Seronegative Rheumatoid Arthritis

Seronegative rheumatoid arthritis can be confusing and finding treatments for it more so. Learn what rheumatoid arthritis factor is, what it means, and what you can after being diagnosed.

In order to be diagnosed with RA, your doctor probably ran a ton of blood work, and one of the things they looked for is called the rheumatoid factor. These are antibodies that you produced that are attacking your joints, and their presence confirms that you have an autoimmune disease. Combined with elevated inflammatory markers and your physical symptoms, you were given a rheumatoid arthritis diagnosis.

Some people don't have rheumatoid factor though. They have pain in the joints on both sides of the body and elevated inflammatory markers, but the rheumatoid factor is negative. This is called seronegative rheumatoid arthritis.

(Sero = blood serum, negative = not present so this term just means that the blood markers they would expect to see are not there. Learning how to translate "medical" terms can really take a lot of the mystery out of discussions with your doctor).

Pathophysiology of rheumatoid arthritis

I'll try to make this less scientific and will link to a scientific version for those of you interested in learning more.

The lining of your joints, the synovial lining, is normally just a few cells thick. In R.A., the joint lining thickens and is full of cells that make more lining and a type of white blood cell.

Underneath the lining where the blood vessels reside, there are numerous inflammatory cells, including T-cells and B-cells. New blood vessels also form, which creates almost a tumor-like growth, with the thickened synovium growing and intruding on the joint space.

For a more detailed explanation, visit the Johns Hopkins Arthritis Center.

Diagnosing Seronegative Rheumatoid Arthritis

To be diagnosed, you must have any four of the following criteria. Your doctor will look for:
  • Morning stiffness that lasts longer than 1 hour
  • Arthritis of 3 or more joints, lasting longer than 6 weeks
  • Arthritis of the hand joints, lasting longer than 6 weeks
  • Arthritis on both sides of the body in the same joints, lasting longer than 6 weeks
  • Rheumatoid nodules
  • Serum rheumatoid factor
  • Changes in the joint visible on X-ray

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