Joint pain but no swelling

Question

Hello: I have had severe joint pain and intermittant swelling in my hands, wrists, elbows, neck, shoulders, knees and feet for 3 months. I had a very hard knot develope on my wrist. My mouth is extremely dry. My joints pop and crack. I have had a low grade fever for 3 months. BUT MY EXTENSIVE BLOOD TEST RESULTS ALWAYS COME BACK NEGATIVE! My rheumatologist has not seen the swelling, and cannot diagnose me. What other tests can be performed to diagnose ra? Can a CT scan show that you have ra? Can an ultrasound? I cannot have a MRI due to interstem device implant. Can the doctor have lab testing done on synovial fluid? Will this show ra when blood work does not? I am desparate for an answer and help. I am a very active person, work full time and college full time, and am a single parent. This has stopped my life. I thank you in advance for an answer. Sincerely, Wendi Foster

Answer

HI Wendi,

This is always a tough situation, when the patient sees swelling but the doctor doesn’t.  In this situation, as you mention, ultrasound or MRI can be used to determine whether there is inflammation in the joints or not.  If MRI cannot be done, then the radiology facility has to have an ultrasonographer who is experienced with the joints.  THis is not as common as one would expect.  But, that is a good next step in the situation described here.

Diffuse pain can also be due to non-inflammatory conditions like fibromyalgia.

Good luck !!

Joan Bathon, M.D.

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.