Can a negative antinuclear antibody test rule out rheumatoid arthritis?

In general, "rheumatoid" refers to rheumatoid arthritis (RA). A negative antinuclear antibody (ANA) test cannot completely rule out RA. Detailed analysis is as follows:

The diagnosis of RA should be based on a combination of clinical symptoms, laboratory tests, and imaging findings. ANA is not a specific marker for RA and is more commonly associated with the presence of other concomitant autoimmune diseases. Core diagnostic criteria for RA include morning stiffness, symmetrical polyarthritis with joint swelling and pain, positive rheumatoid factor (RF), positive anti-cyclic citrullinated peptide (anti-CCP) antibody, and imaging evidence of joint erosion. Among these, anti-CCP antibody demonstrates higher specificity and plays a significant role in early diagnosis.

Some RA patients, especially those in the early stages of the disease or with mild symptoms, may present with negative ANA results. However, if other indicators such as positive RF, anti-CCP antibodies, and clinical symptoms meet the diagnostic criteria, a diagnosis of RA can still be confirmed. Therefore, a negative ANA result can only help exclude certain ANA-associated autoimmune diseases but should not be used as the sole basis for excluding RA. A comprehensive evaluation is necessary.