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Julie from Calgary asks: Does a negative test rule out ankylosing spondylitis?
As of 2017, there are no definitive blood tests which can diagnose or rule out ankylosing spondylitis. HLA B27 is a genetic marker which is often found in patients with AS, but it is not required to make a diagnosis. Similarly, inflammatory markers in the blood may be elevated in AS, but may also be normal. To make a diagnosis of ankylosing spondylitis, or to rule it out, a patient should review their story with their physician or rheumatologist. The rheumatologist often will obtain further imaging, including x-rays or an MRI of the lower spine, to help ascertain a diagnosis.
Steve from Charleston asks: Is an elevated CK a sign of inflammation?
CK, or Creatine Kinase, is an enzyme released by muscle in the body. When the muscle is being damaged, the amount of CK released increases. Some people always have a higher than normal CK, which may be fine for them. Some people have their CK rise after vigorous exercise, which for most individuals, is not a significant concern. CK can increase in diseases which cause inflammation in the muscle, but it is not a specific sign for inflammation. Rather, it only suggests something is happening the muscle, but not specifically what.
Karen from Calgary asks: Is it possible to have both osteoarthritis and rheumatoid arthritis?
Both osteoarthritis and rheumatoid arthritis can happen in the same person. Unfortunately, if you have one, it still is possible to have the other as well. It is important for you and your physician to be able to differentiate which joints are affected by which condition. The best way to do this is to describe to your physician which joints are involved and how they feel, while your physician will complete an appropriate physical exam. Further investigations such as blood tests or imaging can be helpful, they are often far from definitive in making a diagnosis on their own.
Making the right diagnosis ensures the right management choices are being made, as treatment for OA and RA are different. To learn more about OA and RA and treatment options, please click on the highlighted links above.
Anna from Port Alberni, BC asks: I really have no symptoms, but my doctor is concerned that I have mixed connective tissue disease because my RNP test is positive. What should I do?
Mixed connective tissue disease (MCTD) is similar and has some overlap to systemic lupus. By definition, an antibody test called RNP should be positive in MCTD. However, as in many conditions and tests in rheumatology, a positive test does not necessarily diagnose a disease. Conversely, a negative test does not always rule out a disease either. To truly make a diagnosis of MCTD, lupus, rheumatoid arthritis, or many other rheumatic diseases, your doctor/rheumatologist needs to review your personal history with you, complete a physical examination, review the appropriate tests and put all that information together to make an informed diagnosis.