Arthritis Checkup

The ESR (Erythrocyte Sedimentation Rate) test measures how fast red blood cells (erythrocytes) settle in a tube over one hour.

When your body is inflamed, certain proteins, mainly fibrinogen, increase in the blood. These proteins cause the red blood cells to stick together in stacks. These stacks settle faster, leading to a higher ESR.

The ESR test shows that inflammation is present. However, it cannot tell you exactly where the inflammation is or what is causing it. That’s why doctors usually do this test along with other tests. This helps them understand and treat your health problems.

A CBC (Complete Blood Count) test evaluates red blood cells (RBCs), white blood cells (WBCs}, and platelets. Each of these blood cells performs essential functions–RBCs carry oxygen from your lungs to the various body parts, WBCs help fight infections and other diseases, and platelets help your blood to clot–so determining their levels can provide significant health information. A CBC test also determines the hemoglobin level, a protein in RBC that carries oxygen from the lungs to the rest of your body. Evaluating all these components together can provide important information about your overall health.

The Rheumatoid Factor - Quantitative test detects and measures the concentration of rheumatoid factor (RF), an antibody produced by the immune system, in your blood. Increased levels of rheumatoid factor can be detected in the blood in certain autoimmune conditions, particularly rheumatoid arthritis. However, an RF test is not very specific as a rheumatoid factor can also be found in the body in diseases other than RA, such as Sjögren’s syndrome and systemic lupus erythematosus (SLE). RF may also be produced in the body during persistent bacterial and viral infections. Hence, clinical evaluation and other diagnostic tests are crucial for a comprehensive assessment and accurate diagnosis.

The Uric acid test measures the levels of uric acid in the blood. Uric acid is a nitrogenous compound produced by the metabolic breakdown of purine. Purines are nitrogenous bases in DNA forming parts of the structural framework of the cells. Breakdown of purines occurs when cells become old and die, forming uric acid. Uric acid is also formed from the metabolic breakdown of some types of food like red meat, seafood, beans, etc.

Most of the uric acid in the blood is filtered and eliminated by the kidneys and a small remaining amount in the stool. The concentration of uric acid in the blood can increase due to overproduction of uric acid or improper elimination of uric acid, and this condition is called Hyperuricemia. Hyperuricemia can also be caused due to cancer treatment by chemotherapy or radiotherapy. These treatment methods kill the cancer cells, which may leak the uric acid into the blood.

Excess uric acid can form crystals in the synovial fluid between the joints causing inflammation and pain. This condition is called gout and can severely damage the joints if left untreated. The Uric Acid Test can indicate the presence of gout, or risk of formation of gout. However, it is not a definitive test for gout. Confirmatory test for gout is performed by analysis of synovial fluid (joint fluid) for monosodium urate crystals. Chronic Hyperuricemia can cause the formation of tophi, which are hard lumpy deposits of uric acid crystals formed under the skin, in the joints, and at the top of the ears. Tophi cause severe damage to the joints and may compress nerves causing chronic pain and disfigurement. The excess uric acid may also deposit and crystallize in the kidneys causing kidney stones and acute renal failure.

The ASO Titer Test detects and measures the level of ASO in blood to determine the presence of an infection by Group A Streptococcus bacteria. Streptococcus pyogenes or Group A Streptococcus is a bacteria which causes a number of infections like throat infections, skin infections like pyoderma, etc. These infections are easily recognizable and treated with the help of antibiotics. However, if the Streptococcus infection is left untreated or is treated improperly, it may lead to complications like rheumatic fever, glomerulonephritis, scarlet fever, heart and kidney damage, joint inflammation, swelling, etc.

Symptoms caused by an infection of Group A Streptococcus bacteria are caused mainly due to a toxin called Streptolysin O which is secreted by these bacteria. The body produces antibodies against Streptolysin O called Antistreptolysin O (ASO). Production of ASO antibodies by the body can begin anytime from a week to a month after an infection. Levels peak after about 3 to 5 weeks after the condition develops, after which they slowly taper off as the condition resolves. Increase in ASO levels is greater in case of throat infections than in skin infections.