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


Name Matches

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


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.

Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly Systemic Lupus Erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid and psoriatic arthritis, and primary Sjögren's syndrome.

Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly Systemic Lupus Erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid and psoriatic arthritis, and primary Sjögren's syndrome.

Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly Systemic Lupus Erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid and psoriatic arthritis and primary Sjögren's syndrome.

Decreased C3 and C4 levels may be associated with acute glomerulonephritis, membranoproliferative glomerulonephritis, immune complex disease, active systemic lupus erythematosis, cryoglobulinemia, congenital C4 deficiency and generalized autoimmune disease

Decreased C4 level is associated with acute systemic lupus erythematosis, glomerulonephritis, immune complex disease, cryoglobulinemia, congenital C4 deficiency and generalized autoimmune disease

CH50 is a screening test for total complement activity. Levels of complement may be depressed in genetic deficiency, liver disease, chronic glomerulonephritis, rheumatoid arthritis, hemolytic anemias, graft rejection, systemic lupus erythematosis, acute glomerulonephritis, subacute bacterial endocarditis and cryoglobulinemia. Elevated complement may be found in acute inflammatory conditions, leukemia, Hodgkin's Disease, sarcoma, and Behcet's Disease.

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)


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Cortisol is increased in Cushing's Disease and decreased in Addison's Disease (adrenal insufficiency). Patient needs to have the specimen collected between 7 a.m.-9 a.m.


Test for myocardial infarction and skeletal muscle damage. Elevated results may be due to: myocarditis, myocardial infarction (heart attack), muscular dystrophy, muscle trauma or excessive exercise

Clinical Significance

Bacterial sepsis constitutes one of the most serious infectious diseases. The detection of microorganisms in a patient's blood has importance in the diagnosis and prognosis of endocarditis, septicemia, or chronic bacteremia.

Includes

Aerobic culture, anaerobic culture. If culture is positive, identification will be performed at an additional charge (CPT code(s): 87076 or 87106 or 87077 or 87140 or 87143 or 87147 or 87149).
Antibiotic susceptibilities are only performed when appropriate (CPT code(s): 87181 or 87184 or 87185 or 87186).


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.

DHEA-S is the sulfated form of DHEA and is the major androgen produced by the adrenal glands. This test is used in the differential diagnosis of hirsute or virilized female patients and for the diagnosis of isolated premature adrenarche and adrenal tumors. About 10% of hirsute women with Polycystic Ovarian Syndrome (PCOS) have elevated DHEA-S but normal levels of other androgens.


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Useful in the diagnosis of hypochromic, microcytic anemias. Decreased in iron deficiency anemia and increased in iron overload.


A Hemoglobin (Hb) A1c Blood Test evaluates the average amount of glucose in the blood. The A1c test will help determine whether you are at a higher risk of developing diabetes; to help diagnose diabetes and prediabetes; to monitor diabetes and to aid in treatment decisions.

To assist with control of blood glucose levels, the American Diabetes Association (ADA) has recommended glycated hemoglobin testing (HbA1c) twice a year for patients with stable glycemia, and quarterly for patients with poor glucose control. Interpretative ranges are based on ADA guidelines.


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

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Immunoglobulin A (IgA)

Test Highlight

 

   

Clinical Use

  • Diagnose IgA deficiencies

  • Determine etiology of recurrent infections

  • Diagnose infection

  • Diagnose inflammation

  • Diagnose IgA monoclonal gammopathy

Clinical Background

IgA is the first line of defense for the majority of infections at mucosal surfaces and consists of 2 subclasses. IgA1 is the dominant subclass, accounting for 80% to 90% of total serum IgA and greater than half of the IgA in secretions such as milk, saliva, and tears. IgA2, on the other hand, is more concentrated in secretions than in blood. IgA2 is more resistant to proteolytic cleavage and may be more functionally active than IgA1.

IgA deficiency is the most prevalent isotype deficiency, occurring in 1/400 to 1/700 individuals. Many patients with IgA deficiency are asymptomatic, while others may develop allergic disease, repeated sinopulmonary or gastroenterologic infections, and/or autoimmune disease. Individuals with complete absence of IgA (<5 mg/dL) may develop autoantibodies to IgA after blood or intravenous immunoglobulin infusions and may experience anaphylaxis on repeat exposure. 

Elevated serum IgA levels are associated with infection, inflammation, or IgA monoclonal gammopathy.

 

Most Popular
For diagnosis and monitoring of diabetes and insulin-secreting tumors.

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.


Lyme disease is transmitted by a tick vector carrying Borrelia burgdorferi. Immunoblot testing qualitatively examines, with high specificity, antibodies in a patient's specimen. Immunoblot testing is appropriate for confirming a detected EIA or IFA test result.


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