I was initiallydiagnosed as seronegative. The rheumatologist listened to my symptoms, looked at my hands and feet. Blood work was done, but he does not rely on lab work alone. Blood work was done so it would be ready for the first appointment. Based on my complaints and symptoms, I was diagnosed at my first visit.

I am seronegative, too. There was a history in my family. I also have Ankylosing Spondylitis and PsA [positive for HLA-B27].

What's interesting is that long before they thought there was a connection between bacteria and RA, I caught bronchitis and a strep throat while visiting my brother, who had had it. Six months later, after I returned home, I would be diagnosed with RA and PsA. Independently, my brother, 3000 miles away, would also be diagnosed with the same without knowing about MY diagnosis.

After 20+ years I'm still sero-negative, as is he. Our cases are not mild [as some might think]. He uses Enbrel/MTX successfully. I use Humira/MTX.

I have been sero-negative for 39 years. My RA was confirmed by an MRI of my wrist that showed synovial membrane inflammation...the hallmark of RA.

Jen

I was sero-negative for about 30 years. My first rheumatologist just listen to my symptoms, looked at my joints and took lots of xrays on my first visit. On the 2nd visit I was told I had RA. They didn't have the anti-ccp blood test back then...but about 5 years ago my 2nd rhuematologist ordered the anti-ccp blood test just because I was a new patient to her. She knew I had RA but just wanted to run all the normal blood work to see how it would come out. I was positive then. Just wonder if most doctors check their sero-negative patients to see if they turn positive later? Gosh I may of been positive all along but without the anti-ccp blood test I didn't know it. My Rheumatoid Factor has always been negative.

Carrot, about a year after the initial diagnoses of seronegative, I turned positive.

I did not get a diagnosis, despite terrible inflammation in over 100 joints.

So I went to 4 different docs, and still nothing! Finally, a neighbourhood lady walked by my house with a cane. She was in her early 30's, so I asked her what was wrong. She had PsA and had also been to 4 rheumatologists. The 4th correctly diagnosed her and got her on medication.

She gave me the name and phone number of the doc. He was old, and diagnosed by symptoms. He said I had "classic" RA and what was wrong with those other docs? Relying on numbers, instead of symptoms!

I was sero-negative for 4 years. But my numbers were still pretty low. Last year I was tested when my meds failed, and my numbers were finally high. Sigh! I already knew that.

If you are sero-negative and haven't found a doctor to diagnose you, keep on looking. I would think older docs would be better, because they wouldn't be so tied to a wretched lab print out.

I was diagnosed a year ago with negative RA based on my symptoms. But this past January, my new rheumy diagnosed me with ankylosing spondylitis after looking at my MRI of my spine.

CaliforniaLynn, I'm interested in your diagnosis, since we both have AS. Did your doctor tell you that you do still have RA? I need to ask my rheumy that question. I know that the MRI of my foot showed synovial inflammation, so not sure if that's only RA or if AS causes that, too. She did tell me that the inflammation, pain, and fusing in my ankles was a manifestation of the AS.

Hi, FibroLizzy,

I have PsA, sero-negative RA, and AS, diagnosed in that order. The PsA and RA were diagnosed within months of each other [about 1992 when I was in my mid-40's]. The AS wasn't diagnosed until 10-15 years later. To add to the mix, it's believed I also have LGMD [a form of muscular dystrophy, albeit very mild, that affects the lower back/hips and limbs. Then you can add OA [old-age stuff].

My rheumatologist never said I still have or don't have RA.....and it never occurred to me to ask. [I believe you're thinking that possibly it was never RA and it was the AS all along.]

Here's a comparison between the RA and AS:
http://www.ncbi.nlm.nih.gov/pubmed/19822045

Typically AS is diagnosed much earlier than RA. [Who says I'm typical?] Ironically my back was always wonky, even back in my 20's. The slightest overexercise and I had pretty bad sciatica. In retrospect, maybe AS was announcing its presence back then. I certainly never thought to go to a rheumatologist or even a doctor, as it would hurt for a while, go away for a longer while.....

My next appointment with my rheumatologist is in May so I'll ask then.

What about you? How old were you when you got each diagnosis?

Hi, Jen [51PerCent],

You mentioned synovial membrane inflammation. As I understand it, this can occur in any number of rheumatoid diseases, even the non-autoimmune OA. Comparison of the cells in various diseases can be confounded by the drugs and/or method of extracting the cells.

BTW - in my case, 20+ years ago, before I had any diagnosis or before I was on any drug, they aspirated fluid from my knee and the results indicated I had CPPD! After that, I'd had some cortisone injections in the knee, which [I may have misunderstood this part] can confound future tissue analysis.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127008/

At the end of the day, the biologics seem to work well for me.

Lynn, thank you for your quick reply. I have had back issues for many years....maybe going back to my late 20's, early 30's. I just figured I had to live with chronic back trouble, since my father suffered with it.

I used to go to the doctor mainly about my neck pain, but nobody ever did anything for me. Finally, when I started having horrific pain and swelling in my ankles, I sought an answer. That's when I got a diagnosis of sero negative RA. When I switched to a new rheumy, I took along an MRI of my spine that I'd had taken three years ago. That was when she positively diagnosed me with AS.

So yes, I'm wondering if it was AS all along, or if I do also have RA. I have some weird things going on with my hands as well. Enquiring minds just want to know....lol! Please let me know what you find out in may. Thanks!

Lizzy,

Looks like AS is typically diagnosed when patients are in their 20's and RA is diagnosed when patients are over 40. But who says we all follow the text book?

[At least in my case] When I got my first diagnosis around 1992 the diagnostic criteria and tests were a lot different than they are today. So I wonder, if I had been born later, would I still have the same set of diagnoses?

Hi,
I am sero-negative, being dx'd with PsA, I also have inflammation and erosion in my SIJ, partial fusing of my SIJ (ankylosing) upper spine.
I should be starting Stelara Biologics next month.

I also have some combination of PsA and/or AS. Being seronegative is actually part of the diagnostic criteria for PsA. A rheumatologist who won't treat a seronegative patient should be viewed with suspicion. Lab values are part of the picture, "part" being the operative word.