Arthritis

Last updated: Thursday, 11, November, 2010
CausesAppropriate 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.

Rheumatoid arthritis

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

  • Ankylosing spondylitis 

Rheumatoid factor-negative spondylo-arthropathies associated with HLA-B27.

  • Reactive arthritis

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.

  • Psoriatic arthritis

Lyme disease

Borrelia burgdorferi antibodies

Rheumatic fever

Immunodeficiency

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

  • Ankylosing spondylitis
  • Psoriatic arthritis

Rheumatoid arthritis

Septic arthritis

  • Pyogenic arthritis 

Synovial fluid examination must be performed; blood culture should also be performed.

Chronic haemophilic arthropathy  

Haemarthrosis  

See Haemophilia A and B.

  • Trauma
  • Haemophilia

Joint aspiration is rarely necessary and must not be performed without prior consultation with a Haemophilia Treatment Centre.