How do we know if the pain is due to RA or Osteoarthritis
I have been diagnosed with RA for 9 years and I have been told I also have Osteoarthritis in my knees and wrists. I moved from New York to California just a few months ago so I have only seen the new RA doctor twice. When I told her I have been having increased pain in my knees lately, she immediately wanted to improve my RA medication. When I asked her if osteoarthritis could be the cause of my pain, she could not answer me directly, except by saying that my MRI of the left knee from last year did show serious cartridge damage. She increased my RA medication anyway. I am left a little lost. I don't want to overtreat my RA if that is not the cause of my pain, but how do I know? Are there any tests that could define RA or Osteoarthritis accurately? Thank you!
You ask a great question, which I can’t adequately answer. I do believe it is important to recognize OA pain can be as debilitating as RA and should not be minimalized. I think imaging can sometimes help differentiate between OA and RA. There are joints that are more typically affected by OA or RA. For example, our joints nearest the fingertips are more often OA, the knuckles closer to our hands RA. Pain that is symmetrical (same joints on R and L side) often is RA. When my Rheum examines my knees, he has pointed out swollen areas which he feels to be more typical caused by RA than OA. I hope others here can help more with differentiating between RA and OA. And I Hope you are able to have confidence in your diagnosis and get the very best treatment! Jo 
I understand your concern,
. It sounds like you're in a difficult situation, navigating both RA and osteoarthritis, and trying to understand the source of your pain. It makes for one big detective job.
For RA, blood tests such as rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies, as well as imaging tests like X-rays and MRIs, can help diagnose and monitor the condition. However, these tests do not rule out osteoarthritis.
Osteoarthritis is typically diagnosed based on symptoms, physical examination findings, and imaging studies like X-rays, which can show joint damage characteristic of the condition.
Given your history of RA and the serious cartilage damage shown in your MRI, it's understandable why your doctor focused on adjusting your RA medication. However, it's also important to address the possibility of osteoarthritis contributing to your symptoms so this shouldn't go ignored to support your concern there.
I would recommend discussing your concerns with your doctor and exploring further diagnostic options if necessary. You might also want to consider seeking a second opinion from another rheumatologist or consulting with a specialist who can provide additional insight into managing both RA and osteoarthritis.
I've included articles that I think you may find helpful as you try to figure out your next plan of action to getting you some much needed answers. You can Access them here:
Differences between Rheumatoid Arthritis and Osteoarthritis
https://rheumatoidarthritis.net/living/differences-rheumatoid-arthritis-osteoarthritis
OA Is Miserable, Too - But Different from RA
https://rheumatoidarthritis.net/living/osteoarthritis-complications
When Is It Time For Knee Replacement Surgery? Part 1
https://rheumatoidarthritis.net/living/osteoarthritis-progression
Hope this helps!
All the best, Latoya (Team Member)I suffered from knee pain for a long time but just chalked it up to either my RA, OA & OP. Pain Mgmt Dr kept suggesting Surgery (which I refuse to start going down those roads ( Yet anyway!) when I went over what the pain Dr. Was saying with my Rheumatologist he reluctantly kinda agreed but Only if I promised to just take Fish Oil (they make burp less) said if after 2 months it didn't help he'd agree that I needed surgery. Low & behold I'm not kidding only after 2 weeks Both of my knees were 100% better & No One is suggesting any surgery. Now I just take it once a week & haven't had any problems at ALL. Good luck on your journey & hope this helps you with some pain. I always opt for anything that's natural whenever it's possible, but have also learned there's nothing wrong with good pain meds tucked in my arsenal. Anything to avoid surgery or stress 😬 🙏✌️
It’s great to hear that you found relief for your knee pain with fish oil! Fish oil can have anti-inflammatory benefits, which might explain the improvement in your knee pain. It’s amazing how sometimes a simple, natural approach can make such a significant difference. Your story highlights the importance of exploring all possible options before resorting to surgery! I wish nothing but more success on your journey! Kindly, Latoya (Team Member) 
I'm glad the natural methods have worked for you and you've been able to avoid surgery. Each one of us is affected so differently on this journey! Thanks for sharing your experiences. -Effie, team member
Yes I never know what my pain is related to unless it’s obvi. Moved furniture, etc. If I’ve minded my Ps and Qs I figure it’s gotta be RA rearing its ugly head. When I’m not getting any relief from anything and it’s ongoing time to change.
