All Arthritis Tests

There is no single lab test available to diagnose arthritis. Therefore, a diagnosis is often based on the individual's signs and symptoms, like swelling or pain in affected joints and proof of a past or current infection. The following tests are used to assist in confirming the diagnosis and monitoring arthritis.

SEE BELOW LIST OF TESTS FOR MORE About Arthritis Tests


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Clinical Significance

Rheumatoid Arthritis Diagnostic IdentRA® Panel 2 - Early diagnosis of rheumatoid arthritis (RA), ie, diagnosis before significant joint erosion occurs, is difficult. Psoriatic arthritis can also be difficult to diagnose clinically early in the disease process, and there are no specific biomarkers. The 14-3-3η (eta) protein is an emerging biomarker for RA and erosive psoriatic arthritis diagnosis. It may play a biologic role in the joint erosive process. Blood levels appear to be elevated in patients with RA, but not in other diseases including psoriasis, osteoporosis, gout, ulcerative colitis, type 1 diabetes, systemic lupus erythematosus, Crohn disease, primary Sjögren syndrome, scleroderma, and multiple sclerosis. The 14-3-3η protein, used in conjunction with rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibody, may improve diagnostic sensitivity in the early diagnosis of RA. It may also help differentiate those with psoriatic arthritis joint damage from those without joint damage.





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Elevated RF is found in collagen vascular diseases such as SLE, rheumatoid arthritis, scleroderma, Sjögren's Syndrome, and in other conditions such as leprosy, tuberculosis, syphilis, malignancy, thyroid disease and in a significant percentage of otherwise normal elderly patients.

Rheumatoid Factor (IgA, IgG, IgM) 

Reference Range(s)

  • Rhematoid Factor (IgA)
    • ≤6 Negative
    • >6 Positive
  • Rhematoid Factor (IgG)
    • ≤6 Negative
    • >6 Positive
  • Rhematoid Factor (IgM)
    • ≤6 Negative
    • >6 Positive

Rheumatoid factor is commonly used as a blood test for the diagnosis of rheumatoid arthritis. However, rheumatoid factor can also be present in individuals with other conditions such as lupus, infectious hepatitis, syphilis, mononucleosis, tuberculosis, liver disease, and sarcoidosis. Rheumatoid factor is an antibody that is detectable in the blood of 80% of adults with rheumatoid arthritis. Rheumatoid can be detected in the blood of normal individuals and of those with other autoimmune diseases that are not rheumatoid arthritis. In people with rheumatoid arthritis, high levels of rheumatoid factor can indicate a tendency toward more aggressive disease and/or a tendency to develop rheumatoid nodules and rheumatoid lung disease. Rheumatoid factor is actually an antibody that can bind to other antibodies. Antibodies are normal proteins in our blood that are important parts of our immune system. Rheumatoid factor is an antibody that is not usually present in the normal individual. Rheumatoid factor is commonly used as a blood test for the diagnosis of rheumatoid arthritis. Rheumatoid factor is present in about 80% of adults (but a much lower proportion of children) with rheumatoid arthritis.

Rheumatoid factor is commonly used as a blood test for the diagnosis of rheumatoid arthritis. However, rheumatoid factor can also be present in individuals with other conditions such as lupus, infectious hepatitis, syphilis, mononucleosis, tuberculosis, liver disease, and sarcoidosis. Rheumatoid factor is an antibody that is detectable in the blood of 80% of adults with rheumatoid arthritis. Rheumatoid can be detected in the blood of normal individuals and of those with other autoimmune diseases that are not rheumatoid arthritis. In people with rheumatoid arthritis, high levels of rheumatoid factor can indicate a tendency toward more aggressive disease and/or a tendency to develop rheumatoid nodules and rheumatoid lung disease. Rheumatoid factor is actually an antibody that can bind to other antibodies. Antibodies are normal proteins in our blood that are important parts of our immune system. Rheumatoid factor is an antibody that is not usually present in the normal individual. Rheumatoid factor is commonly used as a blood test for the diagnosis of rheumatoid arthritis. Rheumatoid factor is present in about 80% of adults (but a much lower proportion of children) with rheumatoid arthritis.

Antinuclear antibodies are associated with rheumatic diseases including Systemic Lupus Erythematous (SLE), mixed connective tissue disease, Sjogren's syndrome, scleroderma, polymyositis, CREST syndrome, and neurologic SLE. 

Reflex Information: If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge.


ANAlyzeR™ ANA, IFA with Reflex Titer/Pattern, Systemic Autoimmune Panel 1

Includes

  • ANA Screen,IFA, with Reflex to Titer and Pattern
  • DNA (ds) Antibody, Crithidia IFA with Reflex to Titer
  • Chromatin (Nucleosomal) Antibody
  • Sm Antibody
  • Sm/RNP Antibody
  • RNP Antibody
  • Sjogren's Antibodies (SS-A, SS-B)
  • Scleroderma Antibody (Scl-70)
  • Jo-1 Antibody
  • Centromere B Antibody
  • Complement Component C3c and C4c
  • Cardiolipin Antibodies (IgA, IgG, IgM)
  • Beta-2-Glycoprotein I Antibodies (IgG, IgA, IgM)
  • Rheumatoid Factor (IgA, IgG, IgM)
  • Cyclic Citrullinated Peptide (CCP) Antibody (IgG)
  • 14.3.3 eta Protein
  • Thyroid Peroxidase Antibodies (TPO)

 

  • If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge (CPT code(s): 86039).
  • If the DNA (ds) Antibody Screen is positive, then DNA (ds) Antibody Titer will be performed at an additional charge (CPT code(s): 86256).

 

Alternative Name(s)

Expanded ANA Antibodies,Systemic Autoimmune Disorder,ANA and Expanded AI Testing,ANA and Systemic Autoimmunity,Comprehensive AI Testing,Early Systemic Autoimmune Disease,Autoimmune Disorders


HLA-B27 is found in 90% of patients with ankylosing spondylitis and 80% in Reiter's disease. Ankylosing spondylitis affects 1 in 1000 caucasians. Ankylosing spondylitis is 10 times more common among individuals with HLA-B27 compared to individuals without this antigen.

Clinical Significance

This test is used in the evaluation of genetic risk for Ankylosing Spondylitis, uveitis, and several other autoimmune disorders.

esult
Code
Result Name LOINC Code Component Name
86000639 HLA-B27 26043-0 HLA-B27

Useful in differentiating inflammatory and neoplastic diseases and as an index of disease severity. CRP is also useful in monitoring inflammatory disease states.

A synthetic circular peptide containing citrulline called CCP IgG (cyclic citrullinated peptide) has been found to be better at discriminating Rheumatoid Arthritis patients from other patients than either the perinuclear autoantibody test or the test for rheumatoid factor. Approximately 70% of patients with Rheumatoid Arthritis are positive for Anti-CCP IgG, while only about 2% of random blood donors and disease controls subjects are positive.

A Complete Blood Count (CBC) Panel is used as a screening test for various disease states including anemia, leukemia and inflammatory processes.

A CBC blood test includes the following biomarkers: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)

NOTE: Only measurable biomarkers will be reported.


See individual tests

Increased CRP levels are found in inflammatory conditions including: bacterial infection, rheumatic fever, active arthritis, myocardial infarction, malignancies and in the post-operative state. This test cannot detect the relatively small elevations of CRP that are associated with increased cardiovascular risk.

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Serum uric acid measurements are useful in the diagnosis and treatment of numerous renal and metabolic disorders, including renal failure, gout, leukemia, psoriasis, starvation or other wasting conditions, and in patients receiving cytotoxic drugs.

A lipid panel includes:Total cholesterol —this test measures all of the cholesterol in all the lipoprotein particles.High-density lipoprotein cholesterol (HDL-C) — measures the cholesterol in HDL particles; often called "good cholesterol" because it removes excess cholesterol and carries it to the liver for removal.Low-density lipoprotein cholesterol (LDL-C) — calculates the cholesterol in LDL particles; often called "bad cholesterol" because it deposits excess cholesterol in walls of blood vessels, which can contribute to atherosclerosis. Usually, the amount of LDL cholesterol (LDL-C) is calculated using the results of total cholesterol, HDL-C, and triglycerides.Triglycerides — measures all the triglycerides in all the lipoprotein particles; most is in the very low-density lipoproteins (VLDL).Very low-density lipoprotein cholesterol (VLDL-C) — calculated from triglycerides/5; this formula is based on the typical composition of VLDL particles.Non-HDL-C — calculated from total cholesterol minus HDL-C.Cholesterol/HDL ratio — calculated ratio of total cholesterol to HDL-C.




Reactive arthritis is generally an autoimmune condition. It gets its name for the fact that it usually occurs as a reaction to an infection somewhere in the body. Apart from being uncommon, it’s a painful type of inflammatory arthritis that targets the lower back, fingers, toes, heels, and joints, such as ankles or in the heels. Additionally, it is linked with inflammation of the eyes, urethra, and sometimes mucous membranes and skin.  

In most cases, two kinds of bacteria cause reactive arthritis, bacteria involved with genital infections and bacteria involved with intestinal infections. The bacterium that brings about chlamydia, Chlamydia trachomatis, is regarded to be a trigger of reactive arthritis. However, it can be triggered by certain intestinal infections, as well as other sexually transmitted diseases. Common intestinal pathogens, such as Yersinia, Salmonella, Shigella, and Campylobacter, are usually the cause of food contamination.  

As aforementioned, reactive arthritis is quite uncommon, and not all people who develop one of these infections will get reactive arthritis. Genetic and gender predisposition are some of the risk factors when it comes to reactive arthritis. In most cases, the disorder is seen in men between 20-50 years, although it can happen at any age. Although it occurs rarely, women can also acquire reactive arthritis.  

Specific individuals are at an increased risk since they are positive for HLA-B27, which is a protein (named HLA or human leukocyte antigen) that is commonly found on cell surfaces. Also, the gene that typically codes for the HLA-B27 is approximated to be available in about 65%-96% of people with reactive arthritis. Still, HLA-B27 is found in only around 6% of the entire U.S. population. While having HLA-B27 is one of the risk factors for reactive arthritis, there is still some likelihood for individuals who are negative to HLA-B27 to get reactive arthritis, and it might be that other genetic factors are considered.  

Signs and Symptoms

For reactive arthritis, the signs and symptoms might include swelling and pain in several joints that occur suddenly 1-4 weeks after the infection. Non-joint inflammation might occur in the eyes as conjunctivitis, the skin, the urinary tract (bladder, urethra prostate gland), reproductive organs, or mouth. Symptoms might disappear spontaneously and won’t recur, or the condition might persist.  

Around one-third of the people who get reactive arthritis will also go through the following: 

  • Conjunctivitis or Uveitis: The inflammation of the thin membrane covering the eyeballs and lines of the inner eye (uveitis) or the eyelids (conjunctiva). Typically, conjunctivitis causes itching and redness, whereas uveitis is more severe and causes light sensitivity, blurring of vision, pain, and redness in the eye.  
  • Urethritis: The inflammation of the tube that joins the bladder to the exterior part of the body (urethra). Usually, this leads to discharge that is visible in the vaginal area or at the tip of the penis. Also, it causes pain or burning during urination. Men might also have inflammation of the prostate gland (called prostatitis), while women might experience inflammation of the cervix (known as cervicitis), even though urethritis is usually absent in women.  
  • Arthritis: Swelling, redness, and pain generally affecting the feet, ankles, and the knees; usually leads to heel pain; often associated with buttock and lower back pain; can cause swollen toes and fingers; can cause spondylitis (inflammation of the joints within the spine’s vertebrae) 
  • Certain skin symptoms can also be associated with reactive arthritis, such as painless penile sessions, rash, ulcers, and bumps on palms of the hands or soles of the feet. 

Laboratory Tests 

There is no single test available to diagnose reactive arthritis. Therefore, a diagnosis is often based on the individual’s signs and symptoms, like swelling or pain in affected joints, and proof of a past or current infection. Furthermore, healthcare practitioners might suggest the following tests to assist in confirming the diagnosis: 

Erythrocyte sedimentation rate (ESR): To examine for inflammation, enhanced with reactive arthritis and other diseases.  

HLA-B27 antigen: To look for a protein that is commonly found on cell surfaces. If found positive for this protein, it means a higher than average risk of acquiring specific autoimmune disorders, such as reactive arthritis. 

C-reactive protein (CRP): To examine for inflammation, enhanced with reactive arthritis and other diseases. 

Additionally, healthcare practitioners might order other tests to figure out the infection that caused the reaction; these include: 

Chlamydia test: To look for proof of the bacterium called Chlamydia trachomatis. In case it’s positive, considering early treatment could lower arthritis progression.  

Synovial Fluid Analysis: To check for an infection in the joint.  

Urinalysis and Urine Culture: To identify a urinary tract infection.  

Stool Culture: To check for Yersinia, E. coli, Campylobacter, and Salmonella 

HIV Test: To find out if someone is HIV-positive. However, it is generally known that reactive arthritis is associated with other infections to which those infected with HIV have been more exposed to instead of HIV infection itself. 

Some tests might be recommended to rule out other reasons for the symptoms: 

Antinuclear antibody (ANA): To assist in ruling out other diseases, like lupus 

Rheumatoid factor (RF): To assist in ruling out other diseases, like rheumatoid arthritis