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Negative blood & x-ray – still have RA?

  • By jbjb93

    Hi All-

    Had my first meeting with the rheumatologist yesterday. All signs and symptoms point to RA. He did a full blood work up and x-rays of both knees, feet, and hands. Got the results the same day (wow!) and everything was negative. My D level is very low, and RBC off. But otherwise no signs of RA. Going to give me a script for 50,000 Vit D 1xweek and 1,000 UI daily.

    At the appointment he gave me scripts for metho and folic acid. Have been on prednisone 5 mg, and he wants me to stay on until the metho has a chance to work.

    Question – could I still have RA with negative x-rays? I know the blood can be negative and you still have it.

    I have swelling, bilateral pain, dry eyes and mouth, and other symptoms of RA. Symptoms really aren’t osteo.

    Has anyone else been diagnosed with negative labs?

    thanks for any input. I will call the office today when they open.

  • By Tamara Haag Moderator

    Hi, thanks so much for reaching out with your question, and I’m glad you found our site!

    Yes, it is possible to have RA in spite of the bloodwork and x-rays not showing it. It’s great that you are so well informed. Many people are not aware that the standard blood tests do not indicate RA for all people with RA. In case you’re interested in reading any more about that, I wrote about my experience with being seronegative and with finally taking the Vectra test, which indicated moderate RA disease activity: In addition, here’s one about “seronegative RA”:

    Here is an article about x-rays and RA: It’s great news that the x-rays don’t show indications of RA, as this means that you and your doctor(s) have caught this early. RA is a degenerative condition, so it can cause joint erosion over time. Treatment can slow and in some cases even stop stop damage. Beginning treatment before signs of joint erosion bodes well for your bones!

    In addition, I’m including an article about methotrexate: It is the common first treatment for RA. Some people do very well on it, but others have trouble with side effects. Should you experience any side effects, make sure to discuss these with your doctor, as there are other treatment options available (but insurance usually won’t cover them unless you’ve already tried methotrexate). Hopefully you will not have side effects and will find the drug effective!

    Please let us know any time you have questions, concerns, or experiences you want to share. Being diagnosed with RA can be scary, but you’re not alone!

    Wishing you all the best,
    Tamara (Site Moderator)

  • By jbjb93


    Thank you so much for responding and sharing the articles! Very helpful! So good to know this is not unusual.

    I checked with the office and will go on the methotrexate. I will start Friday so I have the weekend.

    I will ask about the Vectra test on my next visit.


  • By Mariah Z. Leach Moderator

    Hi Jbjb93 ~

    Best of luck with the methotrexate! Glad to see you also discussed folic acid with your doctor, as I find that helps significantly with the methotrexate side effects.

    Hang in there and please keep us posted!

    ~Mariah~ (Site Moderator)