Question about lab tests for rheumatoid arthritis....

[Autoimmunity]

I had the positive RA.  And as you may (or not) have read I had the problem with pain/stiffness going from one shoulder to the other over a period of several months until this past week when I could not move my arm and was in severe pain.
My general doctor put me on medrol and decided against sending me to a rheumatologist.   
What other lab tests should I have to test for RA?  Like sed rate, c react. protein, etc. 
And even more important, I have been on motrin for a few weeks for pain after a dental crown - finally went away - and then took it for the shoulder pain, and then put on meloxicam and a course of medrol.  Would any of these anti-inflammatories/steroids have any effect on such lab tests?  Such as they reduce inflammation in the body, therefore could skew the labs to be negative or not as high positive as they otherwise would be?

I want to call my gp and have the other tests run, that is the least that she can do, and then decide what I should do about seeing a rheumatologist or not.

Thanks guys...you are now my go to sjogrens/rheumatology forum 

[harrigan]

Hi Auto - last year when I first saw a rheumy, he diagnosed Sjogrens, gave me plaquenil and said I definitely do not have RA.  I continued to be in pain from fingers to shoulders and toes up wards and eventually my GP arranged a second rheumy to see me.  11 months on, she took a look at me and said I have RA, checked my notes and saw he had missed my high rheumatoid factor and started me on methotrexate too.

I assume you are in UK?  NICE guidelines from last year state that patients with suspected RA should see a rheumy asap and be started on aggressive treatment.  I have found the NRAS website really helpful and there is a patient line where you can call and talk through your worries.  They will advise you what to say to your GP and you will be able to go to the appointment knowing what he should be doing.

Good luck and let us know how you get on XX Ailsa

[syng4hym]

My Rheumy doesn't just look at labs, he looks at symptoms too.  C-reactive protein and sed rate can indicate you have Sjogren's too...  but I would think a + RA factor means you have RA.  I would most certainly tell the GP that you are want to be seen by a Rheumy.  You don't have to give any explaination about why, you just state that and they should refer you.  Also, research or ask around about who likes their Rheumy in your area and go with a referal from a friend instead of who the GP wants you to go to.  The GP may think he's a great doctor, but he's got a terrible bedside manner.  As we all know, when you're hurting, a bad bedside manner can make you feel much worse. 

Good luck.  I hope and pray you get some answers soon. 

[Linda196]

Like most of the autoimmunities, RA isn't as cut and dried to diagnosis as, say a broken bone.

Rheumatoid factor is used to help diagnose RA. It is eventually present in significant concentrations in about 80% of patients with RA but also present in other conditions and in a small percentage of healthy people.
It's considered a "marker" for Sjogren's, too.

Cyclic Citrullinated Peptide Antibody (CCP) - a relatively new test that may be used to help diagnose RA, especially early in the disease and in patients who are RF negative or to narrow the diagnosis from the diseases that RF is common to.

The American Rheumatism Association has established a criteria, including: morning stiffness, arthritis in at least 3 joint areas, arthritis in hand joints, symmetric arthritis, rheumatoid nodules, rheumatoid factor, and radiographic changes are used to help diagnose RA. (A diagnosis of RA is considered in a person who has had at least four of these criteria for several weeks). Unfortunately, at least four of these are also common to SjS, so the addition of X-ray changes and Rheumatoid nodules to pre-existing SjS symptoms may be deciding factors.