Autoimmune Arthritis May Go Undiagnosed Despite Normal Blood Tests
November 13, 2025
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In summary, you should visit a rheumatologist for any non-mechanical issues (due to injury or trauma) in young adults or children affecting joints, bones, muscles, tendons and ligaments, and in some cases other organs.
As a general rule any pain, swelling or stiffness of the joints, muscles, or bones that is not due to trauma, should be evaluated by a rheumatologist first, before seeing other specialties.
Three and half years old girl, brought by parents with a long history of suffering, started when she was only 6 months old, with recurrent attacks of fever, and “colic’s”, that became more frequent over time, and became more defined with fever, very severe abdominal pain and knees pain, and it is now happening every week.
Some years ago I saw a 52 years old gentleman with joints pain and swelling. Labs showed he has rheumatoid arthritis and we advised starting DMARDs (Disease Modifying Antirheumatic Drugs), but he wanted to try a “traditional” remedy from his home country first.
A 50 years old lady comes to the clinic with history of chronic pain all over her body, but her most pressing issue was severe left shoulder pain that began 5 months ago. She was told her labs were normal and that she had a local shoulder problem and was given a local steroid injection that didn’t help.
A mother of a 20 years old gentleman visits me in the clinic for the first time, her son refused to come because he is fed up and lost hope after suffering for so many years.
Marketing in medicine should be governed by certain principles to maintain the ethical integrity of the profession and protect patients’ interest, more specifically it should NOT be done the same way marketing done for “commercial” purposes, like marketing a car brand, or dishwasher detergent. For example, the “shock” or “exciting” tactics should not be used because they may cause misunderstanding about the nature of a medical condition, or trivialize the nature of the subject, namely the human health.
Over the last few decades several new medicines have been introduced into the rheumatology armamentarium for treatment of “arthritis” or “rheumatism”.
While these medicines offer better control for some patients, they do not add much benefit for a lot of other patients, but they may increase the cost of treatment substantially.
Properly done “and properly reported” scientific studies are the major source for “evidence based medicine” and are the main drive in medicine progress, however the impartiality of these studies are being eroded by the increasing effect of Pharmaceutical “Drug” companies and their money on “studies” and “researchers”, since these companies pay the researcher to do the study on their medicine, the researcher may become in many cases biased towards showing favorable outcome that help these companies sell more of their medicine, and may tend to hide negative outcome that can harm the patients but protect the interest of the company that paid for his/her study.
In summary, you should visit a rheumatologist for any non-mechanical issues (due to injury or trauma) in young adults or children affecting joints, bones, muscles, tendons and ligaments, and in some cases other organs.
As a general rule any pain, swelling or stiffness of the joints, muscles, or bones that is not due to trauma, should be evaluated by a rheumatologist first, before seeing other specialties.
Three and half years old girl, brought by parents with a long history of suffering, started when she was only 6 months old, with recurrent attacks of fever, and “colic’s”, that became more frequent over time, and became more defined with fever, very severe abdominal pain and knees pain, and it is now happening every week.
Some years ago I saw a 52 years old gentleman with joints pain and swelling. Labs showed he has rheumatoid arthritis and we advised starting DMARDs (Disease Modifying Antirheumatic Drugs), but he wanted to try a “traditional” remedy from his home country first.
A 50 years old lady comes to the clinic with history of chronic pain all over her body, but her most pressing issue was severe left shoulder pain that began 5 months ago. She was told her labs were normal and that she had a local shoulder problem and was given a local steroid injection that didn’t help.
A mother of a 20 years old gentleman visits me in the clinic for the first time, her son refused to come because he is fed up and lost hope after suffering for so many years.
Marketing in medicine should be governed by certain principles to maintain the ethical integrity of the profession and protect patients’ interest, more specifically it should NOT be done the same way marketing done for “commercial” purposes, like marketing a car brand, or dishwasher detergent. For example, the “shock” or “exciting” tactics should not be used because they may cause misunderstanding about the nature of a medical condition, or trivialize the nature of the subject, namely the human health.
Over the last few decades several new medicines have been introduced into the rheumatology armamentarium for treatment of “arthritis” or “rheumatism”.
While these medicines offer better control for some patients, they do not add much benefit for a lot of other patients, but they may increase the cost of treatment substantially.
Properly done “and properly reported” scientific studies are the major source for “evidence based medicine” and are the main drive in medicine progress, however the impartiality of these studies are being eroded by the increasing effect of Pharmaceutical “Drug” companies and their money on “studies” and “researchers”, since these companies pay the researcher to do the study on their medicine, the researcher may become in many cases biased towards showing favorable outcome that help these companies sell more of their medicine, and may tend to hide negative outcome that can harm the patients but protect the interest of the company that paid for his/her study.