• gma2 gma2
    September 02, 2009
    What is the difference between RA and inflammatory arthritis
    gma2 gma2
    September 02, 2009

    My rheumatoid factor is always negative so my rheumatologist says I don't have RA but rather inflammatory arthritis. What's the difference please?  I am on prednisone and injectable Methotrexate.

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FROM OUR EXPERTS

  • Lene  Andersen
    Health Guide
    September 03, 2009
    Lene  Andersen
    Health Guide
    September 02, 2009

    Approximately 20% of people who have RA are what is called seronegative - in other words, their RA factor tests negative. You can read more about lab results here.

     

    As far as I can tell from a brief visit to Google, inflammatory arthritis involves the autoimmune system and therefore appears to be another word for rheumatoid arthritis (you can see more about that here).  Both prednisone and methotrexate are common treatments off RA, so I'm not really sure where your doctor is coming from.

     

    I would recommend that you ask for some more details about his diagnosis including an overview of the differences between RA and inflammatory arthritis as he sees it. You may also consider getting a second opinion.

    • gma2
      September 07, 2009
      gma2
      September 07, 2009

      Thanks so much for your response; i've been under the weather and apologize for taking so long to respond.  You make so much sense out of what has caused me so much confusion as I have other medical issues.  I almost need a 1,2,3 approach to figure things out especially when given different answers by different doctors.  I will check out your links and again thanks for helping to guide me in this puzzle of my body. Smile

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    • Lene  Andersen
      September 08, 2009
      Lene  Andersen
      Health Guide
      September 08, 2009

      You know that story about how when you get directions, you need to ask three people and choose the way two of them tell you? You may be in the same situation that you need to see a number of doctors until enough of them agree. Not easy, but I'm sure you'll get there sometime and I hope you'll find some answers soon.

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    • gma2
      September 10, 2009
      gma2
      September 10, 2009

      Yes, I do know what you mean it's just so frustrating becasue I've been dealing with this for so long and I'm sure I'm not the only one.  On a light note, do doctors ever agree...one rheumatologist I was seeing had to leave his practice for personal reasons and he said the one I was changing to was a good one.  Well the new rheumatologist said he didn't understand why the old one said I had undifferentiated connective tissue disease.  (shrug)  Thanks for your answer Surprised

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    • penny
      December 09, 2010
      penny
      December 09, 2010

      I'm confused.  My rheumatologist uses the terms RA and inflamatory arthritis interchangebly.  Are they one and the same?  If not, what is the difference?

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    • Lene  Andersen
      December 09, 2010
      Lene  Andersen
      Health Guide
      December 09, 2010

      Penny - as far as I can tell, they're pretty much the same. Well, RA is one of the types of inflammatory arthritis - there are oters, but in your case, he's probably using them to mean the same thing.

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FROM OUR COMMUNITY

  • Lisa V September 10, 2009
    Lisa V
    September 02, 2009

    I, like several others, was initially diagnosed with inflammatory arthritis because my RA Factor was negative.  My diagnosis was actually referred to as Inflammatory PolyArthrosis (IPA) ... because the inflammation / pain was bi-lateral.  My doctor explained that this was basically the diagnosis for sero-negative RA and began treatment with Methotrexate and intermittant steroids for flares. When I didn't reach full pain-free status with 1.0CC (10 pills for those doing it orally) Methotrexate, we discussed adding a biologic. My choice was Humira. In the transition to the additional medication, my diagnosis was changed to RA (sero-negative) for insurance purposes, as she stated that insurance would only pay for the medication if it was used for FDA approved uses - RA being one of them. I never thought I had anything less than sero-negative RA, but it was 12/30/09 when I actually got the diagnosis.  Now when I go in, we talk about the status of my RA rather than the status of my IPA symptoms.  Strange demarcation, but that's how it worked for me.

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    • gma2
      September 10, 2009
      gma2
      September 10, 2009

      Hi Lisa, I've not heard of IPA but my pain is all over which I guess could be called bi-lateral (shrug).  No dr. has ever told me about the sero negative thing (I meant to say this earlier).  When I was taking Methotrexate pills, I came down with methotrexate poisoning at 8 pills hence the change to the shots.  That insurance purposes thing drives me nuts.  I wish you well Smile

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  • BerserkeRA December 10, 2009
    BerserkeRA
    September 02, 2009

    A good friend of mine who is a physician explained it to me like this:

     

    "Saying you have inflamatory arthritis is like saying you have a tree growing in your backyard.  We know it's a tree, but we don't yet know whether its a peach tree or an apple tree."

     

    I took this to mean (and subsequent research did not change my mind) that Inflamatory Arthritis is a broad classification -- a class of diseases, if you will, where RA is a specific type of disease.

     

    My diagnosis started the same way (IA), and I've recently been diagnosed with RA, even with a negative RF and other lab work.  My Rheumy explained that patient history, and examinations are more important in determining RA than the labs, but with negative labs it takes more time for the Rheumy to reach a diagnosis.

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  • MTC
    MTC
    September 29, 2009
    MTC
    MTC
    September 02, 2009

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    Hi. I think I have the same arthritis. It is called Seronegative (RA-) Inflammatory Arthritis. I started also with Prednisone and Embrel.  Methotrexate I believe is too strong in some cases.  I don’t know your age but I’m 30 (I was diagnose at 19) and since I want to have kids that’s not an option for me.   http://rheumatology.oxfordjournals.org/cgi/content/abstract/26/3/172

    At this site you have the answer for you question…. “A case control study of 50 rheumatoid and 50 rheumatoid factor negative (RA–) patients with rheumatoidarthritis has been carried out. As expected, the RA+ group has significantly more nodules and terms of clinical joint involvement, the RA– had large-joint involvement. Radiologically, seropositive disease was characterized by more severe involvement of the metacarpophalangeal joints of the thumb and index fingers and in all the metatarsophalangeal joints of the feet.” factor positive (RA+) vasculitis. In

     

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    • gma2
      September 30, 2009
      gma2
      September 30, 2009

      I just turned 60 and it seems that the sero negative thing is about right, at least to me.  I understand about the MTX and a strange, at least to me, thing occurred recently with regards to it I think.  I was very sick at the beginning of this month, low-grade fever, extreme fatigue, burning up with like heat coming out of my head, a sore throat; i isolated myself for about 5 days and it took awhile to get my strength back...I still sleep a lot.  I was being treated by a new internist who said she didn't think I had the "flu" but sometimes I wonder.  I went back to my long time primary doctor and he didn't think I had it either.  I got the seasonal flu shot. 

       

      A new symptom came up shortly after that illness; white spots in my mouth.  It wasn't thrush from my Advair but I learned something from my dentist.  She said it was a fungus and because of the MTX (and the prednisone) my body is very susceptible to oportunistic infections.  My rheumatologist has never said this to me.  I'm not the best at caring for my teeth but now I have no choice.  She prescribed Nystatin mouth wash for the fungus and it seems to be working already (2 days) but of course I will continue with the full dose.  And as for the nail fungus, the same thing, an oportunisitc body sucks, it's like I've got this sign on me...hey bugs here I am Yell.  I hate going out in public because no one here is taking precautions against the dreaded swine flu and that's the last thing i need.  It seems like after I was ill my immune system totally shut down...I will push my rheumatologist for a difinitive answer to that one.  However, the MTX has helped with the arthritis pain, I've even been able to cut back on my Neurontin for knife-like pains from fractures in my back and spinal stenosis, or...it's the 2 epidurals I've had.  Like my primary doctor has said more than once I have numerous problems.  Thanks all for your input, it means a lot to me that all of you care enough to post.

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  • MTC
    MTC
    September 29, 2009
    MTC
    MTC
    September 02, 2009

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    Hi. I think I have the same arthritis. It is called Seronegative (RA-) Inflammatory Arthritis. I started also with Prednisone and Embrel.  Methotrexate I believe is too strong in some cases.  I don’t know your age but I’m 30 (I was diagnose at 19) and since I want to have kids that’s not an option for me.   http://rheumatology.oxfordjournals.org/cgi/content/abstract/26/3/172

    At this site you have the answer for you question…. “A case control study of 50 rheumatoid factor positive (RA+) and 50 rheumatoid factor negative (RA–) patients with rheumatoid arthritis has been carried out. As expected, the RA+ group has significantly more nodules and vasculitis. In terms of clinical joint involvement, the RA– had large-joint involvement. Radiologically, seropositive disease was characterized by more severe involvement of the metacarpophalangeal joints of the thumb and index fingers and in all the metatarsophalangeal joints of the feet.”

    Hope this help.

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  • 01titansfan September 11, 2009
    01titansfan
    September 02, 2009

      There are over 100 types of arthritis and I'd bet even rheumatologist can't  name them off hand. I do know that inflammatory arthritis is not just another name for sero-neg rheumatoid as some people have told you. There is also such a thing as inflammatory osteo-arthritis but it is not real common, but not considered "rare" either. Inflammatory arthritis is usually treated the same as Rheumatoid ie... mtx, arava, prednisone, enbrel, etc... Ask you M.D. if you are that concerned but I bet he'll just tell you it's just another type of arthritis since they still do not fully know the whys and hows of auto-immune diseases.  I know it's not a complete answer but I hope it helps. I just didn't want you to believe all inflammatory arthritis is a form of RA, because it is not!

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    • gma2
      September 30, 2009
      gma2
      September 30, 2009

      Hi Titan, I understand exactly what you're saying, arthritis is a tricky and nasty thing.  Any kind of input is greatly appreciated and I especially appreciate your reminding me that all inflammatory arthtis is not a form of RA.  My fingers may ache but there is no deformity. Smile

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  • SistaVal May 20, 2011
    SistaVal
    September 02, 2009

    This topic is personally super frustrating to me...I, too, have had a consistently negative RF and citrulline-antibody tests, but ALWAYS have elevated ESR and C-Reactive Protein. My current diagnosis is Inflammatory Polyarthritis. Additionally, I have Fibromyalgia, which has been going on for about 12 years, but was only "officially" diagnosed in 2008. I often joke that I might as well be working with a dentist on my Rheum issues, because trying to get a diagnosis is like pulling teeth!

     

    A little background: My IPA symptoms seemed to appear very suddenly for the first time in September 2009 at the age of 29.  I guess that would be considered my first flare, since the disease was definitely active. I was tested for Parvovirus and a number of other viral/short-term things, all with negative results.  Time would tell that this wasn't something that was just going to "clear up."

     

    I started having regular flares and all the classic symptoms of RA. But no real definitive answers in any lab tests, other than the ESR and C-Reactive protein. Everything else has been negative, including tests for Lyme disease, lupus, anklosing spondylitis, food allergies, etc. My most recent X-rays also did not show any joint damage (yet), which is good, though part of me almost WANTS there to be some so that I could get a solid diagnosis and not feel like I was going crazy.

     

    In the meantime, my Rheumatologist has listed my diagnosis as Inflammatory Polyarthritis.  This was frustrating to me at first, but has been the closest thing to an RA diagnosis yet.  The frustration subsided some when my Rheumatologist told me that only about 1/3 of his patients have a specific, clear-cut diagnosis. Another 1/3 have "pretty sure" diagnoses. And the last 1/3 don't have a clear diagnosis at all. He stated that the medical community is outdated in that there are not enough current diagnoses to describe all the issues that Rheumatologists are seeing.  He also said the same could be said for lab tests...There just aren't as many definitive lab tests as there needs to be, but we remain hopeful that researchers are working on that.

     

    So, for now, I am treated as though I have RA, it just isn't called that. I have unsuccessfully tried Plaquenil and am now on Sulfasalazine.  I am trying to avoid the more "toxic" meds at all costs at this point, but I realize that it may be a very real possiblity in the future.  I am just trying to live day to day and am still getting used to the way this IPA has impacted my life.  It's good to know that I'm not alone!

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