What is sero-negative rheumatoid arthritis?

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Diagnosing rheumatoid arthritis involves a series of lab tests and a physical evaluation of symptoms. Testing blood for rheumatoid factor is a common way to help diagnose the disease, however some patients may test negative while arthritic symptoms persist.

According to the Arthritis Foundation, patients without rheumatoid factor in their blood may be diagnosed with seronegative rheumatoid arthritis. Diagnosing rheumatoid arthritis through lab tests, X-rays, the erythrocyte sedimentation rate, complete blood count, anti-nuclear antibodies and C-reactive protein can be done despite a negative rheumatoid factor lab result.


Performing a battery of tests is common to reach a diagnosis of rheumatoid arthritis. Seronegative rheumatoid arthritis patients have tested negative to the rheumatoid factor test. According to the Arthritis Foundation, 70 to 80 per cent of patients testing positive to rheumatoid factor will have rheumatoid arthritis. Having rheumatoid factor in the blood, and a diagnosis of rheumatoid arthritis, is called seropositive rheumatoid arthritis. Being diagnosed with rheumatoid arthritis, with a negative rheumatoid factor, is called seronegative rheumatoid arthritis.


Swollen and tender joints, flu-like symptoms, muscle pain, stiffness in the morning and a limited range of motion are common side effects of seronegative rheumatoid arthritis. Feeling weak, fatigued and general stiffness in the body is common. After a time of rest, or in the morning after a full night of sleep, seronegative rheumatoid arthritis tends to flare, causing pain and limited use of the joints such as the wrists, back and ankles. Development of rheumatoid nodules is common in one-fifth of patients. Under the skin, small lumps of tissue may form.


Living with seronegative rheumatoid arthritis can be difficult to monitor. Testing for rheumatoid factor in the blood lets the physician know how far and severe the disease has progressed. Higher rheumatoid factor numbers indicate a more severe condition. Patients with seronegative rheumatoid arthritis are unable to monitor the progress of their condition with the rheumatoid factor test, since the factor is absent form their blood.


Watching and documenting periods of flare-ups are imperative for patients with seronegative rheumatoid arthritis. Keeping a calendar of flare-ups will provide the physician with information about the condition that can go through periods of remission. Calculating how severe and often the flare-ups occur will help the doctor determine if the disease is getting more severe, since he cannot perform a rheumatoid factor test successfully.


Medicating seronegative rheumatoid arthritis focuses on pain relief, reducing inflammation and slowing joint damage, according to the Arthritis Foundation. Common medications include non-steroidal anti-inflammatory drugs, analgesic drugs, disease modifying antirheumatic drugs and biologic response modifiers. Complications from severe cases of seronegative rheumatoid arthritis may lead to a variety of surgeries.