Btw, I had pain in two joints, hips and shoulder, saw the assistant clinical director rheumatologist at a renowned medical center and wasn’t diagnosed. My symptoms also included raynards, dry eyes, fatigue, and the joint pain.

I have two sister with two different autoimmune diseases, pemphigus and lupus.

He checked me for lupus, I had a positive ANA and he blow it off. Then gave me a diagnosis of no lupus or evidence of any other autoimmune disease.

I was subsequently diagnosed a year and a half later and I’m suffering in a way that i wouldn’t have to if he had only done the the test for RF and CCP.

Moral of the story, get a second opinion and don’t trust doctors even if they are at a renowned university hospital.

According to the European League Against Rheumatism which is comparable to the ACR, every patient with joint should should have CCP and RF.

To further complicate my case, the Rheumatology Clinic is one of few centers designated as a center for clinical excellence in rheumatology, their specialy is investigative rheumatology.

I was the perfect patient, but the doctor was an incompetent a**hole.

When my new rheumatology saw his report he said immediately those were my early symptoms.

So really the evidence based recommendation, for patients with joint pain complaint RF and CCP if you’re at a rheumatologist clinic.

I now have joint damage in my neck, hands, and feet, and jaw.