Question
My rheumatologist told me he thought I had RA. Although I have high positive test results (RF=330, Anti-CCP=370), I never have any noticeable swelling to me or the rheumatologist. I believe my CRP and ESR were only slightly elevated. I experience extreme joint pain that feels more like tendonitis and the flares tend to come and go. Can RA present in this manner? Specifically without swelling?
Answer
Yes, early RA can present with symptoms but no noticeable swelling. Certainly, I agree that your blood tests are very positive. The diagnostic criteria requires that you have swelling on exam thus technically you do not meet the criteria. In addition, joint damage occurs with joint swelling, so with the lack of swelling, you are less likely to develop x-ray changes of joint damage.
