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🌱 來自: rheumatoid arthritis

laboratory and radiologic studies of rheumatoid arthritis

• RF (IgM/IgA/IgG anti-IgGAb) positive in ~70%;
  • also seen in other rheumatic diseases
    • (SLE, Sjögren’s),
    • cryoglobulinemia,
    • infection (SBE, hepatitis, TB),
    • ~5% of healthy population.
• Anti-CCP (Ab to cyclic citrullinated peptide) positive in ~70% of patients with RA,
  • similar sensitivity but higher specificity (>90%) than RF,
  • particularly for early RA;
  • associated with increased joint damage and low remission rates (Arth Rheum 2009;61:1472).
• Approximately 20% of patients are seronegative (RF and anti-CCP negative).
• Increased ESR/CRP but normal in ~30%; positive ANA in ~40%; increased globulin levels during periods of active disease.
• Radiographs of hands and wrists show
  • periarticular osteopenia,
  • bone erosions, and
  • joint subluxation.
• Increasing use of MSK U/S (musculoskeletal ultrasound) to diagnose
  • synovitis,
  • tenosynovitis, and
  • erosive disease.