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How To Rule Out Rheumatoid Arthritis?

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Posted on Sat, 5 Dec 2015
Question: Have had pain in left hip and lower back for about 5 years with severe loss of range of motion. About 6 months ago, had x-ray and diagnosis of osteoarthritis with instructions to seek orthopedic consult. Orthopedist x-rayed both hips, and I was surprised to learn that my right hip also had osteoarthritis that looked almost identical to that in the left. I have no pain in the right hip. 2 months later, I began having shoulder pain on the right side, also with severe loss of range of motion. MRI later confirmed doctor's diagnosis of adhesive capsulitis. Am now in physical therapy for that. A couple of weeks ago, I found painless nodules on all fingers next to the pip joints, but joints are not painful or swollen. My doctor is also concerned about the fact I have lost a lot of weight over the past couple of years and have a BMI of 17. I am an active 58 year-old woman and am otherwise in good health. Have doctor's appointment in a few weeks, but I'm having a lot of anxiety about the possibility of rheumatoid arthritis. I know the symptoms aren't typical, but I've also learned that RA can be hard to diagnose. Any insights appreciated.
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Answered by Dr. Luchuo Engelbert Bain (58 minutes later)
Brief Answer:
Rheumatoid factor, Erythrocyte sedimentation rate. Check uric acid levels

Detailed Answer:
Hi and thanks for the query,

I think you are absolutely right rheumatoid arthritis might not always present with known classical symptoms. Nodules are for sure suggestive of rheumatoid arthritis.

However, other tests might be necessary to support the diagnosis. Testing for the Rheumatoid Factor, though not present in all patients with rheumatoid arthritis could be of utmost importance to confirm the diagnosis.

Doing a blood test to ascertain uric acid levels could also be important. Though not classical, excess uric acid levels could manifest itself in the form of nodules.

Your medical history is not however classical as that for rheumatoid arthritis. Though important to check out for it, it might be worrying so much at this stage in my opinion. Though a possibility for this to be rheumatoid arthritis, but it is not very typical of it.

Thanks and kind regards as I wish you the best of health.

Dr Bain
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Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Luchuo Engelbert Bain

General & Family Physician

Practicing since :2009

Answered : 3092 Questions

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How To Rule Out Rheumatoid Arthritis?

Brief Answer: Rheumatoid factor, Erythrocyte sedimentation rate. Check uric acid levels Detailed Answer: Hi and thanks for the query, I think you are absolutely right rheumatoid arthritis might not always present with known classical symptoms. Nodules are for sure suggestive of rheumatoid arthritis. However, other tests might be necessary to support the diagnosis. Testing for the Rheumatoid Factor, though not present in all patients with rheumatoid arthritis could be of utmost importance to confirm the diagnosis. Doing a blood test to ascertain uric acid levels could also be important. Though not classical, excess uric acid levels could manifest itself in the form of nodules. Your medical history is not however classical as that for rheumatoid arthritis. Though important to check out for it, it might be worrying so much at this stage in my opinion. Though a possibility for this to be rheumatoid arthritis, but it is not very typical of it. Thanks and kind regards as I wish you the best of health. Dr Bain