Do I have it or not ??

[aieaieaie]

I am a 41 year old male with no personnal or familial history of arthritis/inflammatory disease/dematologic disease. I am in perfect health, take no medication, doesn't use any tobacco/drug/alcohol.
At age 38, I started cycling seriously doing 2500 km the first year, 4500 km the second and 6500 the third one. I had to stop last summer at about 3500 km because of knee pain that woke me up at nignt, no swelling, lasted about 24 hrs. Pain would come back on training then disappear after a while until I had to stop because of constant pain that lasted about 3 months, present without any activity. Pain lessened during winter time and got quite bad after 4 days of winter sports (cross country skiing, climbing, etc...) in march 2009. No swelling, no difficulty walking. Pain has been there almost everyday since, usually starting within an hour after I wake up.
Diagnosed with femoropatellar syndrome.
Knees X-Rays: normal but presence of enthesophytes on the top part of patellas.
Knees MRI: normal
Bone Scan (Tc99): normal
Blood work: no anemia, sed rate:2 mm, C-reactive protein:0,6 (normal), HLaB27 negative, Calcium Normal
Rheumatoid factor: strongly positive at 320 UI/ml
Pain without swelling to both wrists for two days lately and to IPP 3 left hand.
I feel tired, wake up early, not because of pain.
No relief with two differents NSAID (naproxene and diclofenac).
I can't practice any physical activity because of severe knee pain one or two days after activity. Never noted any swelling except 3rd IPP of right hand. Because of that, a rheumatologist says I do not have arthritis and a physiatrist says that I have rheumatoid arthritis. Who should I believe ??

[LadyMary03]

I went through 5 doctors and a total of 3 rheumys (rheumatologists) before I found one who would LISTEN !!!   The blood test even was debated by different physicians.  I get bloodwork every 6 weeks now.  I feel so much better now that I found a rheumy that is treating me.  

I definitly have RA but my hands don't always swell.  Sometimes they do but mostly not.  I say pursue and find another opinion.  It would be a shame for you not to continue to enjoy the active lifestyle that you prefer.  Oh, and the type of arthritis that I have...I feel intense knee pain but it is actually in my BACK...and even though I went in complaining of knee pain, my rheumy MRI'd my spine.  keep looking and keep us informed.  

[txsilver]

I have RA among other things and can tell you from personal experience that you can have it and it can effect you in a myriad of ways and it can be hard to detect - mine did not even show up in xrays.  It did, however, show up on a bone and joint scan (an MRI with contrast.)  When they ran that test, I lit up like a Christmas tree.  
To get that test I had to change docs more than once.  One of my rheumys looked at my hands every time I went in to see him even though, at that time, I did not have any pain in my hands.  
You gotta keep going to the docs until you find the right one.  the one who is interested in your case, willing to invest and partner with you on a solution.  I highly recommend talking to support groups in your area to find out which docs they do and dont recommend.  That helped me find my way to my great doc.  
When I got to the right doc, I could hardly get off the sofa.  I was fatigued beyond words and in constant pain head to toe, front to back.  I am now able to function on an almost normal level.  I still have occasional flares, but I have learned to live with them and work around them.  
Point of all this is, go be your own advocate and be persistent.  It is worth the effort and there is a light at the end of the tunnel!  Keep us posted on how you are doing and we will be here to cheer you on!

[Babs1469]

I would believe A rheumatologist but strongly suggest getting a second opinion because maybe the rheumatologist you saw is wrong or got a false  negative on the blood test.. You sound like a really healthy active person and I wouldnt' settle for any one diagnosis especially since they are conflicting, get a second, and third opinion if needed. I wish you the best of luck and hope you find the answers you need to get back to your life! as painfree as possible. Plus if it is arthritis you want to stop the progression asap. don't give up!!!!