Question

I’ve always had occasional joint pains since developing ME/CFS — as there’s a history of rheumatoid arthritis (RA) in my family. I’ve had a blood test for RA in the past but it was negative for RA.

My joint pains have recently changed with redness and a slight swelling in some of the small joints in my hand as well as pain in the feet. The pain and stiffness is worse in the morning and diminishes as the day goes on. Is this type of joint pain consistent with ME/CFS? Or should I go back to my G

Answer

The simple answer to your question is that, while joint pain can occur in ME/ CFS, this type of pain does not cause redness, swelling or deformity of the joints. If any of these symptoms occur, it's very important to check with your GP – who can examine the joints and arrange for various tests which should help to identify the cause and the best form of management. As there is a history of RA in the family, and the symptoms you describe are not consistent with ME/CFS, you really do need to have the blood tests repeated.

These are likely to include a test for general inflammation (ESR or CRP), a specific test for RA called rheumatoid factor (which may not be positive in the early stages) and a new antibody test called anti-CCP (anticyclic citrullinic peptide) which is more sensitive and specific for RA. X -rays, ultrasound and MRI scans can also provide important evidence of very early joint inflammation in RA.

One important reason for obtaining an early diagnosis (preferably within three months of symptoms starting) of RA is because research now indicates that the long-term damage to the joints can be significantly reduced by the early use of disease-modifying drugs which dampen down the cytokine mediated inflammatory process that helps to maintain this inflammation inside the joints.

• Please let us know if your joint pain has been misdiagnosed as being just another symptom of ME/CFS: Feedback@meassociation.org.uk

See also: Functional Limitations, Rheumatoid Arthritis.

More information

• Joint pain and ME/CFS, and the various joint diseases that can cause ME/CFS like symptoms, can be found in the Clinical Assessment section of the ME Association's ME/CFS/PVFS Clinical & Research Guide (The ‘Purple Book').