Anti Nuclear Antibody out of range

Question  Dr. My wife is 30 years old and has been suffering from joint pain in both elbows both medially and distally. Her range of motion in both elbows severely decresed also. Concurrent to that pain she also has pain in her left ankle on the distal portion and upon extension the pain persists on the anterior portion of the ankle. She has had multiple x-rays of the elbows and neck and ankle and all came back negative after being reviewed by two orthopedic surgeons. The initial diagnosis by the rheumatologist and Orthopedic surgeon was tendonitis in both elbows and no one seems to have an idea on her ankle. The rheumatologist prescribed celebrex 1 SID for the inflammation. This did not help. We have since visited another orthopedic dr and he gave her cortisone shots in both elbows after diagnosing tendonitis. The shots definitely imporved her range of motion in her elbows but the pain is still present. He ordered blood tests for ANA AND RA and from what we can tell the results were out of range higher than 40. She is in a tremendous amount of pain and wanted another experts opinion. She also has been on relafin 1 SID.
 
Answer  You should see her rheumatologist for a more complete interpretation of her lab tests. In general, low levels of elevation in the rheumatoid factor and ANA are not clinically significant and are frequently falsely positive. Importantly, the significance of the lab tests is also dependent on the patient's symptoms.

Last update: 12:20 AM Thursday, April 26, 2007

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Alan Matsumoto, M.D.

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