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Arthritis and Rheumatism

Does Rheumatoid Arthritis Cause Inflamation?

01/07/2008

Question:

Does Rheumatoid Arthritis always cause inflamation? Or does the inflamation occur later in the disease? Also, is there a type of Rheumatoid Arthritis that is sero-negative, and what test would diagnose it?

Answer:

In Rheumatoid Arthritis (RA) the primary inflammatory lesion involves the synovium (the joint lining). In order to establish a diagnosis of RA, there would need to be clinically apparent joint inflammation. In this respect, inflammation would be present upon the diagnosis of RA.

Seronegative RA refers to the absence of detectable rheumatoid factor in an individual with RA. In this scenario history, physical exam, imaging studies such as x-rays or MRI’s, or supplemental labs (acute phase reactants such as a C-reactive protein, other antibodies besides rheumatoid factor) are useful in establishing a diagnosis. Keep in mind that none of the diagnostic tools are 100% specific for RA – it is the entire clinical complex that is important.

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Response by:

Raymond  Hong, MD, MBA, FACR Raymond Hong, MD, MBA, FACR
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University