There are more than 100 types of arthritis. Some show up on an x-ray
while others may not. For example, osteoarthritis is usually easy to see
on an x-ray. But arthritis due to lupus may not appear.
some other difficulties with x-rays. Joint damage due to a bacterial
infection may take a week or more to appear on an x-ray. It may take
three or more months for damage related to rheumatoid arthritis to be
seen on an x-ray. Arthritis missed by x-rays may show up on an MRI and a
A number of other tests can be helpful in the diagnosis
of arthritis. But keep in mind that in many cases, no testing is needed
to confirm the diagnosis or identify a cause. A careful review of a
patient's symptoms and thorough examination may be all that's needed.
testing is needed, the most useful test depends on which type of
arthritis is suspected. For example, commonly used tests for arthritis
- Measures of inflammation
tests for erythrocyte sedimentation rate and C-reactive protein help
predict the presence of a systemic (body-wide) inflammatory disease as
the cause of arthritis. For example, an elevated level of one or both of
these tests is common in rheumatoid arthritis or lupus. Normal values
are typical of osteoarthritis.
- Autoantibody tests
factor and anti-cyclic citrullinated protein are often present in the
blood of people with rheumatoid arthritis while anti-nuclear antibodies
are highly associated with lupus or related conditions.
- Uric acid levels
An elevated blood uric acid level increases that chances (though it does not prove) that gout is the cause of arthritis.
- Joint fluid analysis
the cause of arthritis is not certain, joint fluid may be removed and
tested for look for infection or crystals (such as gout or calcium
crystals). A high white-blood cell count in the joint fluid can also
provide information about how much inflammation is present.
- Antibody tests for infection
levels of specific antibodies for viral infections (such as hepatitis
B, hepatitis C, or parvovirus) or Lyme disease can be useful when these
conditions are suspected.
- Genetic testing
testing for the genetic marker HLA-B27 may be needed when ankylosing
spondylitis is suspected. Approximately 95% of people with this form of
spinal arthritis carry this genetic variant.
cases where the cause of arthritis is uncertain despite extensive
evaluation, surgically removing a small sample of joint tissue can be
quite useful. This is especially true when an infection, such as
tuberculosis, is a concern.
And this is only a partial list!
of these tests are perfect. Some people with arthritis have normal test
results and some people without arthritis have abnormal results. This
can make it challenging to interpret test results. So, if you and your
doctor are concerned that you may have arthritis, the best approach is
to review your symptoms and examination findings in detail and then, if
necessary, have only the tests that are most accurate for the conditions
that seem mostly likely.
Copyright 10/27/2010 Harvard University. All rights reserved. HHP/HMS content licensing handled by Belvoir Media Group.
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