Laboratory and imaging studies used by French rheumatologists to evaluate patients with early arthritis.

Abstract

OBJECTIVE:

To conduct a practice survey of laboratory and imaging studies used by French rheumatologists to identify the cause of recent-onset arthritis.

METHODS:

We selected a random sample of 210 rheumatologists, who were asked to recruit all patients with recent-onset arthritis (at least one joint involved, for less than one year) during a 2 week period, and to record laboratory and imaging studies performed. Results were analyzed in the overall group, in diagnostic subgroups, and in clinical presentation subgroups.

RESULTS:

The 119 rheumatologists who participated recruited 104 patients. Investigations done in 50% to 75% of patients were blood cell counts; erythrocyte sedimentation rate; serum assays of C-reactive protein, rheumatoid factors, antinuclear antibodies; and hand radiographs. Investigations in 50% to 74% of patients were serum ASAT/ALAT, creatinine, and uric acid; and foot radiographs. Finally, 25% to 49% of patients were tested for proteinuria; antikeratin antibodies; hepatitis B, hepatitis C, and Lyme serologies; creatine phosphokinase; blood iron; HLA-B27; and radiographs of chest and pelvis. No differences were found between investigations in patients with suspected rheumatoid arthritis and/or undifferentiated arthritis and those in other patients. In contrast, suspected diagnoses and presence of extraarticular manifestations classically associated with specific diseases modified the selection of investigations.

CONCLUSION:

Although considerable variability occurred, our study suggests that a limited panel of laboratory and imaging studies is performed in at least 25% of patients with recent-onset arthritis, regardless of clues suggesting a specific diagnosis.

• Authors: Alain Saraux, Bruno Fautrel, Jean Francis Maillefert, René Marc Flipo, Olivier Kaye, Pierre Lafforgue, Katell Gourves, Francis Guillemin, Club Rheumatism and Inflammation
• Journal: The Journal of rheumatology (J Rheumatol) Vol. 33 Issue 5 Pg. 897-902 (May 2006) ISSN: 0315-162X [Print] Canada
• PMID: 16583465 (Publication Type: Journal Article)

Chemical References

• Antibodies, Antinuclear
• HLA-B27 Antigen
• C-Reactive Protein
• Rheumatoid Factor

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antibodies, Antinuclear (blood)
• Arthritis (blood, diagnosis, diagnostic imaging, physiopathology)
• Blood Cell Count
• Blood Sedimentation
• C-Reactive Protein (analysis)
• Diagnostic Imaging (statistics & numerical data)
• Early Diagnosis
• Female
• Foot (diagnostic imaging)
• HLA-B27 Antigen (blood)
• Hand (diagnostic imaging)
• Health Care Surveys
• Hepatitis (diagnosis)
• Humans
• Male
• Middle Aged
• Practice Patterns, Physicians' (statistics & numerical data)
• Proteinuria (diagnosis)
• Radiography
• Rheumatoid Factor (blood)