I am inquiring to those with RA to help answer a question. My history - Nov. 2006 I came down with the flu (cough, head congestion, sore throat, fever, body aches and conjunctivitis). The first week I had a fever for 6 days when it eventually broke. 2+ weeks later while I was slowly getting better I starting having a low grade fever in the evenings 5 out of 6 days that went from generalized body aches to localizing/concentrated into my hands/wrists/elbows symmetrically.
2 1/2 weeks into these symptoms involving my hands/wrists - I had blood tests that showed mild anemia, 76 sed. rate and 525 platelets. In the past 3+ months the joint soreness and aching have been constant in my hands and wrists (varying degrees) and in Jan. I had aching in my knees for a few days and heel soreness for two weeks in both feet and one evening of severe fatigue when I had aching joints in all of the areas I have mentioned above all at once.
I went to a Rheumatologist yesterday and he doesn't think I have RA based on my physical examination and no history of swelling in my joints. He thinks this is still caused from the virus that I had in Nov. He took more blood to check my sed. rate and CRP (results coming in a few days) and thinks they will be normal. I highly doubt it, but we will see. My father has had RA for 25 years and his feet and hands are severely deformed and came down with his RA after having the flu. Although, the Rheumatologist believes it would be very unlikely I would come down with it in the same manner.
My question: Has anyone here been diagnosed as having RA WITHOUT SWELLING??? Any answers would be appreciated, because I have a hard time believing this is a virus still kicking around in my body causing constant joint soreness/aching. Thanks
I swell, but not that frequently and only rarely is it visibly. The RD feels it sometimes when I can't see it. But, I do not swell in any kind of remarkable way. The first RD I had said that it wasn't RA because I didn't have huge swelling. He thought it was pregnancy induced and would go away. Two years and another RD later, I got the diagnosis. Don't be afraid to ask for a second opinion.
I had some swelling in the first six months, and very little in the last 3 years, yet x-rays have shown some bone erorsion, so my RD has never suggested it's not RA. Symmetric pain was the biggest symptom for me...I couldn't lift my arms above my shoulders for several months. I never had a high sed rate or RF level. They are indicators but not conclusive. Early treatment is important so be persistent.
Alan
I have RA but don't have any swelling. Just pain. I was diagnosed about 6 months ago. I wonder if the swelling will come later????I had no swelling at first either and therefore the Dx was missed. One and a half yrs later I did swell bad, got Dx'd and started on the meds. By that time I had bone erosion. I highly suggest another opinion and maybe a firm Dx won't come right now but you can start on the meds.
My symptoms began after a bad 3 week infection also, Bronchitis, Strep. One thing the Dr may be thinking is Reactive Arthritis that comes after a bad infection and can last up to 2 years. The Dr thought that in my case but I should have been on meds. My rheumy just permanently Dx'd me this past Monday after over 2 yrs since onset of symptoms. He is a different one, matter of fact the third one that I have seen.
Now the MTX helps the swelling some and I have added Enbrel as well. Do your joints turn red or warm to the touch? Your father having had RA is quite telling.
I also had all normal lab work which makes my Dx sero-negative RA. If you ever do swell or have red joints even a little take a picture. I had to do that because we all know that the best way to get our swelling down is to have a Dr appointment that day, lol.
Take care and good luck.
I have symetric major joint pain and lower back pain with a high sed rate. I have been diagnosed with Ankylosing Spondylitis. On Enbrel since December 2006. I have improvement, but still battle daily shoulder pain, with hip and knee pain. Could barely walk before Enbrel. No real swelling in any of the joints, just stiffness and pain
Welcome Jab1, oh my gosh how awful for you. As you see your father suffering, and this is for sure inherited!!, I can understand your concern. I had swelling in my feet first. I thought it was just the heat from being in a hot climate. It took me several years (maybe 5) to get to an RA (the other doctors kept telling me I had RA), I hope you can get some immediate relief. I am taking prednisone 3X5 and it is a life saver, also MTX & Remicade after a severe flare-up. good luck, keep bringing your father's case up I think that is significant!! How long does the RA want you to wait to see if the virus goes away????Hurtingless I forgot to also ask, do you have any joint stiffness?Thanks for the replies everyone - it is greatly appreciated. Bonny: No, I haven't noticed any redness or warmth either. In regards to stiffness - that was the other thing he mentioned was the fact that I don't experience joint stiffness in the morning. Hurts: My Rheumatologist just said if the blood tests still show my numbers are increased that he would have to "think about it" because he didn't want to put the "cart before the horse" by speculating what it might be......He also didn't think it was rheumatic fever or reactive arthritis.
Hi jab1, I have had very little swelling. Also my joints seldom turn red, and then it is only 1 large knuckle on my index finger.
My sweet rheumatologist, who is very well respected in this area, said "You are a puzzlement, my dear". She took all the blood tests and my rf was 658, crp was 42 and sed rate was 70. Then they did a CCP, as my lack of visible symptoms was unusual. CCP was >250.
She says there is no doubt that I have RA. The pain is very bad, but I also have severe, widespread osteoarthritis, degenerative disc disease, and DJD, fibro, my spine is garbage, had a lumbar fusion last year. I also have kyphosis of the c-spine and the discs are almost gone in my c-spine. So it's kind of hard to sort everything out and determine what is RA and what is something else. But my doctors are still trying to determine what caused all this. At this point they just treat my symptoms as best they can.
But Yes, I have been diagnosed with RA without swelling.
If you're not comfortable with your RD, absolutely get a second opinion.
Best of luck and welcome to the forum. There are a lot of great folks here who can help you, and are always here for support.
Gentle hugs,
Nini
Hi Jab1,
I had pneumonia in January 2004. In late summer of that year, I started experiencing migratory joint pain. The migratory pattern lasted about a year. Now the pain is mostly in my hands, wrists, and shoulders. I have only had visible swelling on two occasions in the last 3+ years; the first one about a year after this all started. My RD made the diagnosis mainly based on the blood tests below. Apparently the Anti-CCP is highly specific for RA especially when combined with a positive RF. Do you know if your doctor ran an Anti-CCP test?
RF 330
Anti-CCP 378
ANA 1:1280
Sed Rate 34
CRP 13
Hi This is quite scary reading your question - this nearly mirrors my symptoms which came on very aggresively and over a few days.
Have you had any weight loss over the last few weeks?
Do you have a salmon coloured rash which appears across the top of your chest or follows your muscles down your arms and legs? This mostly comes out when you have a fever. My visible inflammation was zero but when the blood test results came back average persons level is 5, when you get a bout of flu it increases to 10 but mine registered at 373 and at my worst was recorded at 500 and off the scale, the most my hospital had ever seen.
I've just been diagnosed with Adult Onset Stills Disease which is very rare and only affects 1 in 12 million adults.
Start a diary and monitor your symptoms closely, particularly recording temperature spikes. The effective way of ruling this nasty disease out is by having a blood test which looks at the Feritine Iron levels in your body - it may be an idea to have another chat with your Rhuemy.
Best wishes and I am praying that this does turn out to be a virus for you.
Hi Jab1
When I was first diagnosed I had no swelling,stiffness or redness this has only come later.My Bloods were all showing positive with high levels but all I had was fatigue and the feeling of my shin bones were going to pop out the skin, I also lost a lot of weight as I didnt feel like eating.I did have a knuckle on my little finger that hurt when i tried to bend it. This disease is a mystery as it comes on in so many forms.Hopefully for you it is just a virus.
English Rose: I did lose a little in December - I have since put back on what I lost which was only a few pounds. Kweenb: Anti-CCP as far as I know is not going to be checked by him with the two vials of blood I gave on Friday. I think he is just checking my inflammation level again to compare with the tests in December. He should have the results tomorrow or Wednesday.....I wanted to tell him Friday that it will show inflammation, but obviously he wants to compare what is happening now since he has the baseline numbers to compare them to from December. I'm humoring him at this point by not pushing further just yet. If the numbers come back abnormal again then I will have to start cracking the proverbial whip.RA Can be the devil to DX. No doc wants to brand a patient for life this this dx, especially if it turns out to be false. The same but maybe more so goes to putting somebody on the dmards.
Pred will turn down the inflammation and perhaps you could be lucky and just have this inflammatory codition go away. A burst of pred isn't such a heavy duty medicine or perhaps a lighter weight dmard such as plaquinel. Baseline x-rays should be taken of hands or feet - whatever is hurting the most.
I hope with all my heart this is just a long after math to a virus!