Fuzzy RA/OA diagnosis: How is a definite diagnosis determined?

Posted by patsing78 @patsing78, Dec 5, 2021

I wonder if any of you have had any experience with getting different diagnoses with arthritis?What is the proof positive for RA, or is there one? I have been told I have first RA and then no, OA--by the same doctor. Stiffness is supposed to characterize RA; I am stiff as a board at times. Also, my bloodwork showed a score over 250 on one measure of RA diagnosis (normal is in two figures), but after getting quite excited the rheumatologist later changed his mind and said I had OA. I need to know as relates to any further covid injections. Is it possible that MDs cannot really clearly differentiate the two?

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John, Volunteer Mentor | @johnbishop | Dec 5, 2021

Hi @patsing78, I don't think there is any clear cut test to diagnose RA. Here's some information I found on Mayo Clinic's site -- "How can a doctor tell if you have rheumatoid arthritis? -- Rheumatoid arthritis can be difficult to diagnose in its early stages because the early signs and symptoms mimic those of many other diseases. There is no one blood test or physical finding to confirm the diagnosis. During the physical exam, your doctor will check your joints for swelling, redness and warmth." --- Rheumatoid arthritis - Diagnosis and treatment: https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/diagnosis-treatment/drc-20353653

Here's some other information that speaks to the difficulty diagnosing RA.
-- 8 Diseases That Could Mimic Rheumatoid Arthritis — and Delay Your Diagnosis: https://creakyjoints.org/about-arthritis/rheumatoid-arthritis/ra-overview/rheumatoid-arthritis-misdiagnoses/

You mentioned needing to know as it relates to further COVID vaccine injections. Here's an article from Mayo Clinic that discusses vaccines and their importance for those with RA, including the COVID vaccines.
-- Rheumatoid arthritis: Protect your health with vaccines: https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/in-depth/rheumatoid-arthritis-vaccines/art-20096217

Have you started any treatment or medications for RA?

marm7756 | @marm7756 | Dec 5, 2021

It’s very common to have RA and not have bloodwork show it. I was RA negative for a few years when first diagnosed. Also as far as your COVID tests, it shouldn’t matter whether you have RA or OA. It matters if you are on an immune compromising drug as far as having a weaker immune system.
Your dx may change a few times until your symptoms are clearer. Good luck!

k2drew | @k2drew | Feb 3, 2022

In reply to @johnbishop "Hi @patsing78, I don't think there is any clear cut test to diagnose RA. Here's some..." + (show)

John is correct there is no 100% definitive test for RA. However there are suggestive tests: RA factor Antinuclear antibodies, erythroycte sed rate, Compliment level. These lab values + the clinical presentation of the patient can give a relatively certain diagnosis.