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Laboratory Aspects of RA

- Rheumatoid Factor:
    - present in most RA patients (80% of affected pts);
    - associated w/ increased morbidity;

- Anti-CCP antibodies: (anti-cyclic citrullinated peptide)
       - serological marker that is highly sensitive and specific for dx of early RA
       - associated with bone erosions of RA

- Synovial Fluid:
    - analysis of synovial fluid is extremely useful in distinguishing early RA from non-inflammatory and infectious arthritides;
    - joint fluid from patients w/ RA is sterile & has pleocytosis (usually PMN), incr protein, & decreased viscosity &
            decreased complement;
    - viscosity: expect decreased viscosity and poor mucin clot formation;

- ESR:
    - active RA dz is frequently accompanied by an elevated ESR;
    - although sed rate is elevated in majority of patients who have RA, normal rate does not exclude that diagnosis;
    - for most pts, this test is good indicator of response to medical therapy and the activity of the disease;

- C Reactive Protein

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