Can you have rheumatoid arthritis with a rheumatoid factor 6.9?

Yes you can have RA with an Rf of 20. When a doctor sees the symptoms of RA they automatically check for RF because it is a good indicator that that is the problem when taking the symptoms into account , However you don't need any RF at all to be suffering from RA. When this happens it is described as "seronegative rheumatoid arthritis".

• An RF of more than 23 units and a titer over than 1:80 can indicate rheumatoid Arthritis but may also occur in other conditions.
• A negative test result for rheumatoid factor does notnecesarily exclude the diagnosis of rheumatoid arthritis.