Blood Tests to Help Diagnose Arthritis

An arthritis panel is a group of blood tests physicians order to help diagnose various types of
arthritis. Some patients find it confusing that aching bones and joints are related to blood test
results, but evidence appears on blood testing for certain types of arthritis. A rheumatologist is the
best judge of what arthritis panel results may mean.
Signs of Inflammation ESR and CRP Tests
The Erythrocyte Sedimentation Rate (ESR), commonly referred to as the sed rate, is a blood test that
measures how rapidly red blood cells (erythrocytes) fall in a test tube of blood. Any type of
inflammation, whether related to arthritis, infection, or other condition, will cause red blood cells to
congregate together and fall more rapidly. The faster the cells fall, the higher the sed rate. A high
sed rate, however is a nonspecific finding. While high levels indicate disease process, it does not
specifically identify which process. For arthritis, its clinical utility is more for monitoring
inflammation levels than diagnosing a particular disease.
C-Reactive Protein or CRP testing is similar to ESR testing. It is a non-specific marker of
inflammation levels in the blood. CRP is frequently used to assess risk of heart disease in healthy
patients, but may also be ordered in the arthritis panel for comparison with the ESR to determine
inflammation levels that may indicate the presence of an inflammatory arthritis.
Complete Blood Count (CBC) and Arthritis
The CBC is ordered for many reasons other than arthritis screening. As part of an arthritis panel,
physicians are looking for variations in blood count and composition that indicate an arthritic
process. For example, an elevated white count could indicate septic arthritis or a low white count an
autoimmune process. Lowered hemoglobin and hematocrit (H&H) could indicate the anemia of
chronic disease associated with autoimmune disorders such as RA and lupus. Like ESR and CRP, the
CBC is not, in and of itself, diagnostic for any type of arthritis. It merely supports the diagnosis with
particular findings.
Arthritis Titers and Genetic Markers
More specific arthritis tests include the autoantibodies, RA and lupus titers, and genetic marker
tests. The RF-Rheumatoid Factor Titer and ANA-titer for lupus are the most commonly performed.
The Rheumatoid Factor is elevated in patients with rheumatoid arthritis and is performed when
rheumatoid arthritis is clinically suspected. A newer test, the Cyclic Citrullinated Peptide Antibody
(CCP), may be ordered if the RF is negative and suspicion of RA remains high. CCP detects RA
earlier than RF in some cases.
The ANA-titer is elevated in patients with systemic lupus erythematosus, polymyositis, and other
autoimmune diseases. As with all blood tests, it is correlated to the patients symptoms to support a
diagnosis. In addition to the ANA, physicians may order auto-antibody testing with suspicion of
autoimmune disease.
HLA-B27 testing is the most commonly performed genetic marker screen for arthritis. It is
associated with the spondyloarthropathies as well as psoriasis, ulcerative colitis, and uveitis.

Patients with the marker are prone to these diseases but it is not diagnostic. Patients may also suffer
from the diseases without the presence of HLA-B27.
According to the Arthritis Foundation, there are more than 100 types of arthritis affecting 46 million
people. No single blood test exists to diagnosis any of its forms. Diagnosing and treating all forms of
arthritis is the rheumatologists specialty, and he is the best one to order and interpret the arthritis
panel.

Sources:Arthritis Foundation. Types of Arthritis. (Accessed February 26, 2011).Easy Rheumatoid

Arthritis Treatment. Rheumatoid Arthritis and the CBC Test. (Accessed February 26,
2011).Disclaimer: The information contained in this article is for educational purposes only and
should not be used for diagnosis or to guide treatment without the opinion of a health professional.
Any reader who is concerned about his or her health should contact a doctor for advice.
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