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Differential diagnosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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It is important to realise that the presence or absence of rheumatoid factor is of prognostic and NOT diagnostic value.

The differential diagnosis or early RA includes:

  • viral arthritis (e.g. parvovirus, rubella, hepatitis B)
  • reactive arthritis (e.g. post-infection: throat, gut, sexually acquired)
  • seronegative spondyloarthropathy (e.g. psoriatic, ankylosing spondylitis, Reiter's disease, inflammatory bowel disease)
  • connective tissue disease (e.g. systemic lupus erythematosus, scleroderma)
  • polymyalgia rheumatica
  • polyarticular gout
  • osteoarthritis
  • septic arthritis
  • fibromyalgia
  • medical conditions presenting with arthropathy (e.g. sarcoidosis, thyroid disease, infective endocarditis, haemochromatosis, diabetic cheiroarthropathy, paraneoplastic syndromes, multiple myeloma)
  • Lyme disease


  1. MeReC Bulletin 2007;17(5):1-8.

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