By Ethan Armitage
The first step in examination focuses on the articulations. Then, because of the large variety of organs attacked by rheumatic disease such as lupus, a complete exam is required, and it may be followed by a series of tests using blood, urine and synovial fluid samples.
The most frequent tests and procedures are:
* - Antinuclear antibody (ANA), which verifies the level of antibodies present inside the blood of persons affected by connective tissues disorders or auto immune disorders. Antibodies use as a reactive the material contained in the nucleus of a cell. There are ANAs tests adapted to its individual types, but they may also be found in healthy peoples.
* - Complement is a test t hat measures the level of the homonymous proteins inside the blood. The role of these proteins is to annihilate external substances like germs. In case of lupus, the blood level of complements is much lower than normally.
* - C – reactive protein tests are not specific. They are effective in detecting the inflammation at generalized level. In case of active diseases, the proteins reach higher levels and they are decreased by means of NSAIDs.
* - Erythrocyte sedimentation rate detects inflammation inside the body. In case of inflammation, the sed rates are increased and they point to several typical forms of arthritis and to connective tissue disorders.
* - Creatinine is used to monitor the kidneys health in case of arthritis such as lupus. The creatinine is derived from creatine, an important substance inside the muscle which is eliminated through the kidneys. A normal level of creatine indicates a proper activity of the kidneys.
* - Hematocrit tests hemoglobin and a number of blood cells. A lower number of the red blood cells indicate inflammatory arthritis or rheumatic conditions.
* - Complete blood count (CBC) indicates the number of leukocytes, platelets and red blood cells. In case of rheumatic conditions or some medicines for arthritis, leucopenia, anemia and thrombocytopenia occur.
* - Synovial fluid examination includes a leukocytes search, because they only appear there in case of arthritis or other inflammations or infections. Viruses, bacteria or crystals are also searched for to identify a possible gout or infectious arthritis. A sample of that fluid is taken by means of a syringe that introduces a local anesthetic and extracts the specimen.
* - Urinalysis includes the search for proteins, leukocytes, red blood cells or bacteria inside the urine. The presence of bacteria indicates problems of the kidneys and so the suspicion for lupus or other rheumatic disorders. some medicines for arthritis may alter the purity of urine.
* - Rheumatoid factor test shows whether a rheumatoid factor is present. This factor is an anti body present in case of RA but also of many kinds of disorders.
* - Leukocytes count indicates the number of white blood cells in the blood. A higher number indicates an infection and a decrease may be the result of lupus or particular medications.
* - X – rays are used to see the aspect of the articulations on the inside, of the bones, but they ignore muscles, ligaments and cartilage. Other imaging tests are computed tomography scan, magnetic resonance imaging and arthrography.
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