The diagnosis of rheumatoid arthritis falls under two overarching types: seropositive and seronegative. Seropositive is the most common diagnosis among rheumatoid arthritis patients. Being seropositive means that your blood tests show the presence of antibodies that can cause symptoms of rheumatoid arthritis.
Seropositive rheumatoid arthritis is thought to present a more difficult and severe course of symptoms than seronegative patients. However, this isn’t always the case and the treatment options available for seropositive patients can allow rheumatoid arthritis sufferers to still enjoy their quality of life.
Someone who is diagnosed as seropositive has blood that contains antibodies that can attack their bodies and lead to joint inflammation. This is what can cause rheumatoid arthritis symptoms. The specific antibodies in the blood of seropositive patients are rheumatoid factor or anti-CCPs or both.
Though your blood test may indicate the presence of these antibodies, it may not necessarily result in a rheumatoid arthritis diagnosis. A strong set of other symptoms must also appear in order to make a full diagnosis.
In addition to positive blood test results, seropositive rheumatoid arthritis patients suffer from a distinct set of symptoms. These symptoms include but are not limited to:
Besides the apparent signs of rheumatoid arthritis, doctors will also need to be aware of other symptoms that can be easily mistaken for other conditions. These often include:
A combination of these signs and symptoms can further help diagnose seropositive rheumatoid arthritis.
To diagnose a seropositive patient with rheumatoid arthritis, the patient must test positive for the presence of the rheumatoid factor and/or anti-CCPs antibodies. There is, however, a difference between the two. Anti-CCP testing is newer and more sensitive than rheumatoid factor testing. Anti-CCPs can also show up several years before a patient shows any signs of rheumatoid arthritis. This is as opposed to the rheumatoid factor tests, which usually test positive within a year of developing symptoms.
Once a patient tests positive for anti-CCPs and/or rheumatoid factor, it doesn’t necessarily mean the patient has rheumatoid arthritis. Testing positive for rheumatoid factor has a 70-80 percent likelihood of being diagnosed with rheumatoid arthritis. This leaves a remaining 20-30 percent who test positive for rheumatoid factor but who aren’t diagnosed with rheumatoid arthritis. A positive result for anti-CCP is much more likely to result in a full rheumatoid arthritis diagnosis.
There are a number of different conditions that these antibodies can lead to. For example, a positive rheumatoid factor test result can indicate the patient has Hepatitis C. This is why testing positive for both rheumatoid factor and anti-CCPs leads to a much more certain diagnosis.
To reach a full diagnosis, the patient must also clearly exhibit the pattern of rheumatoid arthritis symptoms as described above, in addition to the positive blood test results. X-ray results are also a helpful indication in diagnosing the disease. X-ray results that indicate patterns of bone erosion and cartilage deterioration allow doctors to bring together a complete diagnosis.
Other blood tests can also be performed such as the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), which test for the amount of inflammation in the joints. These are older forms of testing but are still used as very reliable methods of diagnosing rheumatoid arthritis.
While seropositive results are typically a good indicator of rheumatoid arthritis, a full diagnosis is not generally made unless the signs and symptoms are also prevalent in the patient.
Once a patient has been diagnosed with seropositive rheumatoid arthritis, it becomes much more helpful in narrowing down treatment options. This is because generally, doctors find that seropositive rheumatoid arthritis patients present a more severe set of symptoms throughout the disease course. This is as compared to seronegative rheumatoid arthritis patients although there are many exceptions.
Additional complications such as rheumatoid nodules or vasculitis are more likely to occur in seropositive rheumatoid arthritis patients. Rheumatoid lung issues are also more common in seropositive patients.
Seropositive patients are also more likely to develop other conditions alongside their rheumatoid arthritis symptoms. For example, cardiovascular disease is also associated with seropositive rheumatoid arthritis.
Despite these typical outcomes, no diagnosis can accurately predict the precise prognosis for seropositive rheumatoid arthritis patients. There are simply too many other factors at play and so the progression can vary from patient to patient.
Like all forms of arthritis, treatment for seropositive rheumatoid arthritis is focused on controlling pain and preventing or limiting further joint damage. Treatment for seropositive rheumatoid arthritis can combine medication, therapy, home care, and even surgery.
There are specific medications that help treat seropositive rheumatoid arthritis symptoms. The most specific type of medication is called a disease-modifying antirheumatic (DMAR) drug. These drugs help slow down the progression of rheumatoid arthritis and help prevent further joint damage. Methotrexate is one of the most well-known DMARs available.
Beyond the drugs designed especially for seropositive rheumatoid arthritis, patients may also take nonsteroidal anti-inflammatory drugs like ibuprofen. Inflammation can also be controlled with steroid medications like prednisone.
Therapists who specialize in working with rheumatoid arthritis patients help change daily habits so as to reduce strain on joints. There are also custom devices and tools available for patients so that they can continue their daily activities while preventing further joint damage.
Regular exercise is recommended for seropositive rheumatoid arthritis patients. It helps keep joints mobile and builds muscle strength. During flare-ups, alternating between hot and cold compresses can help manage inflammation and pain. Maintaining a healthy diet is important so as to limit susceptibility to infections and illness.
Sometimes, surgery may be necessary to correct severe damage done to joints. When joints become deformed, surgical procedures can help reduce pain and improve joint mobility. In some cases, complete restoration of joints may be undertaken. Surgery is only pursued in certain cases due to the potential for complications.