What is Seronegative Arthritis?
Seronegative Arthritis is an inflammatory arthritis where the blood testings for Rheumatoid Arthritis – RF and CCP antibodies – are negative.
The term serum here refers to the blood which is tested. Hence the term 'sero-negative'.
The term 'sero-negative' is quite broad and can include many types of arthritis. It can include Psoriatic Arthritis which is a seronegative arthritis associated with the rash, Psoriasis. When we use the term 'seronegative arthritis' we are usually referring to an inflammatory arthritis that does not meet the diagnostic criteria for either Rheumatoid Arthritis or Psoriatic Arthritis.
What are the symptoms of Seronegative Arthritis?
The symptoms of Seronegative Arthritis are similar to other form of inflammatory arthritis.
Joints are swollen and painful, but sometimes they can be painful with very little swelling. Joints are stiff as with other forms of inflammatory arthritis and pain swelling and stiffness get better with activity.
Both joints and tendons can be involved.
A typical seronegative arthritis has the involvement of only a few joints at the original presentation and may have more involvement of the attachment of tendons to joints, called the 'entheses' more so than causing fluid to accumulate in the joints themselves.
How do we diagnose Seronegative Arthritis?
Seronegative arthritis can be difficult to diagnose, in particular in the earlier stages of the disease where swelling may not be apparent either on examination or on blood testings.
Blood investigations for arthritis will be done if you have joint symptoms. These tests will include RF, CCP Ab as well as inflammatory markers and other blood testing looking at how your bone marrow, kidneys and liver are working. Depending on your symptoms, sometimes your Rheumatologist will order more blood testings looking for other causes of joint pains and generalised aching and stiffness.
Xrays and ultrasounds may be done of the affected areas. Sometimes your Rheumatologist will order an MRI of an affected area looking for tendon or joint inflammation to confirm a diagnosis.
Seronegative Arthritis is often what we call a clinical diagnosis as often all of the tests are normal, including inflammatory markers.
How do we treat Seronegative Arthritis?
The treatment for each person's Seronegative Arthritis is tailored under the guidance of your Rheumatologist. The treatment of your arthritis may change in time as your symptoms change.
It symptoms are mild and not many joints are involved, anti-inflammatories or prednisolone may be trialled. If your symptoms are more severe and persistent then DMARD therapy will be recommended by your Rheumatologist.