Diagnosis of Rheumatic conditions
Diagnostic Test list for Rheumatic conditions:
The list of medical tests
mentioned in various sources as
used in the diagnosis of Rheumatic conditions
Tests and diagnosis discussion for Rheumatic conditions:
Diagnosing rheumatic diseases can be difficult because
some symptoms and signs are common to many different diseases. A general
practitioner or family doctor may be able to evaluate a patient or refer
him or her to a rheumatologist: a doctor who specializes in treating
arthritis and other rheumatic diseases.
The doctor will review the patient’s medical history,
conduct a physical examination, and obtain laboratory tests and X rays
or other imaging tests. The doctor may need to see the patient more than
once to make an accurate diagnosis.
It is vital for people with joint pain to give the doctor
a complete medical history. Answers to the following questions will help
the doctor make an accurate diagnosis:
- Is the pain in one or more joints?
- When does the pain occur?
- How long does the pain last?
- When did you first notice the pain?
- What were you doing when you first noticed the pain?
- Does activity make the pain better or worse?
- Have you had any illnesses or accidents that may account for the
- Is there a family history of any arthritis or rheumatic diseases?
- What medicine(s) are you taking?
It may be helpful for people to keep a daily journal that
describes the pain. Patients should write down what the affected joint
looks like, how it feels, how long the pain lasts, and what they were
doing when the pain started.
Physical Examination and
The doctor will examine all of the patient’s joints for
redness, warmth, deformity, ease of movement, and tenderness. Because
some forms of arthritis, such as lupus, may affect other organs, a
complete physical examination including the heart, lungs, abdomen,
nervous system, and eyes, ears, and throat may be necessary. The doctor
may order some laboratory tests to help confirm a diagnosis. Samples of
blood, urine, or synovial
Common Laboratory Tests
- Antinuclear antibody (ANA)—This test checks blood levels of
antibodies that are often present in people who have connective tissue
diseases or other autoimmune disorders, such as lupus. Since the
antibodies react with material in the cell’s nucleus (control center),
they are referred to as antinuclear antibodies. There are also tests
for individual types of ANA’s that may be more specific to people with
certain autoimmune disorders. ANA’s are also sometimes found in
healthy people. Therefore, having ANA’s in the blood does not
necessarily mean that a person has a disease.
- Arthrocentesis—Arthrocentesis or joint aspiration is done
to obtain a sample of synovial fluid. The doctor injects a local
anesthetic, inserts a thin, hollow needle into the joint, and removes
the synovial fluid into a syringe. The test provides important
diagnostic information. For example, the test allows the doctor to see
whether crystals (found in patients with gout or other types of
crystal-induced arthritis) or bacteria or viruses (found in patients
with infectious arthritis) are present in the joint.
- Complement—This test measures the level of complement, a
group of proteins in the blood. Complement helps destroy foreign
substances, such as germs, that enter the body. A low blood level of
complement is common in people who have active lupus.
- Complete blood count (CBC)—This test determines the number
of white blood cells, red blood cells, and platelets present in a
sample of blood. Some rheumatic conditions or drugs used to treat
arthritis are associated with a low white blood count (leukopenia),
low red blood count (anemia), or low platelet count
(thrombocytopenia). When doctors prescribe medications that affect the
CBC, they periodically test the patient’s blood.
- Creatinine—This blood test is commonly ordered in patients
who have rheumatic diseases to monitor for underlying kidney disease.
- Erythrocyte sedimentation rate (sed rate)—This blood test
is used to detect inflammation in the body. Higher sed rates indicate
the presence of inflammation and are typical of many forms of
arthritis, such as rheumatoid arthritis and ankylosing spondylitis,
and many of the connective tissue diseases.
- Hematocrit (PCV, packed cell volume)—This test and the test
for hemoglobin (a substance in the red blood cells that carries oxygen
through the body) measure the number of red blood cells present in a
sample of blood. A decrease in the number of red blood cells (anemia)
is common in people with inflammatory arthritis and rheumatic
- Rheumatoid factor—This test determines whether rheumatoid
factor is present in the blood. Rheumatoid factor is an antibody found
in the blood of most (but not all) people who have rheumatoid
arthritis. Rheumatoid factor may be found in many other diseases
besides rheumatoid arthritis, and sometimes in normal, healthy people.
- Urinalysis—In this test, a urine sample is studied for
protein, red blood cells, white blood cells, or casts. These
abnormalities indicate kidney disease, which may be seen in several
rheumatic diseases such as lupus or vasculitis. Some medications used
to treat arthritis can also cause abnormal findings on urinalysis.
- White blood cell count (WBC)—This test determines the
number of white blood cells present in a sample of blood. The number
may increase as a result of infection or decrease in response to
certain medications, or with certain diseases, such as lupus. Low
numbers of white blood cells increase a person’s risk of infections.
(Source: excerpt from Questions and Answers About Arthritis and Rheumatic Diseases: NIAMS