More than for most other diseases, the diagnosis and treatment of arthritis require a hands-on approach. By examining your tender joints and muscles and listening to your description of your symptoms and their severity, a doctor can usually get a pretty good idea of what’s going on inside your body.
But there are times when a doctor needs information that only a laboratory examination of bodily fluids and tissues can reveal. When he needs to confirm a diagnosis, monitor disease progress or medication effectiveness, or determine if the drugs you’re taking are causing potentially dangerous – but not evident – side effects, lab tests are in order.
The majority of lab tests are performed on blood because it is easily and safely sampled and it holds many microscopic clues to what’s going on throughout the body. Other tests may require urine, joint fluid or even small pieces of skin or muscle. Whether you’re just beginning the diagnostic process or completing your umpteenth year of treatment, the following information should help you understand some of the most common lab tests you’re likely to encounter.
Making a Diagnosis
While lab tests aren’t needed for every form of arthritis, they are very important to verify and confirm the presence of some diseases, according to Robert Lahita, MD, chief of rheumatology at St. Luke’s/Roosevelt Hospital and associate professor of medicine at Columbia University. If your symptoms and physical examination suggest rheumatoid arthritis, lupus, Sjogren’s syndrome, Lyme disease or one of a few other inflammatory forms of arthritis, the following tests can often confirm your doctor’s suspicions:
Antinuclear antibody (ANA) – Commonly found in the blood of people who have lupus, ANAs (abnormal antibodies directed against the cells’ nuclei) can also suggest the presence of polymyositis, scleroderma, Sjogren’s syndrome, mixed connective tissue disease or rheumatoid arthritis. Tests to detect specific subsets of these antibodies can be used to confirm the diagnosis of a particular disease or form of arthritis.
Rheumatoid factor (RF) – Designed to detect and measure the level of an antibody that acts against the blood component gamma globulin, this test is often positive in people with rheumatoid arthritis.
Uric acid – By measuring the level of uric acid in the blood, this test helps doctors diagnose gout, a condition that occurs when excess uric acid crystallizes and forms deposits in the joints and other tissues, causing inflammation and severe pain.
HLA tissue typing – This test, which detects the presence of certain genetic markers in the blood, can often confirm a diagnosis of ankylosing spondylitis (a disease involving inflammation of the spine and sacroiliac joint) or Reiter’s syndrome (a disease involving inflammation of the urethra, eyes and joints). The genetic marker HLA-B27 is almost always present in people with either of these diseases.
Erythrocyte sedimentation rate – Also called ESR or “sed rate,” this test measures how fast red blood cells cling together, fall and settle (like sediment) in the bottom of a glass tube over the course of an hour. The higher the rate, the greater the amount of inflammation.
Lyme serology – This test detects an immune response to the infectious agent that causes Lyme disease and thus can be used to confirm a diagnosis of the disease.
Skin biopsy – Taking small samples of skin and examining them under a microscope can help doctors diagnose forms of arthritis that involve the skin, such as lupus, vasculitis (inflammation of the blood vessels) and psoriatic arthritis.
Muscle biopsy – By going a little deeper into the tissue than with the skin biopsy, the surgeon can take a sample of muscle to be examined for signs of damage to the muscle fibers. Findings can confirm a diagnosis of polymyositis or vasculitis.
Joint fluid tests – In this procedure, which is similar to drawing blood, the doctor inserts a needle into a joint space and removes fluid. An examination of the fluid may reveal uric acid crystals, confirming a diagnosis of gout or bacteria, suggesting that the joint inflammation is caused by infection.
I became a nurse because i had a bad MD when i was a teen and i suffered for yrs with GI issues after many tests cause he couldnt figure out i was lactose intolerant,
my own father who lived states away who has RA was treated for that but, the MD thought all his problems where from that or smoking, they retired he switched and that MD saved his leg, which had blood clots, i could have tool one look and 5 min assment to figure that out, needless to say just cause they went to 8 yrs of medical school doesnt mean there smart or even care
http://implants.webs.com/biotoxins.htm
My goal right now is to get well and inform as many women as I can that you they are not crazy. These symptoms that you are experiencing are not in your head. It could quite possibly be your implants.. WISH ME LUCK!!!
Please consider seeing another rheumatologist for a second opinion. I question why you are taking Methodone long with the other drugs you mention and I've never heard of 250 types of RA! I've had RA for 44 yrs. I had 2 flares when diagnosed at 41 yrs., 2 short rounds of cortisone (without knowing I should take calcium with vit. D at the same time), tried oral gold, Naprosyn, Celebrex, take Plaquenil (42 yrs.)-watch your eyes-- "fields of vision"/peripheral vision loss with that). When one M.D. isn't a good match, try another until you find a helpful one, one you're comfortable with, can talk to etc. He/she is out there. Good luck.
Please see a specialist, a rheumatologist. If need be, ask for your M.D.'s referral to one. when you have a special medical problem, you need a specialist. Family practitioners are very knowledgeable but they are not specialists in particular areas of medicine.
I have been suffering from joint pain since a very long time almost 4 years. But my RF test had been negative. Now I got the RF test done in dilution and the result was 700. Is this reading very high? Is my condition very severe? I am clueless as what’s happening me with? The Dr. gave me oral steroids. Plz help, I need information about these test results
Sunita
I'm very interested to see others' responses, Ann. Maybe someone has some good advice.
One thing I do know is that ANA stands for Anti-Nucleic Antibodies, which attack the nuclei of the body's cells.
I AM NOT A Dr. NOR SHOULD ANYTHING HERE BE USED IN PLACE OF MEDICAL ADVICE.
1st if you don't understand something ask your Dr. to explain it until you understand it if they aren't willing find another Dr. or get a 2nd opinion you can also speak to a Nurse & a Pharmacists. Dr.'s that you should be seeing are a Rheumatologist, Internist, Endocrinologist, Neurologist, Pain Management, Homeopathic/Preventive Medicine Chiropractor, Massage Therapist, Accupuncturist, Go to a medical supply store or your local pharmacy (for various items ranging from support to added assistance) Have lab work done, Find a support group, Read everything that you can pertaining to your illness, & all perscription instructions, interactions & keep a list of all meds. get copies of all test results & bring both to all of your medical appointments. Some things that you can do on your own- stretch, do some form of exercise ie: walk, ride bike, lift weigths or use thera-bands to tolerance, wear shoes that have proper support or use inserts, pace yourself-take breaks, get fresh air & sun (use sunscreen if out for a prolonged time)put a pillow under your knees for back & leg pain, try various pillows & choose 1 that gives you support & comfort, try to go to bed 1/2 hour earlier, learn to meditate, biofeedback or guided imagery, take vitamins, eat 5 small meals a day, working on computers use a wrist rest or rolled up towel, adjust heights of chairs, screens as well as time of use. In the kitchen there are all types of gadgets to assist you from opening jars, carrying, holding, reaching etc. Roll bottom of feet on cans, bottles, frozen juice tubes, use hot/cold packs for sore muscles or joints as well as shower, bath, jacuzzi/hot tub, or capsasian rub, absorbing junior. LAUGH, try to keep on a schedule, maintain interactions with family/friends. Ask for help pray & keep the faith, I know that it may not feel like it but you are not alone. I hope that this maybe of some help to you & that you may find some comfort & or assistance in your day or life.
Take Care & Be Well.
I know what helps me, hopefully it can help you as well!
I take one potassium pill at night all year around. In the summer when I sweat more, I take too. When my potassium levels get too low I get these really horrible cramps. They can be on the front of my legs, on top of my feet etc.
You can buy these over the counter.
I have an aquaintance who is also self-employed and without medical coverage. The medications and tests needed to treat RA are expensive. If you live near a research university with a hospital ask about clinical studies. My friend is part of one through a top notch university, and she is finally treated with Enbrel.
Sometimes the drug companies will give you their drugs for a nominal fee. All you need to do is ask. I get Enbrel through my medical insurance, but Wyeth helps with the copay. Ask your doctor about the programs. If you go untreated your joints could become damaged.
this at all and don't feel that is my problem. I am wondering if it is possible to have RA and
it not show on the blood tests? I sometimes feel people think I'm faking, I have better things to do than fake an illness. If I don't have RA? then what do I have? and why did my Dr. tell me to stay on the RA meds.? He also told me there are 250 different types of RA. I'm confused and tried of Dr.s and feeling bad!
Have you considered your hip may be referring pain to your leg and hip? Sometimes either osteoarthritis or labral tears can be the cause. You would need an xray and MRI with contrast of your hip to see if that is causing your pain.
Bonnie Walton (805) 348-9234
Perhaps your doctor was counting the number of affected joints--there are 20 joints in the fingers and thumbs of both hands alone. This count is used to help make the diagnosis of the disease and monitor its progression.
Good luck to you.
Thank You,
Carole
Thank You,
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Dearsit,
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While we aim to provide important and timely information to help you and your health-care team best manage your arthritis and related conditions, www.ArthritisToday.org and Arthritis Today magazine cannot diagnosis or provide specific medical advice for specific individuals with arthritis and related conditions.
Each person's case is unique, therefore, the information we provide is meant to help keep you informed of the latest treatments, future treatments and management solutions, all of which should be discussed with your physician and fellow members of your health-care team prior to trying the solutions.
Thanks for reading,
The Editors
ArthritisToday.org and Arthritis Today magazine
Could you please inform me if there is any danger to me with these blood results ? Many thanks. Carol
Just recieved a copy of my blood results. I've had RA since 1997. Had recent test which is extremely high, more than ever before. THESE WERE TAKEN 2-24-10
RF 1,912.0 High(normal is up to 20.0)
CRP is 2.5 High(normal is up to 0.9)
SED/ESR 75.0 High(normal is up to 20.0)
Comp Metabolic Panel
Sodium 135.7 Low (norm is up to 144.0)
Chloride 97.4 Low (norm is up to 111.0)
Carbon
Dioxide 32.3 High(norm is up to 32.0)
CBC
RBC 3.83 Low(norm is up to 5.40)
HGB 11.5 Low(norm is up to 14.0 Women)
HCT 34.1 Low(norm is up to 47.0
THE FOLLOWING WERE TAKEN 2-5-10
You'll NOTE anything which was not run between these two periods of tests, were either in NORMAL ranges or weren't ran at all.
CL 100.7 Low (norm is up to 111.0)
Glucose 112 High(norm is up to 105)
GFR(F)
Creatine 0.72 Norm(norm is up to 1.09)
GFR(F) 88.12 Has no numbers to related to however it has numbers out in front of STAGES such as stage 1 thru 5 wherein my number 88.12 falls into the category of Stage 2. I have a fatty diffuse liver due to methotrexate use I was told, also with little holes in my liver with one fatty grizzly looking line across the kidney with one which branches off of it appearing to section the liver into three parts.
CBC also ran:
HGB 11.4 Low (with normal up to 14.9) but I think I read somewhere that womens are rated lower than this.
HCT 35.8 Low (normal rate up to 47.5)
Lymph% 50.2 High (normal rate is up to 45.8
Gran% 37.8 Low (normal rate is up to 77.1)
OK--my question is this: For many years I have had a blood test reading of GGTB that is in the 250-300 range--which is so abnormal that I had to see a rheumy dr. He said it was a "fluke"---but I never can seem to find out exactly what GGTB is? I know its a liver thing--but I cant even find out about it online--where you can find just about everything! Can one of the experts help and explain what GGTB is? Thanks so much!
inflammation of eye-biologic remicade.
did remicade infusion cause episcleritis
request med clarification
It's possible that the barometric pressure (which is influenced by altitude) in Colorado had an affect on your arthritis. Check out our recent article on the subject:
http://www.arthritistoday.org/symptoms/pain/weather-pain.php
Thanks,
The Editors
Arthritis Today magazine
I love your comments! Yes!
Do not sit there like a duck but actively participate. It's your health and your body.
Demand tests and ask for hard copies of them.
Keep in mind that these doctors are humans too and could be tired to not feeling good and can miss a very important info. It happened to me.
My doc ordered a test for calcium and the lab package included the kidney functions. The doc looked (on a computer screen) at the calcium result and did not pay attention to the kidney part.
It turned out months later that he looked at it and we found out that I have a kidney problem. If I have had this piece of paper in my hand I would have noticed the 'out of range' flags.
Another example how docs can miss very important info... I have arthritis in my hands and was concerned if this could be RA and made appointment. My doc faxed her my recent labs (the ones showing my kidney problem). She decided that I have no RA but but she gave an RX for MOBIC for my hands which is a NSAID and people with kidney disease absolutely should NOT take it...
Figure that! If I would have not known that
I would be damaging my kidneys even more...
A moral from this story: Check your labs, check your docs!!! They do not care!
You can have RA and no elevation in RA factor in your blood. My factor was negative when I was first diagnosed 2 years ago but my other blood counts were off and you can tell by looking at my hands and feet that it is RA. Heredity is also a common factor. RA is rampant in my family from my mom and dad, so if folks in your family have it it is the likely culprit.
I hope the Plaquenil is helping. I took it for about 9 years before I moved to Ga. Pain doc here does not use and no funds currently to go to a rheumatologist. It was the best med for Fibromyalgia. Had to "cold turkey" off 12/08 and feel horrible. It might take some time to feel the full potential of the Plaquenil but it is a wonder drug. Don't forget to have your eyes examined every 6 months.
Thank care,
Vicki
Hope this will help someone in need.
Thank you,
Joe
/
Is there any hope for survival for me!
Thank you.
People with RA should check out the following websites:
http://members.tripod.com/~charles_W/arthritis.html
http://www.nutritiondata.com/tools/nutrient-search
The first is by a chemist who has studied RA for 40 years and cured himself of it. The second is a government food database which allows you to search for foods high in potassium, or copper, and low in calories, or fat, for instance. How food is prepared makes a huge difference. Foods canned or boiled in fluid and then the fluid discarded lose 50% of the potassium. Charles says fructose can make a copper deficiency worse, so don't depend heavily on fruits to get potassium.
Charles says RA is caused by low potassium and low potassium shuts down copper enzymes to mobilise copper for the immune system -- a permanent potassium deficiency causes a permanent shut down of copper enzymes leading to aneurisms, among other things. Many Americans are low in copper regardless of potassium levels according to a study cited by Charles, but w/o a potassium-wasting disease, the available copper would be utilized differently.
You need to read Charles's 300 page document to do the right thing. He says, for instance, that your kidneys must work and you must not have Wilson's disease to increase your potassium or copper intake, and that you must correct any B-1 deficiency before correcting a potassium deficiency because a B-1 deficiency causes heart disease which is not possible if potassium is also deficient. He says that Vitamin C is some kind of copper agonist and too much in the presence of a copper deficiency can kill you (I think via nonfunctional cuproenzyme lysl oxidase which leads to sudden aneurism). So maybe a multi vitamin is in order. I happen to know that zinc also binds with copper and makes it unabsorbable if eaten at the same time.
There is a study cited by Lowe "Is there a potential therapeutic value of copper and zinc for osteoporosis?" in which post menopausal women were given 1 g calcium, 15 mg zinc, 5 mg copper, and 2.5 mg manganese, and did not suffer bone loss (they gained bone mass 0.5%). Estrogen helps you absorb copper. I had a hair analysis before menopause and had normal copper status, then during menopause a hair analysis showed low copper. Serum copper is variable and thus not indicative of copper status. Charles_W has a whole chapter on copper. Copper is a poison so be well informed. As always, consult your doctor.
http://charles_w.tripod.com/arthritis.html
This man is a chemist, studied RA for 40 years, and has cured himself of it. He says it is a potassium deficiency, and it causes a copper deficiency, which itself causes low dopamine, high blood pressure, osteoporosis, aneurisms, among other things. When you have low potassium, your body thinks you have a potassium wasting disease, like cholera, and it trys to conserve metals by drawing them into tissues. It is iron particles in the joints that cause the joint problems.
Meanwhile, take milk thistle for your liver 600-1200 mg (I would take 1200 mg for a few weeks or months, then drop to 600 mg). Milk thistle has saved people's livers from amanita mushroom poisoning at the 1200 mg dose. While you are on the milk thistle, do nice things for your liver (you will have to research on the web what your liver likes, but Adele Davis once said your liver needs protein to rebuild, even if your colon does not like it). For a few months only (LOW protein is linked to long life so this is NOT a smart lifestyle choice) I would boost my protein intake to help the liver rebuild. Take vitamin E, a good multi vitamin, and whatever else your research tells you might help.
I have been denied Medicaid twice since husbands death because doctor scribbled on state forms and did not answer half of forms. I need a rheumatoid expert with knowledge of numerous drug allergies and I need some help paying. I am receiving a small VA benefit and I had to appeal widows disability and I have another year wait, I am not old enough for social security. I am always in excruciating pain.
Any suggestions?
I have Osteoarthritis...could the pain in my thumbs be RA ?I've had injections in both thumbs with no relief...is there anything that will help?
Thanks for your time to read my add and trying to help me.
36 is high as my understanding is that they quit measuring at 40.
You definitely should see a Rheumatologist that specializes in rheumatoid arthritis.
Who should I believe????
very confused
At the suggestion of a Orthopedic Surgeon I
had an mri performed, The tech stated that
the joint was not torn. The Dr. was ready to
perform arthiscopic surgery. We decided to
look into "Regenexx" treatment if I am a
candidate. While taking the steps to get
ready for the regrowth of the cushion we
found out that the proceedure used on me
was a short cut to surgery. He should have
had a blood test first to check for the
cause of the inflamation, and then a draw
from the knee to check for septic bacteria.
We had to go to our PC for the blood test
and she has referred us to a rhuematolist
for the Synvial test. We could not find a
Orthopedic Dr. who used the proper proceedure before operating.
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