SERONEGATIVE RHEUMATOID ARTHRITIS: CLINICAL CHARACTERISTICS AND DIFFERENTIAL DIAGNOSTIC
Keywords:
Seronegative rheumatoid arthritis, inflammatory polyarthritis, autoantibodies, synovitis, erosions, differential diagnosis, spondyloarthritis, psoriatic arthritis.Abstract
Seronegative rheumatoid arthritis (SNRA) represents a diagnostically complex subset of rheumatoid arthritis characterized by the absence of rheumatoid factor and anti-citrullinated protein antibodies in serological testing. Despite seronegativity, patients often exhibit persistent inflammatory polyarthritis, structural joint damage, and functional impairment comparable to seropositive disease. Epidemiological studies indicate that approximately 20–30% of rheumatoid arthritis cases are seronegative, with a global prevalence of rheumatoid arthritis estimated at 0.5–1% of the adult population. Clinical heterogeneity, overlapping features with spondyloarthropathies, psoriatic arthritis, and undifferentiated inflammatory arthritis complicate early diagnosis. Imaging modalities such as ultrasound and magnetic resonance imaging have enhanced early detection of synovitis and erosions in seronegative patients. This article synthesizes current theoretical frameworks, clinical data, and research findings to elucidate the pathophysiology, phenotypic spectrum, and differential diagnostic principles of seronegative rheumatoid arthritis, emphasizing evidence-based strategies for accurate identification and management.
References
1. Aletaha, D., Neogi, T., Silman, A. J., et al. (2010). Rheumatoid arthritis classification criteria. Arthritis & Rheumatism, 62(9), 2569–2581.
2. Burmester, G. R., & Pope, J. E. (2017). Novel treatment strategies in rheumatoid arthritis. The Lancet, 389(10086), 2338–2348.
3. Firestein, G. S., & McInnes, I. B. (2017). Immunopathogenesis of rheumatoid arthritis. Immunity, 46(2), 183–196.
4. Humby, F., Lewis, M., Ramamoorthi, N., et al. (2019). Synovial tissue heterogeneity in RA. Annals of the Rheumatic Diseases, 78(6), 761–772.
5. Innala, L., Kokkonen, H., Eriksson, C., et al. (2011). Antibody status and radiographic progression. Annals of the Rheumatic Diseases, 70(2), 341–347.
6. Katchamart, W., Johnson, S., Lin, H. J., et al. (2010). Predictors of remission in RA. Arthritis Care & Research, 62(8), 1128–1143.
7. Mouterde, G., Lukas, C., Logeart, I., et al. (2014). Radiographic progression in seronegative RA. Rheumatology, 53(8), 1507–1515.
8. Nell, V. P., Machold, K. P., Eberl, G., et al. (2004). Benefit of early DMARD therapy. Rheumatology, 43(7), 906–914.
9. Ronnelid, J., Hansson, M., Mathsson-Alm, L., et al. (2018). Autoantibody systems in RA. Frontiers in Immunology, 9, 2093.
10. Smolen, J. S., Aletaha, D., & McInnes, I. B. (2016). Rheumatoid arthritis. The Lancet, 388(10055), 2023–2038.
11. van der Helm-van Mil, A. H. M., Huizinga, T. W. J., & de Vries, R. R. P. (2005). Genetic factors in RA. Arthritis Research & Therapy, 7(5), 223–232.
12. Wakefield, R. J., Balint, P. V., Szkudlarek, M., et al. (2005). Musculoskeletal ultrasound in RA. Arthritis & Rheumatism, 53(5), 769–777.*
OBJECT, A. K. I. O. (2022). SUBJECT AND SYNERGETIC CATEGORIES IN SCIENTIFIC WORK. Spectrum Journal of Innovation, Reforms and Development, 3, 25-29.
Абдуллаев, У. С., & Каримова, М. А. (2014). Основные направления традиционных межэтнических процессов в Ферганской долине (XIX-XX в. в). Социально-гуманитарный вестник Юга России, (4), 3-7.
Каримова, М. А., & Нажимидинова, Д. Ғ. (2023). ФАРЗАНД ТУҒИЛИШИ ВА БОЛА ТАРБИЯСИ БИЛАН БОҒЛИҚ УРФ-ОДАТЛАРДА ЗАРДУШТИЙЛИК ИЗЛАРИ. Journal of new century innovations, 12(1), 69-76.
OBJECT, A. K. I. O. (2022). SUBJECT AND SYNERGETIC CATEGORIES IN SCIENTIFIC WORK. Spectrum Journal of Innovation, Reforms and Development, 3, 25-29.
3 ta maqolaga
Burxaniddinovich, X. B. (2026). PIRIZIDENT SHAVKAT MIRZIYOYEV ASARLARIDA INSON FALSAFASI. TADQIQOTLAR, 79(1), 110-120.
ҚУТИБОЕВ, З., & ХАЗИРОВ, Б. ХОЖА АҲРОР ВАЛИЙ МУЛКЛАРИ: МАНБАЛАРИ, БОШҚАРИЛИШИ, САРФИ (РИВОЯТ ВА ЁЗМА МАНБАЛАР АСОСИДА). ILMIY ХABARNOMA. НАУЧНЫЙ ВЕСТНИК Учредители: Андижанский государственный университет им. ЗМ Бабура, (1), 34-38.
8 ta maqolaga
Хусанова, Ш. А., & Андижон, Ў. МИНГТЕПА АРХЕОЛОГИЯ ЁДГОРЛИГИ. МАРКАЗИЙ ОСИЁ ДАВЛАТЛАРИ ОЛИМА АЁЛЛАРИНИНГ ИЛМ-ФАН СОҲАСИГА, 323.
XUSANOVA, S. (2025). QADIMGI MINGTEPA MAROSIMLARI HAQIDA (ANDIJON VILOYATI MARHAMAT TUMANI MINGTEPA ARXEOLOGIYA YODGORLIGIDAN TOPILGAN ARXEOLOGIK TOPILMALAR ASOSIDA). «ACTA NUUz», 1(1.3), 35-37.
BAYRAMOĞLU, G., YILMAZ, O., PALABIYIK, N., & YÜKSEL, Ü. (2025). Globalization and Innovation The Foundation of Scientific Research, Social Development, and Modernization.
HEAVENLY HORSES OF ANCIENT FERGANA (based on new petroglyphs found near Mingtepa). (2023). Scientific Journal of the Fergana State University, 28(1), 26.
7 ta maqolaga
Ismoilova, K. M. Transformation processes of the concept of family customs and values in the culture of the Uzbek people. Илмий хабарнома.
Ismoilova, K. M. (2024). FERGHANA VALLEY FAMILY VALUES SPECIFIC NATIONAL MENTAL CHARACTERISTICS IN THE MODERN PERIOD. Journal of Modern Educational Achievements, 2(1), 52-58.
Ismoilova, K. (2024). THE ROLE OF NATIONAL TRADITIONS IN THE FORMATION OF FAMILY VALUES OF FERGHANA VALLEY. Confrencea, 1(1), 342-348.
Makhammadjonov, K. M. I. M. M. (2024). THE HISTORY OF CATARACT DISEASE, CHARACTERISTICS, AND ITS SIGNIFICANCE TODAY. Scientific Journal Of Medical Science And Biology, 3, 170-180.
Manzura, B., & Ismoilova, X. (2024). Antibiotiklar: Hayotni saqlab qoluvchi kichik qahramonlar. SHOKH LIBRARY, 203-209.
Ismoilova, X. M. (2024). FARG ‘ONA VODIYSI OILA QADRIYATLARINING HUQUQIY TARTIBGA SOLINISHIDA O ‘ZBEKISTON MILLIY QONUNCHILIGINING AHAMIYATI. Academic research in educational sciences, 5(TSUE Conference 1), 593-596.
Ismoilova, H. M., & ugli Rakhmatullaev, O. K. (2022). Financial activity in the Republic of Uzbekistan. Galaxy International Interdisciplinary Research Journal, 10(12), 770-773.
2 ta maqolaga
Alimova, N. I. (2019). FROM THE HISTORY OF JADID SCHOOLS IN TURKESTAN. Theoretical & Applied Science, (10), 89-92.
18ta maqolaga
