Arthritis workup
Posted by dkwinter


  • Joint distribution
  • Inflammation
  • Extra inflammatory features



  • Anatomic site(s), activity vs damage


"Make up your mind after H&P, use labs to confirm your diagnosis"



  • "Innocent bystanders"
    • RF
    • ANA (if positive once don't reorder)
    • Most extractable nuclear antigens
  • Pathogenic
    • dsDNA
    • ANCA
    • Anti-Ro


  • MRI: "STIR sequence" if investigating spondylitis


When to refer to rheumatology

  • Patients with chronic back pain (if considering ankylosing spondylitis)
    • >3 months of continuous pain/stiffness
    • Onset of symptoms less than 45 years
    • Abnormal imaging of SI joints or HLA-B27 or EAF
  • Refractory gout