Changes in the blood, confirming the development of many joint pathologies, appear within 6 weeks. Therefore, laboratory tests for rheumatoid arthritis make it possible to diagnose abnormalities in the early stages. Arthritis is a progressive disease characterized by inflammation of connective tissues. Initially, the symptoms of the pathology are nonspecific; it is impossible to diagnose it without special differentiated tests.
Early rheumatoid arthritis initially causes a feeling of stiffness and malaise upon waking, which is not a cause for concern. No changes will be recorded on x-rays during this period.
There are 4 criteria that the doctor pays attention to before sending the patient for testing. Diagnostic criteria for rheumatoid arthritis, which indicate the need for adults to undergo research:
Over time, a person develops pain in the bones, wrist, and foot. After waking up, it becomes more difficult to move; every movement causes increased discomfort. At this stage, self-medication is contraindicated; it is recommended to quickly visit a therapist or rheumatologist. If a pathology is suspected, the doctor will prescribe an ultrasound, x-ray and tests for arthritis, which will confirm the presence of the disease.
Diagnosis of rheumatoid arthritis is a set of measures, according to which the doctor will be able to confirm the diagnosis. Thanks to laboratory tests, it is possible to identify the disease quickly, while instrumental tests show negative results, which is why the disease is detected after 7-8 years. The treatment plan will depend on the data obtained from tests of the CBC (complete blood count), biochemistry, ACCP (antibodies to cyclic citrullinated peptide), and sometimes you need to take a urine test.
Plasma examination in the laboratory notices the slightest changes, deciphering the results can tell the doctor a lot. Especially the erythrocyte sedimentation rate (ESR), hemoglobin, if its number decreases, and leukocytes, whose number increases. These laboratory values are important because ESR, white blood cells, and platelets indicate the development of inflammation, and hemoglobin helps determine whether the body is suffering from anemia. The development of anemia in patients is associated with a reduction in the life of blood cells. Normal hemoglobin levels differ between women and men.
The concentration of C-reactive protein, fibrinogen and sialic acids will be shown by a biochemical blood test for arthritis. The importance of diagnostic criteria in biochemistry:
Arthritis is an autoimmune disease. This means that the immune system eliminates its own cells, and RF is the antibodies that are produced by the immune system for this fight. When the process in the joints is disturbed, this factor is usually increased. The increase leads to the appearance of specific growths on the vascular walls, which interferes with normal circulation. An increased figure accompanies not only skeletal pathologies, but also various infections and tumors. The normal RF level is 0-14 IU/ml.
The production of the ACCP substance begins a year before the first symptoms appear, which makes the analysis very valuable, since the disease is detected earlier. The reason for the production is the body’s reaction to the development of rheumatoid disease, when its own tissues begin to be perceived as foreign. In medical language, it is more correct to say that B lymphocytes fight the cells of the body.
As the disease progresses, any laboratory parameters (leukocytes, ESR) change, but ACCP does not change. Therefore, the test will help determine arthritis, but not assess its progress.
The norm for this criterion is less than 200 units/ml. ASLO is a type of antibody, the production of which is associated with the presence of streptococcal infection. Group A streptococcus can cause rheumatic inflammation, which has been scientifically proven. The ASLO result is used to distinguish rheumatism from RA. Diagnostic criteria for arthritis and rheumatism:
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ANA are cells that come into conflict with the cells of their own tissues. In approximately 10% of patients with arthritis, studies confirm the presence of the substance. AN is also used to detect systemic lupus erythematosus. A blood test for markers of SLE in RA shows positive results for the lupus coagulant, and also records a high number of IgG antibodies.
Diagnosis of arthritis involves examinations:
Immunoglobulins are antibodies that are produced due to the development of pathological agents. To determine their quantity, immunological tests are indicated. These are studies that show increased levels of substances such as immunoglobulin A, G and M. When immunoglobulin is elevated, the amount of uric acid in the synovial fluid increases when a sample is required.
The symptoms of arthrosis and arthritis are very similar. Often, even for an experienced specialist, it is difficult to make a correct differential diagnosis solely on the basis of examination.
In order to avoid medical errors, various laboratory tests are prescribed, the results of which “tell” the doctor a lot. That's why if your doctor orders an additional blood test, you should be happy. This means that you are in the hands of a true professional. If you were diagnosed with “arthritis” or “arthrosis”, but were never sent for tests (or, God forbid, prescribed treatment), politely say goodbye and go in search of another specialist. What tests are required for arthritis or arthrosis and why does the doctor need your blood test?
Many people mistakenly believe that arthritis and arthrosis are practically the same thing. However, this is completely untrue. Arthrosis is a destructive pathology, while arthritis is an inflammatory disease of the joints. Externally, the diseases have some similarities in clinical manifestations, but in order to prevent medical errors, the following types of laboratory tests are prescribed:
Laboratory data is sometimes not enough to make a more precise diagnosis, and then other research methods are used that can give an experienced specialist the most complete clinical picture of the disease. Among such methods it is customary to highlight the following:
An untimely and incorrect diagnosis is a direct path to a wheelchair for patients with various joint diseases. The differential diagnosis “arthritis/arthrosis” most often becomes fatal for the patient. Although the symptoms of arthrosis and arthritis are quite similar, these are completely different diseases that have different etiologies. Treatment of these diseases is based on completely different goals. Thus, laboratory blood tests are a necessity and the key to successful patient treatment. The answer to the question of what tests are taken for arthritis is unequivocal - all, without exception, prescribed by your attending physician.
It is necessary to undergo testing to identify the exact pathology of the disease.
Rheumatoid arthritis is an autoimmune systemic disease that leads to inflammation of the joints spreading to the connective tissues. The pathological condition is often severe and sometimes leads to impaired mobility and physical disability. Suspecting this systemic disease, the doctor will prescribe a series of tests to help make the correct diagnosis in order to prevent complications such as disability. Tests for rheumatoid arthritis will show the presence of the disease at the end of the first month of development. Laboratory research methods are an effective method for the early detection of inflammatory pathology.
What tests are done for rheumatoid arthritis? To confirm an inflammatory disease, the patient is given a referral to donate biological materials, namely blood and urine. Imaging diagnostic methods at an early stage of the development of the disease may not show its presence, and blood and urine tests determine the presence of rheumatoid arthritis even after six weeks from the onset of the disease.
Inflammatory markers are a comprehensive study of various proteins and their quantities in the blood serum. To diagnose rheumatoid arthritis, the victim needs to donate blood to determine the level of the following indicators:
If rheumatoid arthritis is suspected, CRP is one of the first tests taken. In case of autoimmune joint disease, CRP will indicate that the inflammatory system is on. CRP results at the initial stage of formation will show increased protein content. With this condition of the joints, RF is used as an auxiliary diagnostic tool. The detection of rheumatoid factor in blood serum is considered to be a specific sign of systemic joint disease.
ESR is another indicator of the inflammatory process. Blood to determine ESR is taken from a patient’s finger. An increased ESR indicates an acute course of systemic pathology.
For differentiation, other mandatory tests are prescribed for rheumatoid arthritis. What tests need to be done? To confirm the diagnosis, the patient will be sent to undergo an immunological test to determine the state of general immunity, a biochemical blood test and blood test for antibodies to cyclic citrullinated peptide, puncture of intra-articular fluid, a biopsy of the joint membrane, and a complete blood test.
The results of the examinations will show the development of the acute phase of the disease; from the decoding, you can find out the stage of development of rheumatoid arthritis. A biochemical blood test establishes the activity of haptoglobulin, fibrinogen, sialic acids, seromucoids, peptides, ? - globulins and cryoglobulins (IgM, IgG, IgA, etc.). In the acute course of the pathological condition, an increased level of these components will be detected in the blood plasma.
To determine inflammatory pathology, biomaterial must be submitted for detection of antibodies to cyclic citrullinated peptide. Analysis for ACCP is one of the modern, early methods for detecting the disease. This is the best way to detect arthritis before the initial symptoms of the disease appear. Analysis for ACCP in rheumatoid arthritis gives the patient hope of curing the disease.
Proteomic analysis of urine studies the synthesis, modification, and decomposition of proteins. The methods of this method make it possible to diagnose and analyze up to 10 thousand individual proteins in one sample and record changes in their concentrations. Then the obtained test results are compared with the norm, which makes it possible to confirm the presence or absence of the disease, as well as to evaluate the monitoring of the course of the disease.
Table. Proteomics and fermentury of urine in patients with rheumatoid arthritis and in the control group.
Since the diagnostic sensitivity of tests varies, doctors analyze all received transcripts of the tests performed.
In diseases caused by streptococci, the immune system cells in the patient's body produce antibodies called antistreptolysin-O. Protein compounds in the blood plasma that prevent the proliferation of harmful microorganisms appear in patients with rheumatism of the joints. This method of diagnostic research is carried out to clarify the diagnosis. Also, the antistreptolysin-O test can distinguish rheumatism from rheumatoid arthritis.
An increase in antistreptolysin-O levels occurs 3–5 weeks after streptococcus enters the body. ASLO rates in autoimmune disease are slightly lower than in rheumatism. Sometimes antistreptolysin-O levels remain unchanged. In an adult, ASLO is up to 200 units/ml, in adolescents under 16 years old - up to 400 units/ml. ASLO indicators can be used to control and monitor the development of rheumatism, but not rheumatoid arthritis. After the disease is cured, the patient’s tests show that antibodies are at elevated levels for another 6–12 months. This indicator helps doctors determine that the patient has recently suffered from a disease associated with streptococci.
Diagnosis of the disease requires more than just blood and urine. It will also be necessary to conduct instrumental research methods so that the doctor can make a diagnosis with 100% accuracy. The patient needs to take an x-ray; if necessary, CT and MRI are performed, but with rheumatoid arthritis, often only x-rays are sufficient. The diagnosis is made based on laboratory, instrumental and clinical indications of the patient. The ACCP analysis is considered the most accurate; if it shows the presence of the disease at an early stage, treatment should be started immediately.
Clinical indicators include the presence of rheumatoid nodules, stiffness (mainly in the morning), hyperemia, swelling, the presence of rheumatoid factor in the blood, weight loss, single or multiple erosions, fever, periarticular osteoporosis, narrowing of the gap between the joints, insomnia, loss of appetite. To make a diagnosis, four clinical indicators are enough. The diagnosis of rheumatoid arthritis is confirmed if the patient complains of signs of RA for 6 weeks, and also if the transcripts of the tests taken indicate the presence of an inflammatory process. This disease is sometimes difficult to diagnose; you will need to undergo various tests, and you will also need to donate blood and urine for testing after a course of treatment.
Rheumatoid arthritis is an autoimmune disease due to which inflammatory processes actively develop in the connective tissue. The disease is severe and often leads to disability. What tests are taken for arthritis and do they help identify the disease in the early stages? Laboratory tests require the patient's blood. It is subjected to biochemical analysis, the hemoglobin level is measured and the number of formed elements (erythrocytes, leukocytes, platelets) is counted. Characteristic changes in the blood appear already at the beginning of the second month of the disease, so laboratory diagnosis is an effective way of early detection of the disease.
How to diagnose arthritis? There are characteristic signs, the presence of at least 4 of which indicate this disease. The following are diagnostic criteria for rheumatoid arthritis:
At an early stage, the disease may only manifest itself as weakness and mild morning stiffness, so people do not seek help from a doctor. An X-ray may still show no pathological changes, but a blood test can suggest the disease even after 6 weeks from its onset. For an objective result, all tests are taken on an empty stomach.
In a general blood test (CBC), the following pathological changes are possible:
An increase in ESR and an increase in the number of leukocytes is the result of an acute inflammatory process. Normally, ESR is 2-15 mm/hour, and in patients this figure is usually at least 25 mm/hour (depending on the severity and period of the disease). In a healthy person, the number of leukocytes in the CBC ranges from 4000-9000, but in patients with rheumatoid arthritis there is a slight increase in this indicator.
The norm of hemoglobin in women is 120-140 g/l, in men – 135-160 g/l. A decrease in numbers indicates anemia, which develops in patients who have had rheumatoid arthritis for a long time. This is due to a shortened red blood cell life cycle and metabolic disorders.
Rheumatoid factor (RF) is an antibody produced in response to one's own cells that are perceived as foreign due to disease. RF is detected in the blood not only in diseases of the musculoskeletal system, it is also formed in viral and bacterial infections, liver damage, and malignant tumors. The normal value for healthy people is 0-14 IU/ml.
Increased RF occurs in 60% of cases of the disease. There are also seronegative forms of arthritis, in which this indicator remains unchanged. RF is dangerous because it forms insoluble complexes. They are deposited on the walls of blood vessels, which leads to disruption of the blood supply to tissues and the development of vasculitis.
Antistreptolysin O (ASLO) are antibodies that appear when a streptococcal infection develops in the body. They are mainly increased due to group A hemolytic streptococcus, which causes rheumatism.
This indicator is used to clarify the diagnosis and helps distinguish rheumatism from rheumatoid arthritis. In the first case, ASLO increases significantly, and in the second, it remains unchanged or increases insignificantly.
The normal ASLO value in an adult is up to 200 units/ml, in children under 16 years old – up to 400 units/ml. It also increases with reactive arthritis. This is an inflammatory process in the joints caused by a primary infection localized in other organs.
The causes of reactive arthritis can be intestinal infections, sexually transmitted diseases, the proliferation of pathogenic bacteria in the ENT organs, etc.
In the biochemical analysis of this disease, the following changes may appear:
Sialic acids increase due to the inflammatory process in the connective tissue. In healthy people, they are found in the blood at a concentration of 2-2.33 mmol/l. An increase in their level may indicate rheumatoid arthritis or polyarthritis of another etiology.
Fibrinogen is a protein involved in blood clotting processes. Normally, its amount does not exceed 2-4 g/l, but with rheumatoid inflammation of the joints its content increases. High levels of fibrinogen are dangerous due to the formation of blood clots in blood vessels, which interfere with normal blood flow and can cause ischemic changes in various organs.
The content of C-reactive protein increases in the blood during any inflammatory process. In the acute period of rheumatoid arthritis, its value reaches 400 mg/l and higher. The higher this indicator, the more severe the pathological process. Normally, C-reactive protein is contained in an amount of 0-5 mg/l in the blood.
ACCP are substances that the body produces during autoimmune reactions that occur in the body during rheumatoid arthritis. In this case, the body perceives its own tissues as foreign and secretes antibodies to fight them.
These antibodies are present in the blood even in seronegative types of the disease. This is very important for establishing the correct diagnosis, because in this case rheumatoid factor is not detected in the blood.
The value of this analysis is that it helps to identify the earliest forms of the disease. ACCPs are formed in the blood approximately 12 months before the first severe symptoms appear.
The ACCP norm is from 0 to 3 units/ml. The analysis is used to make a diagnosis, but not to assess the course of the disease over time. This is due to the fact that as the patient’s condition worsens, the indicators of ESR, leukocytes and hemoglobin change, and the level of ACCP remains the same as at the beginning of the development of the pathological process.
Antinuclear antibodies (antinuclear antibodies or ANA) are antibodies that the body produces against the constituent parts of the cell nuclei of its own tissues. The test is more often used to establish the diagnosis of systemic lupus erythematosus. But in about 10% of patients with rheumatoid arthritis, the results of such an analysis are positive.
Arthrosis is a chronic disease of the joints that leads to their destruction. Inflammatory processes in this disease are not so acute; they progress over a long period of time. Although some symptoms are similar to those of rheumatoid arthritis (pain, stiffness and swelling), the two diseases are quite different.
There are no characteristic changes in the biochemical blood test for arthrosis; in contrast to arthritis, markers of inflammation are not detected in this case.
In most cases, a general blood test remains unchanged. The processes are slow, sluggish and do not have acute symptoms, so the ESR and the number of leukocytes are within normal limits. An increase in these indicators is possible only when large joints are involved in the process, where inflammation develops over a large area, causing the person to suffer from severe pain.
For differential diagnosis, in addition to laboratory tests, X-rays, MRI and endoscopic examination methods are used.
The research results should be assessed by a qualified doctor who takes into account the patient’s complaints, objective examination data and the results of instrumental examinations. But it will not hurt anyone to have an idea of what tests are taken for arthritis, because the disease can appear in any person, and the reasons for its occurrence have not yet been precisely studied.
Rheumatoid arthritis is a severe and common pathology, which is based on an autoimmune inflammatory reaction in various organs of the body. The cause of the disease is unknown, which complicates the diagnostic algorithm. To establish the correct diagnosis of rheumatoid arthritis, the doctor needs to comprehensively examine the patient and conduct laboratory and instrumental studies.
Tests are one of the most important methods for diagnosing rheumatoid arthritis, but their specificity is low. What tests for arthritis need to be taken to get a reliable result?
Laboratory tests for rheumatoid arthritis occupy a special place. There is no test or analysis that would definitively confirm the presence of the disease. Therefore, examining the patient and identifying signs of the disease using laboratory and instrumental data add up to a complex diagnostic process.
What tests should be taken if you suspect a disease:
The listed indicators in total will help determine the diagnosis. But the final assessment is made by the attending physician, who has studied the patient’s objective data and the results of radiography of the affected joints.
Diagnosis of a disease is a complex process; you cannot trust only the result of one study.
When diagnosing most diseases, the doctor prescribes a general blood test and a general urinalysis. What data do these studies contain?
A general blood test provides information about the number of cells in one unit of volume. In addition, the study contains information about ESR - erythrocyte sedimentation rate. This indicator will be discussed below.
A general analysis of urine not only determines its physicochemical properties, it also shows the content of cells and bacterial cells and some biochemical substrates in the urine.
What indicators are the doctor interested in if rheumatoid arthritis is suspected? The specialist tries to determine:
In general, general blood and urine test results are extremely uninformative. Studies are carried out to exclude other diseases.
A special place in the general blood test is occupied by the ESR indicator. The principle of the study is as follows:
An increase in ESR most likely indicates the presence of an inflammatory process. This also happens with rheumatoid arthritis.
ESR has a special role in determining disease activity. An increase in erythrocyte sedimentation rate indicates not just the presence of a disease, but also an active autoimmune process that must be stopped with treatment. During treatment, the doctor needs to reduce the ESR to an acceptable level - this will indicate that the therapy has been chosen correctly.
Disease activity consists of many indicators, but ESR plays the most important role.
A biochemical study involves taking blood from a vein and determining the amount of certain substrates. They can be proteins, enzymes, acids, metabolic products.
In rheumatoid arthritis, biochemical analysis allows you to determine:
As can be seen from the above, blood biochemistry also does not allow us to judge whether the patient has a disease. However, research is necessary to prescribe therapy.
We should also talk about such a biochemical indicator as C-reactive protein.
The level of C-reactive protein is determined as part of a biochemical study, but this requires that the doctor make a special note in the referral. Why is this indicator determined?
C-reactive protein is one of the most important proteins in the acute phase of inflammation. Without this metabolite, the immune system would not respond with inflammation to the damaging factor.
An increase in CRP indicates an existing inflammatory process of unknown localization. It can be bacterial, viral, autoimmune in nature - it is impossible to determine this by this indicator. However, increased protein levels increase the likelihood of systemic pathology in the body.
For various autoimmune diseases, doctors determine the level of rheumatoid factor. What does this indicator represent?
Rheumatoid factor is a collection of substances: antibodies of our immune system, produced by connective tissue cells included in the membrane of the joint. Rheumatoid factor is formed there. From the articular cavity it enters the blood, where it is determined using analysis.
Rheumatoid factor can be elevated in the following pathological processes:
Therefore, an increase in RF cannot be considered an unambiguous sign of the disease. However, this indicator determines the form of the disease: seropositive or seronegative.
The seropositive variant of the pathological process is characterized by a more severe course and requires active therapy. Therefore, the RF indicator is very important for a doctor.
A more specific marker of the disease, which indicates the probable presence of arthritis, is the detection of anti-citrullinated antibodies (ACCP - antibodies to cyclic citrullinated peptide) in the blood.
According to its chemical structure, citrulline is an amino acid - a component of protein, which is part of epithelial and connective tissue. If antibodies are produced to this amino acid, it means that they affect the elements of the connective capsule of the joints.
An increase in ACCP levels is 95% likely to indicate the presence of rheumatoid arthritis. The most valuable property of the marker is its presence in the blood already in the early stages of the disease.
However, there is evidence of an increase in ACCP in other systemic diseases, as well as in patients without clinical manifestations of joint disease. Therefore, you cannot rely solely on this indicator either.
In autoimmune rheumatoid arthritis, some antibodies are produced by the immune system against proteins in the nucleus of the body's own cells. Such antibodies are called antinuclear antibodies.
The level of antinuclear antibodies must be determined if there is evidence of an inflammatory process in the body of unknown origin (for example, an increase in ESR).
However, it is worth remembering that antinuclear antibodies cannot be considered as a highly specific marker of rheumatoid arthritis; they are detected in tests for other conditions of the body:
If there is a suspicion of rheumatoid arthritis, the specialist must give the patient a referral for a serological blood test. During the study, markers of viral hepatitis are determined.
Chronic hepatitis B and C may not manifest itself clinically except for reactive inflammation of the joints, which masquerades as a systemic autoimmune process.
In this case, markers of an infectious disease will make it possible to exclude a reactive process, which is eliminated during the treatment of hepatitis itself. Even if the disease is confirmed, the presence of hepatitis should be checked, since the prescribed treatment may worsen the condition of the infected liver.
The obtained laboratory test results must be interpreted by the attending physician. To make a final diagnosis of the disease, a rheumatologist will take into account:
During treatment, monitoring of laboratory data is required to correct the therapy.
Arthrosis is a rather insidious disease that develops slowly and at the first stage is almost imperceptible to the patient. Few people go to a medical facility when they detect primary symptoms of diseases of the knee, hip and other joints.
Regardless of the stage of arthrosis at which the patient turned to specialists, one interview with the patient, clarifying complaints and examination is not enough. In order not to confuse arthrosis with a number of other diseases, the symptoms of which may be similar, it is necessary to conduct a series of clinical tests and studies. The results obtained allow us to establish the most accurate diagnosis and prescribe the most correct and effective treatment for the knee, ankle and hip joint.
An analysis that can immediately determine whether a person has osteoarthritis of the knee or any other joint does not yet exist. But there are a number of studies that make it possible to exclude the presence of other pathologies in the body. These include:
X-ray examination allows us to identify arthrosis and determine the extent of the disease and the disorders caused by it. Thanks to the image, the main signs can be identified that indicate the presence of arthrosis, and not other pathologies of the knee, hip and other joints. These signs include: a significant reduction in the gaps between the joint-forming bones, compaction of cartilage tissue, the presence of osteophytes, the presence of bone growths and other symptoms of arthrosis. It is believed that X-ray analysis is the main thing in diagnosing joint diseases. But there are cases when the image does not give accurate answers and raises doubts about establishing an accurate diagnosis (at the early stage of arthrosis it is very difficult to identify destruction and deformation of the joints). In such cases, they resort to MRI examination.
MRI for arthrosis
Magnetic resonance imaging provides a clearer image than X-ray analysis. However, MRI is also distinguished by its cost, which is several times higher than classical X-rays. But it is precisely such a study that makes it possible to confirm or refute the presence of osteoarthritis in a patient, since the image clearly shows not only the articular bones, but also all the soft tissues (capsules, menisci, cartilage and ligaments). Regular clinics, unfortunately, do not have the equipment to conduct such tests, so if you suspect the presence of arthrosis, it is better to contact specialized clinics and centers.
Computed tomography is usually prescribed if an MRI examination is contraindicated for a patient (if he has a cardiac pacemaker, etc.) or it is simply not possible to conduct it. CT also allows you to obtain an image of all layers of the knee and any other joint. This examination is a cross between an X-ray and an MRI.
As for ultrasonic analysis, it can be used to assess the degree of wear and thinning of the cartilage layer, as well as to monitor the quantitative change in fluid accumulating in the joint. Ultrasound is rarely prescribed specifically for diagnosing arthrosis. This type of analysis makes it possible to simply determine the complexity of the situation. For example, an ultrasound of the knee joint allows you to see the degree of preservation of the menisci, determine the presence or absence of a Baker's cyst and uric acid crystals. It should be noted that only a highly specialized doctor, an ultrasound specialist, can objectively describe the picture of the disease.
Arthroscopy is prescribed even less frequently than ultrasound. The examination is carried out by inserting a camera into small incisions in the joint area. At this time, all the structural features of the affected joint can be seen on the screen. Arthroscopy is more appropriate for arthrosis of the hip joints, although it is also applicable to the knee and other joints.
Thus, to obtain a complete picture of the disease and assess the situation, it is necessary to conduct a comprehensive examination, in which special attention should be paid to blood tests. Only after collecting enough information can treatment begin.
As already mentioned, tests for arthrosis are prescribed not to identify it, but to exclude other diseases in a person, narrowing the range of all possible diagnoses. Blood for arthrosis is usually prescribed and donated in laboratories of medical institutions of two types: clinical research and biochemistry.
The peculiarity of a clinical blood test is, first of all, that in the presence of arthrosis it has normal readings. But in quite frequent cases, fluctuations in the erythrocyte sedimentation rate (ESR) - red blood cells - can be monitored.
If the ESR is elevated and at the same time there is also pain in the patient, then we can talk about the presence of processes that are rheumatic in nature. The pain is usually worse in the morning and at night, and this already indicates arthritis and rheumatism, but not osteoarthritis. If the ESR is elevated to a level of 25 mm or more, this may indicate the presence of inflammation in the joints. With a high level of ESR and leukocytes in the body, inflammation of an infectious nature can occur, which is reflected in the condition of the knee and other joints of the lower extremities.
Consultation with a doctor
That is, when the cartilage layer in the joints of the legs is destroyed, no deviations are observed in clinical tests. All indicators should remain at normal levels. Only in rare cases of arthrosis, which are accompanied by the accumulation of synovial fluid in the joint (synovitis), the ESR may have a level that is significantly elevated. Whenever the level of ESR in the blood is elevated, we can talk about the presence of inflammatory processes in the human body, the nature of which must be clarified using additional tests.
The second option for a blood test for arthritis is biochemical. Blood biochemistry (blood is taken from a vein) for arthrosis should be carried out on an empty stomach (the patient should not eat for at least 6 hours, ideally 12). This will result in cleaner results. Using this analysis, it is also possible to determine whether an inflammatory process is present in the body or not. And, therefore, makes it possible to distinguish arthritis from arthrosis.
As practice shows, with arthritis there will be an increased level of C-reactive protein, seromucoids and various types of immunoglobulins. All these indicators for arthrosis remain within acceptable normal limits. This is why taking a BAC is so important if you suspect arthritis or arthrosis. After all, their symptoms are quite similar and can only be distinguished by a blood test showing the presence or absence of inflammation in the joints.
Since arthrosis is a non-inflammatory disease, deviations from the norm of certain indicators indicate other pathologies. The presence of uric acid indicates gout, high levels of globulins and immunoglobulins indicate rheumatoid arthritis.
Thus, by carrying out the described list of tests, doctors can easily distinguish between what problems there may be - inflammatory joint diseases and arthrosis.
Good evening! I consulted a rheumatologist about recurring joint pain (without swelling or redness) in the small joints of the arms and legs. The tests are normal, the x-ray also showed nothing. The rheumatologist told me to check the trace. blood tests: CMV, herpes, E-B, antibodies to chlamydia, Micopl. pneum (something like this is written) and ureaplasma. 1) is it really necessary to take so many tests 2) in the laboratory they say that there are different IgM or IgG. The doctor did not explain which ones were needed. What kind of tests should I take anyway?
Good afternoon Everything has been written to you in detail, follow the doctor’s instructions.
Consultation is provided for informational purposes only. Based on the results of the consultation received, please consult a doctor.
Arthritis and arthrosis differences
Many people suffering from joint diseases believe that arthritis and arthrosis are the same disease. Meanwhile, these are completely different diseases that have only one thing in common - joint damage. The causes of these diseases, the course of the disease and treatment methods differ significantly from each other, which is why it is so important to correctly diagnose the patient.
Arthrosis is a disease of older people; it usually begins to develop in people after 45 years of age and is characterized by gradual deformation of the joints. We can say that arthrosis is an age-related joint disease. Arthritis affects younger people, usually under 40 years of age. Of course, there are exceptions in both cases. For example, an elderly person may develop arthritis due to severe flu. And after a serious injury, a young man may develop arthrosis.
Clinical features of arthritis
Another significant difference between arthrosis and arthritis is that arthrosis affects only a person’s joints, while arthritis affects the entire body system. Arthritis affects important organs such as the heart, kidneys, and lungs. This is due to the different causes of these different diseases. Thus, arthritis in young people can occur as a result of other diseases and infections. Arthrosis occurs as a result of age-related changes in the body.
Clinical features of arthrosis
According to statistics, people suffer from arthrosis much more often than from arthritis. In fact, almost every third person over sixty years of age has this disease, and every second after seventy years of age.
Arthritis and arthrosis have common joint damage, but at the same time they manifest themselves differently, even the nature of pain in these diseases is different.
I want to get tested, but the financial crisis forces me to save money - I want to come to the consultation ALREADY with tests;)! Can anyone with experience tell me WHAT should I take, besides biochemistry?
Clinical (with ESR); fibrinogen; SRB; rheumatoid factor, ASL-O. I took this to establish a diagnosis. Maybe since you have a diagnosis, you don’t need to take as many tests as I do?
I would also do an MRI. You have to do it yourself, but you have to save money. I don’t want any more X-rays: they don’t really show anything.
For 4 years of illness, not a single doctor helped me, they just gave me different diagnoses (each doctor has his own :)). Now I stupidly drink cinquefoil: it helps, ttt.
Wow, what a discussion unfolded here while our broken cable was being repaired;).
Thanks to everyone who enlightened me on the terms, now I’m savvy: flower. Also thanks for the recommended doctors: support. Now all that remains is to snatch my pictures from the hands of the clinic, get tested and go for a consultation!
On the topic, I’ll also say that I’m not overweight, on the contrary: 005. physical activity has increased slightly in the last month, but not criminally. And I can also see that the right joint sticks out much more, this particular riding breeches turns out to be:010:
About 15 years ago I was diagnosed with arthrosis of the hip joints. Then I didn’t go to the doctor anymore, I didn’t want to hear at the age of 20 that by the age of 30 I would end up in a wheelchair (the doctor consoled me so much:010:) Now my legs really started to hurt, but a polyclinic x-ray showed that I was healthy:073 .
If you have any questions, please go to Podyacheskaya at the REVMOCENTER, they will tell you there
What examinations should a patient undergo with arthrosis of the knee joint - gonarthrosis?
Nowadays, to clarify the diagnosis of gonarthrosis, they most often resort to clinical and biochemical blood tests, radiography and magnetic resonance or computed tomography.
Clinical blood test. For this test, blood is taken from a finger prick. With arthrosis, a clinical blood test, as a rule, does not show any specific changes. Only in some cases may there be a very slight increase in the erythrocyte sedimentation rate (ESR or ROE): up to 20 mm.
On the contrary, a significant increase in ESR (higher) in combination with night pain in the joint should prompt us to think about the possible rheumatic, inflammatory origin of these pains. If the patient also has an increased number of leukocytes, then this circumstance confirms the presence of some kind of infectious-inflammatory process in the body, which affects the joints in particular. However, in any case, a clinical blood test does not give clear answers; it only indicates trends and narrows the circle of diagnostic search.
Blood chemistry. When performing this test, blood is taken from a vein, and always on an empty stomach. A biochemical blood test can provide significant assistance to the doctor in the differential diagnosis of joint lesions: arthrosis or arthritis?
Thus, with rheumatic diseases (arthritis), the level of so-called inflammatory markers in the blood increases significantly: C-reactive protein, seromucoid, some globulins and immunoglobulins. In arthrosis, these biochemical parameters, on the contrary, remain normal.
True, there are cases when certain types of arthritis also do not lead to a significant change in biochemical parameters. But still, such an analysis, as a rule, helps to make a clear distinction between inflammatory and metabolic-dystrophic diseases of the joints (between arthritis and arthrosis).
Attention! In cases where we detect inflammatory changes in blood parameters taken from a finger or from a vein in a patient with arthrosis, we should be wary - after all, arthrosis does not cause any changes in the tests. And if inflammation indicators are elevated, there is a high probability that we are dealing not with arthrosis, but with arthritis. Then it is necessary to continue examining the patient until the diagnosis is finally confirmed or refuted.
X-ray of joints. Radiography is the most common and one of the most important methods for diagnosing arthrosis. In most cases, even the stage of arthrosis is established solely on the basis of an x-ray: after all, x-rays clearly show changes in the shape of the joint and bone deformations; compaction of the bones under the damaged cartilage is noticeable and osteophytes (spines) are clearly visible. In addition, an X-ray image can be used to judge the width of the joint space, that is, the distance between the articulating bones.
But X-ray examination has a serious disadvantage: only bones are captured on the X-ray image. But we will not be able to see the soft tissues of the joint (cartilage, meniscus, joint capsule, etc.) on an x-ray. Therefore, using only X-rays, we will not be able to assess with absolute accuracy the degree of damage to the articular cartilage, meniscus and joint capsule.
Fortunately, in recent years, magnetic tomography has become increasingly widespread.
Magnetic resonance imaging - MRI, or NMRI. The research uses, as the name suggests, magnetic waves. They are able to reflect the smallest details of the joint in the resulting image. The magnetic resonance imaging method is very accurate: it helps to detect the earliest changes in cartilage tissue (which are not yet visible on a regular x-ray), and also allows you to see damage to the menisci and ligaments of the knee.
Therefore, I often recommend that my patients, in addition to X-rays, carry out magnetic resonance imaging of the joint to clarify the diagnosis.
Although here one thing must be kept in mind. Usually, having received tomographic examination data, doctors are so confident in their infallibility that they do not consider it necessary to double-check the research results and conduct a personal examination of the patient. It is not right.
Firstly, the specialist in the tomography department who interprets the images is also a person and can make mistakes. In particular, I have repeatedly encountered situations where ordinary age-related changes or other diseases similar in picture to arthrosis were mistaken for arthrosis. This happens very often.
Secondly, arthrosis detected on a tomogram may not be the patient’s only disease. And the main cause of pain, even in the presence of arthrosis, may be another disease: for example, arthritis or meniscus damage. And these diseases will need to be treated first (in parallel with the treatment of arthrosis).
In general, even after receiving a complete package of examinations of the patient (X-ray, tests, tomogram), the doctor must still first conduct a personal examination of the patient and only then prescribe treatment.
Computed tomography - CT. In addition to magnetic resonance imaging, some hospitals still use computed tomography. In essence, computed tomography is the most advanced version of x-ray: computed tomography uses the same x-rays as in a conventional x-ray examination. The only difference is that with computed tomography, the tomograph seems to shred the joint with a series of x-rays, and as a result, the image is more voluminous and detailed than with x-rays. But it is still an order of magnitude inferior in information content to a magnetic resonance imaging scan. Therefore, CT should be used only in cases where for some reason we cannot perform magnetic resonance imaging on the patient (for example, if the patient has a pacemaker, a pacemaker, and magnetic waves can disrupt its operation).
Ultrasound of joints (ultrasound examination). In recent years, ultrasound has been actively used to diagnose joint diseases. After all, ultrasound, like magnetic resonance imaging, allows you to see changes in the soft tissues of the joint - for example, using ultrasound you can detect thinning of cartilage tissue in arthrosis or an increase in the amount of joint fluid in arthritis; it is possible to detect damage to the menisci in the knee, etc. However, the method has a significant drawback - it is very subjective, and the data obtained depend entirely on the qualifications of the specialist conducting the study.
Of course, this does not mean that joint ultrasound specialists are always wrong. But even if such an accurate method as tomography leaves room for discrepancies in the interpretation of the data obtained and disagreements in the diagnosis, then the data from ultrasound examination of joints raises questions especially often.
Therefore, I am not inclined to blindly trust the diagnosis obtained by ultrasound of the joints, and I always double-check such conclusions (through a personal examination of the patient, as well as using X-rays or magnetic resonance imaging).
Article by Dr. Evdokimenko for the book Leg Pain, published in 2004. Edited in 2011 All rights reserved .