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Figuring out my diagnosis

Hello, I was diagnosed with “inflammatory arthritis” with no tests to support. My RA test was negative. I have had extreme swelling, stiffness, and decreased mobilization in one knee since March 2021. An orthopedic surgeon performed a plica surgery and synovectomy on it. No improvement. Referred me to rheumatologist where I had a positive ANA test and the other specified tests (like RA) came out negative. Predisone has done the trick so far with keeping it at bay. Hydroxycloroquine was also prescribed with no success. Doctor wants to prescribe me methotrexate but in my opinion, I do not believe I am ready for that yet. Any thoughts?

  1. Thanks for sharing and reaching out. I see that you mentioned that some of your lab work was negative. Have you seen a Rheumatologist? There is more involved with making an RA diagnosis than just the lab work. I hope that others here chime in with their personal experiences to share with you. In addition to speaking with your doctor, this article on when to change you RA medications may be helpful to you: https://rheumatoidarthritis.net/living/when-to-change-medications. Additionally, here's an article on Methotrexate as you continue to research: https://rheumatoidarthritis.net/treatment/methotrexate.

    Fo many the goal of treatment is to minimize symptoms and long-term joint damage. Of course, each person has to weight the pros and cons together with your doctor. Wishing you some answers and relief ahead. Best, Kelly, Rheumatoidarthritis.net Team Member

    1. Thank you, and yes I have been seeing a rheumatologist. They first prescribed predisone and hydroxycloroquine together. Now they want me to try methotrexate which I don’t know if I’m comfortable taking yet

      1. I am sure you and your rheumatologist will make the right decision. I know for me I am glad I started methotrexate from the very beginning a few over 20 years ago. I know that what methotrexate has done for me is save joint damage I hope whatever choice you make you will preserve your joints as well. I have never looked back and I would not give it up even today................. rick

    2. Absolutely you are likely ready for MTX. Why? Because:
      1. Hydroxychloroquine rarely does the job; it's a starter drug.
      2. Damage from RA is not reversible [has no one mentioned sero-negative RA?].
      3. Prednisone should never be used long term. It's just to get you over the hump while the real drugs kick in.


      Remember - the dose of MTX for RA is far lower than that used to fight cancer. I've been using it to 30 years.

      1. Hi . As others have mentioned, seronegative RA is very real and not uncommon. In fact, as noted in this article on the topic, about one third of cases are seronegative: https://rheumatoidarthritis.net/living/seronegative-ra-blood-tests-dont-tell-entire-story. It is good to hear that you are seeing a rheumatologist and actively being treated. On top of the excellent information from others, I want to share with you this article from our contributor, Kelly Mack (full disclosure - I'm her husband), on questions for the doctor: https://rheumatoidarthritis.net/living/questions-for-the-doctor. This may be helpful in working towards developing a plan for treatment. In addition, I can tell you that, while she is currently on a biologic medication, Kelly did take methotrexate for quite a few years. It worked pretty well, with only minor side effects. That said, every person's experience and condition is different. Please know that whatever you decide and treatment you pursue, this community is here for you. Best, Richard (RheumatoidArthritis.net Team)

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