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Polyarticular Joint Pain - Lab findings & Conditions

  • February 20,2021
  • 5 Min Read
Polyarticular Joint Pain - Lab findings & Conditions

This list is to be viewed only in the context of evaluation of patients with polyarticular joint pain. 

 

Laboratory or Imaging Tests 

Condition(s)

 

Complete Blood Count (CBC) 

 

Anemia 

Many inflammatory arthritides, especially SLE, RA, IBD and human parvovirus B19 infection 

Polycythemia 

Myeloproliferative disorder 

Thrombocytopenia 

SLE, human parvovirus B19 infection 

Thrombocytosis 

Acute-phase reaction, vasculitis, infection 

Leukopenia 

SLE, RA, Felty's syndrome, Sjogren's syndrome, human parvovirus B19 infection Leukocytosis RA, vasculitis, reactive arthritis, infection

Absolute Lymphocytosis 

CLPD (polyarthritis can be one of the components of clinical manifestation) 

Eosinophilia 

SLE, RA, IBD, sarcoidosis, dermatomyositis, scleroderma, Churg-Strauss syndrome, PAN, eosinophilic fasciitis, cholesterol emboli 

Chest X-Ray 

  • Infiltrates or Nodules
  • Serositis
  • Upper Lobe Fibrosis 
  • RA, sarcoidosis, Wegener's granulomatosis, Churg-Strauss syndrome 
  • SLE, RA 
  • Ankylosing spondylitis

Diffuse Fibrosis 

RA, Scleroderma, Polymyositis 

Joint Aspiration 

Growth on culture 

Infection 

Crystals 

Gout, Pseudogout 

WBC Count 

>2000/mm3 — Inflammation 

> 50000/mm3 — Probable infection 

Urinalysis 

Hematuria

SLE, Wegener's granulomatosis, PAN 

Pyuria 

Reactive polyarthritis (due to UTI) 

Proteinuria 

SLE; Wegener's granulomatosis, amyloidosis 

ECG 

Atrioventricular Block

Lyme disease, neonatal lupus, ankylosing spondylitis 

APTT/Lupus anticoagulant/APLA 

Prolonged/Present 

SLE, APLA Syndrome 

Rheumatoid Factor 

RA, SLE, Sjogren's syndrome, sarcoidosis, reactive arthritis, PMR, polymyositis, psoriatic arthritis, endocarditis, chronic infections, cancer, chronic liver disease, many nonrheumatic causes 

Anti-CCP Antibody 

RA 

Inflammatory markers 

Infection, most inflammatory arthritides, advanced age, PMR, giant cell arteritis, cancer, anemia, pregnancy; menses 

Antinuclear Antibody 

SLE, RA, scleroderma, Sjogren's syndrome, vasculitis, polymyositis, medications, many nonrheumatic causes

Elevated SGOT/SGPT 

SLE, PAN, sarcoidosis, hemochromatosis, Sjogren's syndrome, infectious hepatitis, polymyositis 

Elevated ALP 

Bone metastases, Paget's disease, osteomalacia, PMR, ankylosing spondylitis, hyperparathyroidism 

Elevated LDH 

Autoimmune hemolytic anemia, myositis 

 

dsDNA

SLE, especially lupus nephritis 

Anti SS-A/Ro, Anti SS-B/La 

Sjogren's syndrome, SLE 

HLA-B27 

Spondyloarthropathies, reactive arthritis

Elevated Uric Acid 

Gout, psoriatic arthritis, Paget's disease 

False-Positive VDRL 

SLE, APLA Syndrome 

c-ANCA 

Wegener's granulomatosis 

Elevated Creatinine 

SLE, Wegener's granulomatosis, vasculitis 

Elevated Creatine Kinase (CPK) 

Polymyositis, dermatomyositis, hypothyroidism 

Elevated Calcium 

Hyperparathyroidism, cancer, sarcoidosis 

 

RA: Rheumatoid Arthritis, SLE: Systemic Lupus Erythematosus, IBD: Inflammatory Bowel Disease, CLPD: Chronic Lymphoproliferative Disease, PAN: Polyarteritis Nodosa, UTI: Urinary Tract Infection, APLA: Anti Phospholipid Antibody

References:

  1. Alpay-Kanitez N, celik S, Bes C. Polyarthritis and its differential diagnosis. Eur J Rheumatol. 2019 Nov 11;6(4):167-73.
  2. Mies Richie A, Francis ML. Diagnostic approach to polyarticular joint pain. Am Fam Physician. 2003 Sep 15;68(6)1151-60.
 

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