Raised Rheumatoid Factor - what else could it be?

[thaneofglamour]

I am posting this here , having not got any nibbles on the General Health board:
I went to my GP at the end of December because of agonising pain in my left second toe and some pains in my hands.
He sent me for a blood test that was all fine apart from an elevated rheumatoid factor. Not hugely raised - it was 24.
So he requested x rays on my hands and feet and referred me to rheumatology. Even before X ray results came back I got a snotty sounding letter from Circle Healthcare which counts for being 'seen in clinic' these days. This letter implied that the raised RF means nothing without symptoms (errrmmmmm - I wouldn't have gone to GP without symptoms??) but to 'reassure' I should have an ultrasound (hands only, not feet).
Meanwhile the X ray came back which did show numerous signs of growing gaps between joints in hands and feet. I then had the US which came back normal. I am now at the 'take paracetamol' advice and 'you can have physio if you want'. I do have some recent experience with medical gaslighting which may influence my response to this but I can't understand how the pains in hands and feet and an abnormal x ray along with a raised RF can't signal something.
Dr Google tells me that other reasons for raised RF are other auto immune disease, some cancers , diseases I definitely don't have such as HIV ,and ageing. However, it suggests that a raised RF is mainly found in the elderly. I'm not elderly! Although the pain in toe sent me to the GP I do have multiple painful joints and often very fatigued.
Has anyone got any experience or insight with this? I have asked to see GP again but would like to go armed with any advice.

Approximately 3% to 10% of the healthy, general population has a raised rheumatoid factor (RF), with the prevalence increasing to over 20% in individuals aged 65 and older.

Medical tests and diagnosis is all probability theory. So to interpret a test you need to have a pre test probability. Your symptoms don't sound classic for rheumatoid arthritis although you don't mention which joints in the hands are affected.

I wish medical tests were binary! Rheumatoid factor and ANA are some of the worst.

Remember a diagnosis of RhA is a big deal so you don't want them to give you this label if they are wrong!

But to answer your question no it doesn't have to be something.

I have a lung disease and during tests to find out the cause of my lung problems, I was told I have a high rheumatoid factor and referred to rheumatology, I count myself lucky that even though at the time I didn’t have any symptoms, I was still seen regularly and monitored (or to be more precise, I didn’t think I had symptoms at the time) I was eventually told I have rheumatoid arthritis. It’s only when I properly learn about RA that I could see I’ve had symptoms for a very long time and that I had been quite ignorant in thinking RA is joint pain and so I had been dismissive of my many other symptoms.

My raised rheumatoid factor turned out to be ankylosing spondylitis. This was diagnosed after numerous joint issues / symptoms, and like the PP, a referral to a rheumatologist.

Thanks.

I definitely don't want to have RA but I also don't want it to be missed !

I have had lots of blood tests in the last four years (due to them looking for issues with other things) and the RF has never been raised before. I guess it's possible it's never been tested, though. I am not sure whether it's one of the standard ones.

My understanding is that RF is raised in those over 65 but that doesn't mean there isn't something wrong per se - ageing means that something has deteriorated in the immune system. I am nowhere near 65.

RhF isn’t a regular blood test. It would only be done in the context of inflammatory joint symptoms.

low titres usually don’t mean very much by themselves but it all boils down to symptoms & signs & a competent assessment.

Thanks - so I have symptoms and signs as far as I can tell so I am still confused!

I woke up this weekend with my jaw clamped shut!