Joint Health Series: Lab Work
Written by: Dr. Claire Arcidiacono, ND
For further questions or concerns email me at [email protected]†
Joints are a part of our body that get used constantly, as a result of this, many things can go wrong with their health. To determine exactly what is going on, a visit to your primary care doctor is a great first step. One way that the doctors diagnoses inflammatory conditions such as rheumatoid arthritis is with a blood test.
Rheumatoid factor or RF is a protein made when the immune system attacks healthy tissue. Approximately 70-90% of people with a high RF have Rheumatoid arthritis (RA). Now while a high percentage of cases of high RF are associated with rheumatoid arthritis, I just wanted to mention that other autoimmune can cause an increase in the number. These conditions can include but are not exclusive to lupus, scleroderma and Sjogren’s syndrome. †(1)
Additional Lab tests
Another blood test that is usually done along with the RF test is called the anti-cyclic citrullinated peptide (anti-ccp). A positive test is almost always indicative of rheumatoid arthritis. In fact if there is a positive test there is a 97% chance you have rheumatoid arthritis.† (2)
Another inflammation maker that is common to test is Erythrocyte sedimentation rate (ESR). The doctor may refer to this test as a Sed rate. Basically what happens is that when we have inflammation, our cells become heavier and fall faster. While Sed rate is not linked to any particular disease, it can be useful to determine how much inflammation there is thus how much severe the disease is. It is also very useful to use this test to judge how well a certain treatment protocol is working.† (3)
C-Reactive protein is another blood test that is for non-specific inflammation. That means while it can tell us you have inflammation it doesn’t tell us where that inflammation is coming from. It is often used to monitor the treatment of different autoimmune and inflammatory diseases.† (4)
Another well-known marker for inflammation is creatine kinase (CPK). CPK is associated with inflammation but is very nonspecific. CPK can be elevated due to trauma, muscle injection, muscle diseases, medications, and headache and is often elevated in the case of lupus.† (5)
Antinuclear antibody tests (ANA) are test for the presence of certain antibodies in your blood. ANA is associated with Lupus, scleroderma, and Sjogren’s syndrome. Unfortunately it does not distinguish which autoimmune disease you have.† (6)
Uric acid is often tested to rule out gout. While not everyone with an increase in uric acid develops gout it is an important step in ruling out gout as a source of joint pain.† (7)
Complement tests measure a group of proteins that are called complement. It is used to monitor both Lupus and rheumatoid arthritis. (8)
In addition to blood tests there are a few imaging tests that your doctor can order. An X-Ray will show any changes in the joints and any bone damage. An ultrasound which uses sound waves can help us see the quality of synovial tissues, the tendons, ligaments and even the bones. An MRI is very similar to an X-Ray however it is much more detailed and can damage to the joints including the muscles, ligaments and even the cartilage.†
Arthroscopy uses a thin tube with a light and camera to look inside the joint. Basically the tube is inserted into the joint through a small incision and an image is projected onto a screen. A CT scan or computerized tomography combines a series of X-Ray images taken from different angles to create cross sectional images of the body. CT scans provide a more detailed image than a regular X-Ray. CT scans can be done with or without a contrast agent. It is important to talk to your doctor about any concerns you may have in regards to both the radiation and contrast agent used in this test. †(9)
In addition to these tests your doctor will most likely do a physical exam and ask you a series of questions to help determine the best course of treatment or to determine what blood tests they should order next. While there are other tests that can be used to help determine the cause of joint pain these are the most common. As we delve into different types of joint concerns I may mention individual tests that can be done to help rule out certain types of joint problems.†
Next week we will finally be getting into the bulk of this topic and it is Osteoarthritis! As always I’ll be including some helpful tips!†
For further questions or concerns email me at [email protected]†
REFERENCES
https://www.webmd.com/rheumatoid-arthritis/rheumatoid-factor-test
https://www.webmd.com/osteoarthritis/blood-tests
https://www.webmd.com/a-to-z-guides/your-sedimentation-rate
https://www.webmd.com/a-to-z-guides/c-reactive-protein-test
https://www.webmd.com/osteoarthritis/blood-tests
https://www.webmd.com/a-to-z-guides/what-is-an-antinuclear-antibody-test
https://www.mayoclinic.org/diseases-conditions/gout/diagnosis-treatment/drc-20372903
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/arthritis-diagnosis
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/arthritis-diagnosis
