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It is very common to have joint pain, stiffness, or swelling that doesn’t meet any of the diagnostic criteria for RA. When this happens, many rheumatologists will tell you that you have early RA, meaning that you will likely go on to develop the disease if you don’t do anything. This is called seronegative because your blood tested negative for RA antibodies. In fact, 60 percent of people with early rheumatoid knee arthritis have a normal ESR and CRP (markers for inflammation), while 70 percent have a normal RF test and 70 percent have normal X-rays.17 This is called a diagnosis of exclusion: first we do the detective work to rule out other possible causes, such as a virus, Lyme disease, gout, or another autoimmune disorder. (See sidebar on pages 18–20.) If we can’t find anything, as long as your arthritis symptoms are in the typical RA pattern (generally fingers or toes), then you can be given this early, or seronegative, RA diagnosis.

Early RA is a cause for concern because it means that you’re heading toward a full-blown version of this disease unless you do something about it. This is exactly what happened to me. When I realized that I had arthritis in my fingers, even though all my tests were normal, the fear that I could wind up with rheumatoid arthritis propelled me to commit 1,000 percent to the Arthritis Protocol. By fixing my gut, sticking with my mind-body practices, and following the Leaky Gut Diet for Arthritis, I cured the arthritis and ensured that I would never end up with RA. Sometimes early inflammatory arthritis comes and goes mysteriously in episodes lasting hours to days, and symptom-free periods last days to months. The attacks can happen without any obvious triggers. This type of arthritis, called palindromic arthritis, is thought to be an early form of RA even though all tests are normal. Polymyalgia rheumatica, another kind of seronegative inflammatory arthritis, appears similar to RA because there is synovitis in the smaller joints in the hands and feet. But the joint pain is much milder and usually on only one side of the body (asymmetrical), and patients experience a lot of muscle pain, too. People with these conditions should also follow the Arthritis Protocol.