The diagnosis of seronegative rheumatoid arthritis may be delayed, especially in early disease. These patients may be classified as undifferentiated arthritis.
Double negative:
(1) negative for rheumatoid factor
(2) negative for anti-citrullinated protein antibodies
Triple negative:
(1) negative for rheumatoid factor
(2) negative for anti-citrullinated protein antibodies
(3) negative for anti-carbamylated protein antibodies
The diagnosis of rheumatoid arthritis may be made with the 2010 ACR.EULAR criteria if there is:
(1) persistent disease
(2) progressive joint involvement (> 10 joints with >= 1 small joint)
(3) elevated CRP and/or ESR
(4) absence of an alternative diagnosis.
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