Rheumatoid arthritis (RA) is an inflammatory condition of the joint, in which there is swelling, stiffness and joint pain. Rheumatoid arthritis or RA is a result of an autoimmune reaction in the body, in which the body's immune system attacks the joints. It can be diagnosed using certain criteria, which includes laboratory tests, imaging studies and clinical examination.
Sometimes, the blood test results may be negative but clinical picture may be suggestive of rheumatoid arthritis. Such cases can be termed as seronegative rheumatoid arthritis.
Rheumatoid Factor (RF)
As rheumatoid arthritis is considered an autoimmune disorder, certain tests that detect the presence of antibodies are used in the diagnostic criteria. Rheumatoid Factor (RF) is one factor that tests such antibodies and if found positive, add to the possible diagnosis of rheumatoid arthritis. It is believed that elevated rheumatoid factor occurs in autoimmune disorders like RA.
However, there are healthy people with positive RF but absence of clinical complaints or any joint pains and hence they do not have rheumatoid arthritis. Also, there are cases, who show all clinical signs of rheumatoid arthritis and even respond well to the treatment but test negative for RF (seronegative). Seronegative rheumatoid arthritis is a condition, which tests negative for RF but has arthritis.
Seronegative Rheumatoid Arthritis
Seronegative rheumatoid arthritis is similar to rheumatoid arthritis but tests negative for RF. It is a type of arthritis or inflammatory joint condition, which is a result of body's auto immune reaction. Whether it is considered as a type of Rheumatoid arthritis (RA) or not, the fact remains that the person suffers from joint pain and related symptoms.
Some also classify seronegative rheumatoid arthritis under a group of disorders that are similar to Rheumatoid arthritis (RA) but test negative for RF. These could be the conditions affecting the joints and muscles like spondyloarthropathies and may show some typical features, which should be differentiated.
The diagnosis of Rheumatoid arthritis or RA is hence based on clinical condition of which positive RF is just a part but not necessarily a mandate. People with sero negative rheumatoid arthritis may be tested again for RF over a period of 4 to 6 months during the initial years, as there are chances of RF showing positive later, in some cases.
Symptoms of Seronegative Rheumatoid Arthritis
Usually, complaints of rheumatoid arthritis are symmetrical and affect same joints on both the sides. It involves small joint in the fingers, toes, wrists, hands and legs but can also affect large joints like the knee. The pain and stiffness is usually worse in the morning or at the initial movement of the affected joint. It gets better with continued motion. Pain, swelling, stiffness and tenderness is a common feature noted in the affected joints.
More than one joint is involved in seronegative rheumatoid arthritis and may have increase in symptoms on some occasions, commonly called flare-ups. Some people also complaint that changes in weather, cold climate cause more joint pain and stiffness.
Rheumatoid arthritis may show bone erosion and other changes on imaging studies in advanced cases.
Diagnosis of Seronegative Rheumatoid Arthritis
There are many types of arthritis and most of them have overlapping symptoms. It is now considered that presenting arthritic features could also be a part of a group of autoimmune conditions. As a result, there is a possibility that one may have Rheumatoid arthritis or RA like symptoms but the diagnosis may be a part of a group of autoimmune conditions. There are specific investigations to detect the presence of autoimmune disorders. The presence of any of these disorders can be related to inflammatory joint pain and arthritis.
Hence proper evaluation, clinical examination, laboratory tests and imaging studies should be done to rule out other causes. Presence of fever, history of recent injury or surgery should be evaluated. In case of excessive swelling of the joint, aspiration of fluid or joint aspiration may have to be performed. This can be done in an out-patient setting and the aspirated fluid can be sent for laboratory analysis to find the exact cause of joint effusion. It also helps to reduce pain and swelling.
Treatment for Seronegative Rheumatoid Arthritis
Treatment for Seronegative Rheumatoid Arthritis is based on the presenting symptoms and usually include anti-inflammatory medicines to reduce pain and swelling. Specific medicines to slower the progression of disease may be given. Calcium, vitamin D nutritional supplements and may be considered.
Rest may be advised as required but physical therapy and regular exercise can help in managing the Sero Negative Rheumatoid Arthritis. It helps to maintain flexibility, reduce stiffness and build muscle strength, so being active within limits is the key. Exercises like stretches, isometric muscle tensing and relaxing, low impact workouts, strength training and swimming are the best for helping you cope with Sero Negative Rheumatoid Arthritis.
Important to note is to avoid high impact exercises like jogging or sports. Know what suits you the best and plan an individual RA friendly exercise plan with the help of an expert. Avoid overdoing exercises and daily activities. Take adequate rest and maintain a balance of activity and relaxation. Warm compresses can be used as appropriate for Sero Negative Rheumatoid Arthritis.
A healthy diet that includes more fruits and vegetable with natural anti-oxidants is helpful in Seronegative Rheumatoid Arthritis. Including garlic, ginger, green tea to help reduce inflammation and olive oil, flaxseeds, fatty fish for a boost of omega-3-fattya acids is also considered useful. Drinking plenty of water and leading a healthy, active life can help to manage seronegative rheumatoid arthritis.