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)