X-ray has been the standard procedure to monitor or evaluate the conditions of the patients suffering from joint diseases or rheumatoid arthritis. But over the years the research has shown that rheumatoid arthritis can be detected early with better diagnosing and photographic methods. Ultrasound Imaging of the joint helps in detecting the erosion of the joints in cases of arthris and rheumatism. X-Rays show the bony structure on the other hand ultrasound gives a detail picture of the ligaments, muscles, tendons, cartilages and even nerves, helping in detecting the region from where the pain is originating.

 

When is Ultrasound Joint Testing Ordered

A physician can order a patient to undergo the test when the person is suffering from pain and needs to get a better understanding of the region from where the pain is originating. In cases of arthritis and rheumatism the detection of the erosion is far superior to X-ray and the abnormalities of the region can be seen well in the ultrasound pictures.

What can be Detected with Ultrasound Joint Testing

The testing is used in detecting muscle abnormalities, which can range from tears to swelling up of the soft-tissues. Different types of cartlidges and ligament conditions like the meniscus in the knee. Collection of fluids in the joints, muscles and burase can be detected too as well as the mixed nerves and tendons. Even the erosion of bones due to arthritis and rheumatism can be detected. Tearing or swelling of tendons in the ankles, elbows, knee and wrists are diagnosed with the ultrasound joint imaging.

Benefits of Ultrasound Testing

It is a noninvasive procedure hence painless and does not have any radiation or magnetic field so it can be used on pregnant women, people with metal implants as well as cardiac patients with pacemakers. Ultrasound imaging gives a clear picture of the soft-tissues and tendon structures also since a real-time imaging is used it can be used as a guide for targeted injections. Carpal Tunnel Syndrome can be detected or diagnosed with ultrasound imaging where the swelling of the median tendons and nerves get a clear visibility in the image. Apart from all these the technique also gives the opportunity in comparing the various other joints to that of the one with the swelling or problem.

Many times ultrasound joint testing in rheumatism and arthritis is used in detecting the effectiveness of the treatment that the person is under.

C-reactive protein (CRP) is a protein that appears in the blood, which is produced in the liver. The test results help as an inflammation marker for the body and the level of the protein in the blood rises with the increase of inflammation.

What causes C-reactive protein to rise

 

C-reactive protein can be elevated due to inflammations caused by inflammatory arthritis, burns, various infections, trauma and even some kinds of cancers. Recently it has been discovered that heart disease and atherosclerosis (plaquing of the arteries due to cholesterol) can cause the rise in CRP. Even excessive exercise, pregnancy, overweight, not-so threatening infections and presence of intrauterine device (IUD) can cause the elevation in CRP.

When is C-Reactive Protein Test Ordered 

Doctor can order to undertake a C-reactive protein test when an acute or chronic inflammation poses a threat to the patient or the inflammation is suspected based on the other symptoms. Physicians can prescribe the test to evaluate the condition and the progress of treatment in cases like lupus, rheumatoid arthritis and other auto-immune diseases. Even patients with organ transplants, surgical incisions and burns are asked to take the CRP test to detect inflammations which might be an indicator for other infections.

What Conditions can be Assessed with C-Reactive Protein Test

CRP is a test that can detect the inflammation in the body but cannot give the result on a specific disease, condition or ailments. However, here is a list of conditions that causes inflammation and is helpful in assessing, inflammatory arthritis (rheumatoid arthritis), inflammatory bowel disease, pelvic inflammatory diseases, autoimmune diseases, even cardiovascular and coronary heart disease patients.

How is C-Reactive Protein Test Done

Blood sample is taken from the vein and then the sample is analysed at the laboratory. At times the result can vary from lab to lab and in most cases the measuring of the CRP is done in the traditional way to deduct the rise or presence of the inflammation in the body. But to assess the risk associated with the cardiovascular conditions more sensitive measurement method is used, which is also known as the hsCRP (high sensitive C-reactive protein). Also another point is to be noted that various conditions, which might not be dangerous can even cause inflammation in the body, so often two CRP tests are done within two weeks span to check the level and compare the results to for deduction of the inflammation.

The physical, chemical and microscopic examination of the urine is called urinalysis. Number of various tests can be performed to measure and detect the various compounds and abnormalities in the urine, which can signify other diseases or ailments in the body.

 

Types of Urinalysis

There are many tests that can be performed; here are some of the common tests run on the urine to find out the problems.

  • Colour – The colour of the urine is the basis of this test, where the water content is of the prime concern along with the effects that some medicines that can cause.
  • Clarity – Generally normal urine is clear but the presence of mucus, blood, bacteria, crystals, sperm can make it cloudy.
  • Odor – Urine has a light smell, but some diseases or infection can cause it to have strong odour.
  • Specific Gravity – Kidney passes water with other substances in urine, this test analysis the water content in the urine and the other materials that kidney passes in the urine. The higher the specific gravity, it means the water content is low.
  • pH – pH test is used for measuring the nature of the urine, whether acidic or alkaline. A 7 in pH test means its neutral and a 4 is strongly acidic in nature whereas 9 is very much alkaline. A doctor can advise on how to maintain a balance to prevent kidney stone formation.
  • Protein – Kidney diseases, pregnancy, auto-immune conditions and other aliments can cause protein to be present in urine which is normally not there.
  • Glucose – Kidney ailments, damages or even diabetic patients are likely to have the presence of glucose in urine, which is normally not present in urine and can be found in blood.
  • Nitrites – Urinary tract infections (UTI) are caused due to bacteria and that transforms the urinary nitrates to nitrites.
  • Leukocyte esterase (WBC esterase) – This test shows the presence of leukocyte (white blood cells) in the urine and it generally means the presence of UTI.
  • Ketones – Ketone is the substance that is formed when the body breaks down the energy and it is then passed in the urine, but the presence of large amount of ketones means the person is suffering from some serious ailments of conditions.
  • Microscopic analysis – In this test the urine is taken in a test tube and put in the certrifuge (a special machine) where the tube is spun so that the solid materials would settle down at the bottom. The solid materials are then taken and put on a slide for further testing.

Here is a list of different tests performed under microscopic analysis.

1. Red or white blood cells,

2.Casts,

3. Crystals,

4. Bacteria, parasites, yeast cells, and

5. Squamous cells.

Why Urinalysis

Many diseases or ailments can be detected from urinalysis. Generally these are the primary reasons for which it is done.

  • Regular medical evaluation – A yearly or a regular check up for an assessment of the health or before surgery is done where the condition of the kidney and other diseases are checked with the urinalysis.
  • For Particular symptoms – A doctor can ask an individual to undergo urinalysis so that a particular condition or problem can be detected from the symptoms.
  • Diagnosing a medical ailment – Some chronic medical ailments or conditions can be detected from this test.
  • Monitoring the progression of a therapy – At times a doctor advises urinalysis within a short  or a particular time span to check the progression or the responses the patient has to the therapy to the ailments.

How to prepare

This test need the attention and the awareness in the technical aspect of the patient as the urine sample is to be collected by the individual. So listen to the advice the lab authorities give regarding collection of the sample.

Hematocrit is the volume of the presence of red blood cells in the blood and it is measured in percentage. The hematocrit (Hct) test evaluates the percentage of the red blood cells in the blood and the doctor can deduce the kind of disease or condition a person is suffering from the result of the test.

How is the Hematocrit Test Done

 

Blood is taken as sample from the person and is put in a test tube with is then attached to a device called centrifuge in the lab. The centrifuge spins the test tube at very high speed, which separates the blood into the plasma (fluid component), the red blood cells and other blood cells. From there the proportion of the red blood cell percentage is calculated.

When is Hematocrit Test Ordered

A physician generally orders Hematocrit Test to have the complete blood count (CBC) and often it is done at regular intervals to monitor as well as diagnose various conditions like anemia and polycythemia even recovery rate from dehydration. At times while treating a patient suffering from anemia or to check the severity of ongoing bleeding are asked to have the hematocrit test.                                                                                       In the case of rheumatoid arthritis patients, the hematocrit has a different percentage than that of normal as the ailment is an autoimmune disease, affecting the blood too.

Understanding the Hematocrit Test Result

Normal Hematocrit percentage differs according to the sex, males: 40.7% – 50.3%, and the female: 36.1% – 44.3%.

Low hematocrit – People who suffer from low hematocrit percentage are anemic in nature. There can be several reasons for anemia and it can range from nutrition deficiency (folate, vitamin B12, iron), internal bleeding due to some surgery, traumatic injury, bleeding colon cancer, bone marrow problems, kidney failure, result of suppression by chemotherapy and even sickle cell anemia or even overhydration.

High hematocrit – Normally a person living in high altitude will have high hematocrit percentage due to the less oxygen available at heights, even people suffering from dehydration will show high test result, but if the latter is given proper fluid hematocrit will come down to normal. Patients suffering from conditions or ailments like erthyrocytosis, congenial heart disease, rheumatoid arthritis, pulmonary fibrosis, cor pulmonale, polycythemia vera and hypoxia (low blood oxygen level) will show high percentage in hematocrit test.

Note

Often during pregnancy there is a slight decrease in the hematocrit value because of the presence of extra fluid in the pregnant person’s blood.

Erythrocyte Sedimentation Rate (ESR) Test is also known as the Sedimentation Rate (SER) Test, which is used to calculate the speed of the sedimentation of the red blood cell (erythrocytes or RBCs) within a span of an hour. In the test anticoagulated blood is used to see and measure the rate at which the plasma of the blood separates itself and the red blood cells settle in the bottom in a tube.

 

When in ESR Test Ordered

A doctor orders the patient to have the ESR test done when he suspects that some kind of disease or condition is causing the patient inflammation in the body. ESR test is used to detect quite a few inflammatory conditions.  It is difficult to detect the exact location of the inflammation so ESR test is done in conjecture with other tests. At times a doctor may ask the patient to repeat the ESR test several times over a particular span of time to monitor the course or the development of the inflammation caused by a condition or ailment.

Ailments Detected by ESR Test

Three main inflammatory diseases can be detected by ESR tests, Giant Cell arteritis, Rheumatoid arthritis, and Polymyalgia rheumatic. Apart from these other diseases that cause chronic or acute inflammation can be detected, like cancers, autoimmune diseases and other chronic or recurrent infections.

Understanding ESR Test Results

The sedimentation rate will vary with age, sex and at times even with labs. ESR is measured in millimeters per hour and a normal result doesn’t always mean that the person is not suffering from any inflammatory disease. On the other hand a not-normal result does not signify any specific ailment, the test result should be studied with the patient’s other medical results, conditions and history.

Greater than normal result – When the ESR Test indicates greater than normal value, it is caused due to inflammation which can happen due to autoimmune diseases like rheumatoid arthritis, few types of cancer, or infections. In this greater than normal result the red blood cells settle to the bottom of the tube faster than in normal cases.

Lower than normal result – There are cases where the ESR test result might be lower than normal, in such cases it can be due to the diseases such as sickle cell anemia, congestive heart failure and polycythemia, which is a condition where the person has higher number of red blood cells circulating.

It is important to know what rheumatoid factor is, before learning about its test. Rheumatoid factor is an antibody that is generally not present in the blood. Antibodies are found in blood and are normal protein important in the functioning of the immune system. In the cases where rheumatoid factor is measured in the blood, as an antibody it attaches or binds itself to other antibodies.

 

Rheumatoid Factor Test

It is a blood test ordered by the doctors to diagnose rheumatoid arthritis. It helps in distinguishing rheumatoid arthritis from the other forms of arthritis or any other diseases or conditions that might have similar symptoms to that of rheumatoid arthritis. As the rheumatoid arthritis is a connective tissue condition or disorder many times the signs and the symptoms of the patient cannot be readily identified, in such cases rheumatoid factor (RF) test is an important tool in diagnosis.

It is estimated that about 80% of the adult have rheumatoid factor present in their blood but very few children suffer from rheumatoid arthritis.

When to have Rheumatoid Factor Test

Doctor orders the patient to have the rheumatoid factor test done when there are rheumatoid arthritis symptoms like swelling, warmth, stiffness and pain in the joints. Also forming of nodules under the skin, and when an X-ray is done which shows the loss of bone and cartiledge and also swelling of the joint capsules.

Presence of Rheumatoid Factor

It is not only patients with rheumatoid arthritis in whose blood the rheumatoid factor can be found, people suffering from other conditions can show traces of rheumatoid factor too. People suffering from infectious disease like hepatitis, tuberculosis, infectious mononucleosis, syphilis will have the rheumatoid factor present in their blood. Patients with connective tissue diseases like systemic lupus erythematosus will have positive in the rheumatoid factor test. At times people without any of these diseases can test positive and it is likely to happen who have a family history of rheumatoid arthritis.

At times even after tests the rheumatoid factor can be negative or very low in a patient, often it happens that with age the test value increases.

Significance of Rheumatoid Factor in Rheumatoid Arthritis

People who are diagnosed with high level of rheumatoid factor are generally associated with chronic rheumatoid diseases. It can also be an indication that the person is likely to develop other kinds of rheumatoid diseases that are non-joint ailments like rheumatoid lung disease or rheumatoid nodules.

Muscle metabolism generates a chemical waste molecule known as the creatinine. It is produced from creatine, which is the most important molecule in the production of energy in muscles. Everyday about 2% of the creatine is converted into creatinine and it flows from the blood to the kidney which is then filtered and most of the creatinine is disposed with urine.

 

Why Creatinine Test

In diagnosing the proper function of the kidney creatinine test is very important. In spite of being a waste it has become a reliable factor in determining the functioning of the kidney. Rise of the creatinine level is a clear indicator that the kidneys are in the verge of malfunctioning. At times even before the patient reports the symptoms of the kidney problems there can be raise in the creatinine levels and the test will help the doctor to medicate and treat the patient accordingly.

Creatine and Arthritis

Since creatine is one of the primary chemicals that enhance the muscle movement and the exercising power, people suffering from rheumatoid arthritis patients are recommended to take it for improving their muscle movements. Even patients with bipolar disorder, depression, congestive heart failure, high cholesterol, and nerve and muscle diseases are given creatine supplements to increase the function of the muscles.

Creatine Supplement and Side-effects

It is said that people having asthmatic symptoms or with allergies are warned not to have creatine supplements. Apart from affecting the heat tolerance and the hydration capacity of a person often leading to muscle cramp, diarrhea, it is said that there is a chance of damaging the kidney of a person.

Creatinine Test and Arthritis

In most cases it is the rheumatoid arthritis that can be detected with a creatinine test. There is generally a lowering of the creatinine level in the case of rheumatoid arthritis, but at times the creatine supplements might damage the kidney or liver and the test will help the doctor to work accordingly. Generally the presence of protein in the urine is the indicator of problem of the kidney. The doctor can monitor it and investigate the reason behind the presence of creatinine, whether it is due to medication or infection or disease and treat the patient accordingly.

Normal Creatinine Level

The normal range of creatinine that should be present is approximately 0.6 to 1.2 milligram per deciliter in blood.

Symptoms of high Creatinine Level

The person may feel dehydrated, shortness of breath, fatigue and also confusion with other uncertain and nonspecific symptoms.

Complement Protein Test is also known as the C-Reactive Protein (CPR) Test that measures a special type of protein concentration in the blood serum. This protein is produced by the liver and is present when there is acute infection or inflammation in the body. The CPR is important in the immunologic defense mechanism by interacting with the complement system.

 

Types of Complement Protein Test Works           

There are two categories under which the Complement Protein Test or CPR is used to determine the abnormality or deficiency in the complement system that is the cause of the disease in the patient. They are Complement Component 3 (C3) and Complement Component 4 (C4).

Ailments Diagnosed

Complement Protein Test are used by the doctors to diagnose inflammation, angioedema or chronic microbial infections. Apart from these it is also used for testing and monitoring immune complex-related ailments such as rheumatoid arthritis, serum sickness, glomerulonephritis (a kidney disorder) and visculitis. Autoimmune diseases that are chronic or acute like systemic lupus erythematosus (SLE) can also be diagnosed with CPR Test. In the case of the diseases the complement levels drop or get cleared from the blood as the immune complexes form.

When is Complement Protein Test Ordered

A person suffering from unexplained inflammation or having the symptoms of autoimmune disorder can be asked to take the test. Also a doctor can ask to get the test done if he suspects a patient suffering from some kind of immune complex-related disease and needs to check the complement system of the person. Generally C3 and C4 tests are ordered together as it is important to find out the relative levels. The Complement Protein Testing gives the doctor an idea about the severity of the disease by the decrease of the complement levels.

Deducting the Complement Protein Result

There can be increase or decrease in the complement protein level, if there is a decrease in the level due to hereditary cause, the individual is them prone to recurrent microbial infection. Decrease in the Complement Protein can also be linked with development of autoimmune diseases.  The increase in the complement protein generally can be seen during chronic or acute inflammation. In both the cases complement protein can return to normal when the cause of the abnormality is treated.

­Arthritis and Complement Protein Test

The test is used mainly for rheumatic arthritis, where there is inflammation and eventual degeneration too. Doctor uses this test to monitor the flare-up of the disease as well as to evaluate the success of a particular treatment on the arthritic patient.

Anti-nuclear antibody or ANA autoantibodies that damage the cell nucleus and are mostly present in autoimmune diseases. To understand ANA one needs to know the difference between Antibody and Autoantibodies.

Antibodies: Present in white blood cells and are proteins work against the foreign properties like toxins, viruses and bacteria

Autoantibodies: They do not prevent the body from the foreign properties but instead attacks the host cells.

 

What does Anti-Nuclear Antibodies do

Anti-nuclear are autoantibodies and can form a certain binding structure and then attack or destroy the nucleus of the cell. Nucleus is the cell’s innermost core containing the DNA, which is the genetic material. The damaging of the nucleus can result in the cells working against its own immune system also known as autoimmunity. Generally ANA is found in patients whose immune system is predisposed to causing inflammation and there is an abnormal production of the autoantibodies.

Autoimmune Diseases

In most cases the autoimmune diseases have inflammation of the tissues on various parts of the body. Patients who are likely to suffer from ANA are rheumatoid arthritis, systemic lupus erythematosus, juvenile diabetes mellitus, vitiligo, Sjogren’s syndrome, scleroderma, Addison disease, pulmonary fibrosis and even in cancer.

ANA(Anti-Nuclear Antibody) Test

ANA test is also known as the FANA (Fluorescent antinuclear antibody) test, where a blood sample is take from the patient and send for testing to the lab. The serum from the patient’s blood is drawn and added on the microscope slides that has artificially prepared cells on the surface of the slides. If the patient is having ANA the serum binds to the cell of the slide.

In the Fluorescence technique the serum is tagged with a fluorescent dye and then put on the slides where there are commercially prepared cells too. The serum gets attached to the serum if they contain ANA and when the slides are viewed under the microscope the antinuclear antibodies can be seen as the fluorescent cells.

In the test if the fluorescent cells can be seen, the ANA test is called positive, whereas in case of the absence of the fluorescent cells the ANA test is said to be negative.

ANA Statistics

It is the Systemic Lupus erythematosus that scores the presence of ANA to over 95%, Progressive Systemic sclerosis has it from 60 to 90%. Rheumatoid Arthritis has about 25 to 30% of the ANA.

What after ANA Test is positive

There are various ways of treating the aliments but in many cases like rheumatoid arthritis, full cure is not possible. It can range from physiotherapy to drugs to wax pack, depending on the patient’s condition. At times removal or fusion of joints is also one of the procedures to give better stability to the patient.

Computerized tomography scan, commonly known as CT scan is a medical imaging method used to see a section of the human body in minute details. CT scan is more effective in diagnosing the ailment than an X-ray as its imaging is so powerful that it can reveal the soft-tissue and making the required area 100 times more clear than conventional X-ray.

Ailments Diagnosed by CT Scan 

It can be used for determining various conditions, ranging from head injury, tumor, and fractures, other traumatic injuries like skull fracture or blood clots and even infections. In arthritis also CT scan is used, but primarily in osteoporosis, the non-inflammatory degenerating arthritis. The bone density of the joints that are hurting can be measured accurately with this technique.

Why CT Scan

When an ailment or an injury is hard to detect even in an X-ray, doctors order for CT scan. But apart from providing accurate and detailed image of the ailment or injury CT scan is painless. It also helps the radiologist in finding the exact positions from where to draw a fluid from the joints to run various tests in case of arthritis, biopsies for cancer and eventually decreasing the chances of elaborate surgeries where minimal invasive procedures can be done.

Risks of CT Scan

Computerized Tomography Scan (CT scan) does not pose much risk to the patient; however, there is an allergic reaction that a patient can suffer. In CT scan an intravenous contrast liquid is injected, which is iodine based. This liquid helps in making organs like kidney, liver, and other body structures and blood vessels more visible to the scan. Some patients might get rashes, hives or itching and at times a feeling of warmth running through the body. In most cases they are self-limiting, but in rare occasions anaphylactic allergy may occur. The patient will suffer from severe hives and might have difficulty in breathing, if not treated immediately it can be life threatening. People with kidney problems can suffer from toxicity of kidney and result in kidney failure. But such cases are rare and new intravenous drugs are being developed that eliminates such complications.