An overactive or malfunctioning immune system drives inflammatory arthritis. There are many types, including seropositive and seronegative arthritis. So how do you know whether you have an inflammatory arthritis, and what should you look for?
Types of inflammatory arthritis
Inflammatory arthritis encompasses a range of diseases that affect the joints of the upper and lower limbs and the spine. The three most common types are rheumatoid arthritis, psoriatic arthritis, and gout. Other types include reactive arthritis, ankylosing spondylitis (axial spondyloarthritis), and enteropathic arthritis (linked to inflammatory bowel disease).
Inflammatory arthritis can affect a single joint — as gout often does — or many joints at once, as in rheumatoid arthritis.
How is inflammatory arthritis diagnosed?
Diagnosing autoimmune arthritis relies on the pattern of joint pain combined with blood tests and imaging.
Clinically, people report joint pain and swelling. The pain is often worse in the morning, eases with exercise, and can be disturbing at night. The location of the pain points to the type of arthritis: rheumatoid arthritis usually affects the hands and feet bilaterally. In contrast, psoriatic and other seronegative arthritides often affect the spine and sacroiliac joints.
Blood tests
Blood tests help pinpoint the diagnosis, usually as part of a rheumatoid panel test. In brief: inflammatory markers (ESR and CRP) are often raised but aren’t specific; rheumatoid factor and anti-CCP are raised in rheumatoid arthritis (a positive result is termed “seropositive”), and anti-CCP is the more specific of the two; psoriatic arthritis is usually “seronegative” (these markers are negative); the genetic marker HLA-B27 is often positive in seronegative arthritis; and a uric acid test helps confirm gout. For what each test means in detail, see the rheumatoid panel test page.
Imaging and joint fluid
X-rays may show joint damage, but ultrasound and MRI are more sensitive to early inflammation. Sometimes, taking fluid from a swollen joint and testing it for inflammatory cells (or crystals) helps confirm the diagnosis.
Frequently asked questions about inflammatory arthritis
What is dactylitis, and is it related to autoimmune arthritis?
Dactylitis — a “sausage” finger or toe — is common in chronic inflammatory arthritis, and is often its first sign, sometimes years before other symptoms. The swelling reflects inflammation of the tendons and small joints of the finger or toe. A persistently swollen finger or toe should raise the possibility of inflammatory arthritis.
How does inflammatory back pain differ from mechanical back pain?
Most low back pain is mechanical — from the discs, joints, and ligaments. But some is due to inflammatory (seronegative) arthritis, which behaves differently: it’s typically worse in the morning, improves with exercise and anti-inflammatory medication, and comes with morning stiffness that can worsen as the disease progresses.
Can exercise cause a rheumatoid arthritis flare?
No exercise helps keep rheumatoid arthritis well controlled. The exception is during a severe flare, when you should rest until it settles.
Does a normal blood test rule out inflammatory arthritis?
No. Normal inflammatory markers (ESR and CRP) and a normal rheumatoid panel make inflammatory arthritis less likely, but don’t exclude it. Doctors combine the clinical findings with blood tests and imaging to confirm or rule it out.
Does inflammatory arthritis show on X-ray?
It can — X-rays may show swelling and erosions (cartilage and bone damage). But ultrasound and MRI detect these changes earlier, so a normal X-ray doesn’t exclude inflammatory arthritis.
Final word from Sport Doctor London about inflammatory arthritis
Inflammatory arthritis covers many conditions, but the clues are consistent: joint pain and swelling that’s worse in the morning, eases with movement, and is often symmetrical. Spotting it early matters because prompt treatment protects the joints. If you have these features, see a doctor for the right combination of examination, blood tests, and imaging.
Dr Masci can assess joint pain in London and arrange the appropriate tests, working with rheumatology colleagues where needed. Contact the team here or call +44 (0) 203 488 0350.
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