Joint pain due to Arthritis


Joint pain is quite common these days and most of us learn to live with it. Unless the pain progresses to a level that it becomes unbearable, people avoid visiting a doctor and getting themselves diagnosed.

This can lead to severe consequences, if your joint pain is due to a serious condition like arthritis. This is usually a common reason why people suffer from joint pain. ‘There are different forms of arthritis and the most common one is osteoarthritis which is prevalent mainly in adults over the age of 60 years,’ says Dr Abha Shroff, chief pathologist and director at Disha Pathology Labs, Mumbai. Osteoarthritis is a condition in which the cartilaginous lining of the bones is slowly lost leading severe joint pain. With early diagnosis you can treat the condition well.

According to Dr Shroff diagnosis of the type of arthritis is done clinically and the diagnostic tests are used in conjunction with its clinical findings. She briefly explains the baseline diagnostic tests used for diagnosis of arthritis:

1. Complete Blood Count (CBC): Apart from checking your RBC and hemoglobin and platelets, a CBC also checks for white blood cell, which suggests whether you’re suffering from any kind of inflammation. A count higher that 4,000 to 11,000 is indicative of inflammation, which may be because of rheumatoid arthritis (RA). But WBC count alo increases in other conditions like infections and stress. A lower hematocrit, the percentage of total blood volume made up of red cells, can also indicate RA.

2. Erythrocyte sedimentation rate (ESR) test: The test involves determination of the rate at which red blood cells (RBCs) can settle down in an hour. A person who has arthritis will also have some proteins in the blood which causes the RBCs to aggregate and form a clump allowing them to settle much faster than healthy blood cells. But this test can give a false positive result hence cannot alone be used to confirm arthritis.

3. R A Factor: R A factor or rheumatoid factor is a specific antibody that immune cells of the patients with rheumatoid arthritis produce. About 80 percent of patients with rheumatoid arthritis will have this antibody in their blood. But RF test can be positive in other infectious diseases as well.

4. Test for Uric Acid: This test is used to diagnose gout, a form of inflammatory arthritis that is caused due to increased levels of uric acid.

5. C Reactive Protein (Quantitative): C-reactive protein (CRP) is a protein that your liver will produce in response to inflammation. So, if you have arthritis, your CRP levels are likely to be high.

6. Anti Nuclear Antibody test: Patients with autoimmune diseases like arthritis have antibodies that are specific to nucleus of the cells they affect. These antibodies are called antinuclear antibodies, are can be easily detected in patient’s blood serum.

7. Blood creatinine test: Creatinie is a waste product generated by your muscle cells and eliminated by the kidneys. In some forms of arthritis the kidney function may get affected and lead to an increase in the blood creatinine level.

The cost of entire arthritis profiling that involves all the above tests is approximately Rs 1900 at good labs with adequate quality control processes in place,’ says Dr Shroff.

Are there any advanced tests for diagnosis of arthritis?

‘Anti-CCP, which stands for anti-cyclic citrullinated peptide antibody, is a new and exciting blood test to help doctors confirm a diagnosis of rheumatoid arthritis. Anti-CCP is a very useful test for a person suspected with rheumatoid arthritis. If present in such a patient at a moderate to high level, it not only confirms the diagnosis but also may indicate that the patient is at increased risk for damage to the joints. (Low levels of this antibody are less significant,’ say Dr Shroff.