What are the standard tests for Rheumatoid Arthritis?

Posted by grrranny @grrranny, Oct 27, 2025

What are the standard tests for RA?
My 84 yr-old husband's new (and younger) Rheumatologist (since old one retired) just gave him 2 new tests that supposedly show he does not have RA, after having been treated for it for over 30 years!
She says he should drop the Azathioprine, and doesn't have to come back to her office, but to continue seeing ENDO for monthly Evenity injections for Osteoporosis and Osteoarthritis.

Interested in more discussions like this? Go to the Autoimmune Diseases Support Group.

Absolutely. Dr Mayur Patel - in Burlington on Huffman Mill Rd at Kernodle Clinic. I have had him since 2017 - first in Winston and when we both happened to move east of Greensboro I was able to keep him.

He is Awesome. Has Pharm-D as well. It sounds like he might be a bit of a hike for you, but it’s not like we see a Rheumy every week.

REPLY
Profile picture for fairn @fairn

@grrranny
I have not tested positive using the older RF test, but I did test positive on the CCP test. It's a newer test that can detect RA inflammation. You can have RA, but not test positive on the RF test, they call it sero-negative RA. The CCP test was developed to help detect it. If you can find a rheumatologist that will treat the symptoms of inflammation regardless of test results, that's a helpful approach. Here's a link to the CCP test info: https://www.healthline.com/health/ccp-antibody-test

Jump to this post

@fairn another even newer test is called anti-CarP, which helps diagnose RA even before many symptoms are present. It is predictive of disease joint erosion in sero- negative patients.

REPLY

I have had RA for over 25 years. Back then the anti-ccp ,which is a more precise diagnostic test, was not yet available. My RA factor was high, my CRP and sed rate were very high. And I was symptomatic, primarily in my hands. My Rheumatologist did not diagnose me with RA, but with inflammatory disease.
The reason being that RA factor can be elevated for reasons other than RA.
Once the Anti-ccp was available and was also very high, he changed my diagnosis to RA.

"A positive rheumatoid factor test result shows that you have a high level of rheumatoid factor in your blood. A higher level of rheumatoid factor in your blood is closely linked with autoimmune diseases, especially rheumatoid arthritis. But a number of other diseases and conditions can raise rheumatoid factor levels, including:

Cancer.
Chronic infections, such as viral hepatitis B and C.
Inflammatory lung diseases, such as sarcoidosis.
Mixed connective tissue disease.
Sjogren syndrome.
Systemic lupus erythematosus.

Some healthy people — usually older people — have positive rheumatoid factor tests, though it's not clear why. And some people who have rheumatoid arthritis will have low levels of rheumatoid factor in their blood.

Cigarette smokers also may have positive rheumatoid factors. Smoking is a risk factor for developing rheumatoid arthritis."
https://www.mayoclinic.org/tests-procedures/rheumatoid-factor/about/pac-20384800

REPLY

I recently left the emergency room with bloodwork done because I was supposed to have RA but all my tests showed normal.
Next move? Anyone?

REPLY
Profile picture for tamella @tamella

I recently left the emergency room with bloodwork done because I was supposed to have RA but all my tests showed normal.
Next move? Anyone?

Jump to this post

@tamella Hmmm, curious why you went to the Emergency room for these tests? This kind of condition is diagnosed and treated by aprimary provider or a rheumatologist.

The role of Emergency departments is to treat injuries and diagnose acute illnesses. Then they stabilize the patient and send you home to contact primary care or the proper specialist.

Who suggested that you have RA, and why didn't they test you? In your place, I would call them back and ask.

Also, please know that up to 20% of people with RA cannot be confirmed by blood tests alone. In that situation a rheumatologist can perform further tests and exams.

REPLY
Profile picture for lindaadele @lindaadele

what happened to me was I was originally diagnosed with PMR and things changed over the years. I really don’t know if there’s a specific blood test that diagnoses you for rheumatology arthritis or not. My rheumatologist went by my symptoms which really changed a lot my feet were heavy my legs were weak I had numbness in my fingers I could hardly move my fingers so all the all of these problems got my rheumatologist to figure out that I may have RA. If you’re having problems with your rheumatologist It can’t hurt to get a second opinion if you feel that would be helpful for you. Best wishes to you going forward!!!

Jump to this post

@lindaadele a lot of the symptoms that you were talking about sound very similar to my symptoms and I am diagnosed right now with RA even though things changed now and then. I started out with a diagnosis of PMR and later that changed to RA, which happens quite often it just changed around a little bit. It’s kind of confusing but it happens. It’s not a bad idea. I always check with your doctor. It really can’t hurt.. wishing you the very best going forward!!!

REPLY

Currently here in the UK it's rheumatoid factor positive result, compliment c3 and C4 high and also symptoms. If sound well and treatment is working they fully expect your bloods to get better and have a possible remission. This is when they can say "if we only looked at nows results we would say you don't have RA" I hope that means your husband is doing well

REPLY

Definitely don’t give up. I suffered for 25 years with back pain going from ortho to ortho, without relief. The last one even did a CRP and ESR which was normal. If only he’d done a Rheumatoid Factor test … the next doctor was a physiatrist and he ran that and it was 80 - normal is something like 14 or less. We finally figured out the source of my back pain was autoimmune despite normal inflammatory markers. My disease has progressed to consist of multiple autoimmune diseases and my inflammatory markers are no longer normal so it is important to a find a rheumatologist you trust to follow with.

It is entirely possible to have seronegative RA based on symptoms. Look for a second opinion. Best of luck 😊
https://creakyjoints.org/education/rheumatoid-arthritis/tests-to-diagnose-rheumatoid-arthritis/

REPLY
Please sign in or register to post a reply.