Arthritis
Last updated: Thursday, 11, November, 2010
| Causes | Appropriate Tests |
|---|---|
Careful clinical assessment: diagnostic imaging and pathology tests contribute to diagnosis, assessment of severity and complications, monitoring of disease activity and drug therapy. FBC; CRP; ESR.Joint aspiration may be indicated: synovial fluid examination with tests as appropriate to the clinical context. Synovial biopsy, if indicated. | |
Polyarticular arthritis | Rheumatoid factor; antinuclear antibodies and extractable nuclear antigen antibodies; HLA typing (HLA-DR4), CCP antibodies. |
Virus-associated arthritis | Rubella antibodies, arbovirus antibodies (Ross River virus, Barmah Forest virus), cytomegalovirus antibodies and parvovirus B19 antibodies; hepatitis B virus testing (HBsAg), HIV antibodies. |
Connective tissue disease, especially | |
Seronegative arthritis, especially | |
| Rheumatoid factor-negative spondylo-arthropathies associated with HLA-B27. |
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In the acute phase, microbiological studies may be useful to identify the precipitating infection: faeces - microscopy, culture and antigen detection (Salmonella, Shigella, Campylobacter, Yersinia sp); genital swab (urethral or cervical) or urine for Chlamydia trachomatis detection. | |
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Borrelia burgdorferi antibodies | |
Paraprotein-associated arthritis | See Paraproteinaemia |
Mono- or oligo-articular arthritis | |
Degenerative joint disease (osteoarthritis) and gout | Joint aspiration is frequently indicated: synovial fluid examination, incl microscopy crystals and bacterial culture; other tests as appropriate. |
Chondrocalcinosis (pseudogout) | |
Seronegative arthritis, especially | |
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Septic arthritis | |
| Synovial fluid examination must be performed; blood culture should also be performed. |
Chronic haemophilic arthropathy | |
Haemarthrosis | See Haemophilia A and B. |
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| Joint aspiration is rarely necessary and must not be performed without prior consultation with a Haemophilia Treatment Centre. |