Has anyone here had a rheumatologist suspect seronegative/psoriatic arthritis even with mostly normal bloods?
29, female
I’ve had intermittent swelling in two fingers since around 2021 (I found old photos recently), along with wrist pain, occasional elbow/ankle pain and intermittent back pain. My rheumatologist saw swelling in my PIP joints during examination and wrote “presumed seronegative arthritis” in the clinic letter. Methotrexate was discussed and I had all the screening bloods/chest X-ray done.
My bloods were mostly negative/normal:
- ANA/ENA/CCP negative
- CRP low
- ESR previously raised twice (third test came back as insufficient sample)
- IgG 18.86
- IgM 2.77
- vitamin D low
I’m still waiting for my hand X-ray result and have a follow-up appointment at the end of June.
I think what I’m struggling with most is not knowing what usually happens next if the X-ray is clear/normal. Do rheumatologists usually:
- monitor over time?
- order more imaging?
- still treat based on symptoms/exam?
- discharge if imaging is normal?
Just trying to understand what I might expect going into the next appointment.