We can’t provide diagnoses on-line. Usually a careful history and physical examination are needed. Also, a rheumatoid factor and anti-CCP tests would be of interest. Sometimes different kinds of arthritis need time to fully develop in order to identify their cause. An ANA titer of 1:640 is significant though and one should always consider lupus seriously in a young woman with arthritis and positive ANA.
About Joan Bathon, M.D.
Dr. Bathon was a Co-Deputy Director of the Division of Rheumatology at Hopkins Bayview. She was also the founder and director of the Hopkins Arthritis Center.