Jack-I agree that "less is more" in most instances but I definitely feel the additional information from a RF and ACPA is needed in this case. I looked at your previous blog and would note that most patients today have access to a patient portal and information on the internet that supports the need for initial testing for sero-positive RA for this patient. As they walk away with the AF Pamphlets available in the office (No patient should leave without an attempt at patient education), they should have a grasp of the issues and can process the results of labs with adequate explanation. In this way, the patient is not the "ball" but becomes a team player in the diagnostic game! Indeed, this patient can be evaluated for inflammatory arthritis with a modest prednisone challenge while waiting for the lab results. I think we all appreciate that "things are not always what they seem" regardless of lab test results and must keep all possibilities in mind with critical thinking and intellectual honesty. Keep up the good work!