "your score was 30". In my firs appt said she was testing for CCP so I spent 3 days thinking my CCP was 30 but, in reality, it was my RA Factor...guess that is good news. Going to watch it a few more days and she said if things stay the same she wants to try me on Planquenil.

She also indicated that she has never seen joint damage occur without positve inflammation? Have you here found that to be the case? The way my joints have been sounding I'm finding it highly unlikely there is no damage (crunching, grinding).

Also, she said it takes 6 months from onset of symptoms for damage to show up on an x-ray which means she doesn't really want to x-ray until June.

Thanks again for educating a newbie.....just trying to understand all of this.

Interesting...Many docs order baseline x-rays so they have something to compare future x-rays with. I would say that your tests are pretty darn good, but to me it would be more of a reason to see what the heck is causing all the funky sounds in your joints.

Hope you're having a superfantastic and extra-comfortable evening!You guys rock...thanks for the feedback. I'll definitley challenge the x-ray suggestion.

Have you ever heard of joint damaging occuring without positive inflammation? (before any meds have been taken)?

Hi Teczit,

Welcome to AI! This is a great place for information. Lots of nice folks here!

The popping, creaking, cracking (aka snap, crackle, pop!) we get is likely"crepitus", which can be brought on by inflammation in the sinovium. I had it quite a bit until my meds kicked in.

I'm curious about the no inflammation = no damage question. I have new damage in my right foot, which gets far less inflammed than my left foot -- which as no damage. This has happened since I started meds, so I'll be switching to Remicade soon.

Hope you are feeling better soon.

- Joy

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Hi, techzit. I haven't had a chance to welcome you yet!

I met a girl on another forum. Her husband was in the service and was stationed overseas. She was having joint pain without swelling and her inflammatory markers were normal. Because everything appeared normal, the military docs told her she was just home sick.

When she finally got back to the states, her new RD ran x-rays and she had lots of damage. From her experience, I'd say it's definitely possible, though I'm not sure if it's likely.

Looks like I'm going to go ahead and start on plaquinel.....when all you hear is "early agressive treatment" is the best way to attack this thing, it is hard to decide to play the waiting game.

It's hard not to ponder what 10 years from now my condition will be when I'm 43 with an 18 year old, a 14 year old, and a 12 year old. I'm hoping that new medicines and treatment will keep me active for years to come and allow me to enjoy the best I can out of this life.

Thanks again for all your insight and will keep you posted.

Decided to see a new GP for a second opinion and he seemed to really think that I might be the 1 out of the 20 people who have a positive RA factor but does not really have RA. This is based on the fact I don't have any visible swelling, stiffness, etc. He has referred me to a second Rhuemy who I see next Wednesday.

I've decided to hold off taking any meds until that appt to just make sure.....being in this "gray" area is really tough...anyone know a "clear" litmus test for deciding to start meds? I've read a study was done in 2007 that highlighted 9 factors that predict the likelihood of developing RA. I'd love to plug my numbers/stats into that formual but can't seem to find it. At a glance, most of the factors work for me (young, male, no swelling, no symterical joints, etc). The biggest factor making this tough is the positive RA factor.

Thanks again for helping someone who is not even sure if they have RA.

I sure hope you DON'T have RA. That would be wonderful news!
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