Differential diagnosis of rheumatoid arthritis 4.25/5 (4)

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Diseases similar to arthritis (RA)

Osteoarthritis

  • Normal blood samples

Borrelia arthritis

  • Often knee-jointed, non-symmetric, CCP antibody. Borrelia tests knock out

Fibromyalgia

  • Widespread pain, no obvious swelling, normal blood tests

Haemochromatosis

  • Fewer attacked joints, high hemoglobin (blood percentage) and very high iron level (ferritin)

Lupus (Systemic lupus erythematosus, SLE)

  • Not a-CCP, but ANA is clearly elevated, rash

Mixed connective tissue disease (MCTD)

Multicentric Reticulohistiocytosis

  • Rare disease
  • Nodes under the skin (histiocytes / macrophages)
  • Arthritis in PIP and DIP joints

Neuropathy

  • Disease of the nervous system, numbness, pain or decreased feeling, most often in the feet. Normal blood samples (check B12 vitamins in blood sample). May occur in other rheumatic diseases, especially Vasculitis

Pachydermodactyly

  • Swollen joint fibromatosis, typically middle finger (PIP) in the fingers

Polymyalgia rheumatica

  • Higher age
  • Quick start
  • Rare joint swelling
  • Not CCP antibody

Psoriatic arthritis

Sarcoidosis (with swollen joints)

  • Typical lung abnormailities, not α-CCP

Septic arthritis

Metabolism, low (hypothyroidism)

  • Normal blood samples excluding metabolic tests (f-T4 is low, TSH is high)

Gout

  • Not CCP Antibodies in blood
  • High uric acid
  • Uric acid crystals in joint fluid

Virus Infections

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