Full Blood Count (FBC) |
- Infection & haematological disorders e.g. anaemia |
Erythrocyte Sedimentation Rate (ESR) |
- With FBC + CRP, inflammatory/neoplastic/infectious process |
Rheumatoid Factor (RF) |
- Vague aching, symmetrical joint involvement +ve ESR + CRP |
Anti-Cyclic Citrullinated Peptide (Anti-CCP) |
- More specific than RF for RA, erosive diease |
Serum Calcium |
- Malignancy, Metabolic bone disease, renal disease/hypocalcaemia |
Serum Inorganic Phosphorus |
- Metastatic bone disease, metabolic bone disease, renal disease |
Parathyroid Hormone (PTH) |
- Metabolic bone disease/metastatic bone tumours - PTH + Serum Calcium + Phosphorus |
Serum Total Protein & Albumin |
- When ESR/CRP is elevated, FBC reveals dyscrasias/malignancy - multiple myeloma |
Serum Alkaline Phosphatase |
- Primary/metastatic tumours, osteomalacia, Paget's/hepatobiliary disease |
Serum Prostatic Acid Phosphatase (PAP) |
- Mets of Prostate Cancer |
Serum Uric Acid |
- Suspicion of Gout |
Anti-Nuclear Antibody |
- Inflammatory process - SLE (Fatigue, Arthralgia, Malar Rash, photophobia, alopecia), autoimmune disorders, infective endocarditis & some malignancies |
HLA-B27 |
- Insidious LBP - AS, Reiter's syndrome + psoriatic Arthritis |
Serum urea and creatine |
- LBP + suspicion of renal disease (pyelonephritis, glomeulonephritis and renal calculi) |
Serum total protein and albumin |
- When ESR/CRP is elevated - malignancy/multiple myeloma (drops albumin/globulin rate to >1.0) |
Total Bilirubin: |
- Pain in mid back/right upper back - Gallbladder gallstones, tumour, inflammation, Liver problems |
Serum Creatine Kinase (CK) |
- Elevated in the absence of heart disease = soft tissue diseases - polymyositis & dermatomyositis |
Suspected Inflammatory arthritis |
- FBC, ESR/CRP, RF/Anti-CCP, ANA |
Monoarticular pain: |
- As above + Serum urate + X-rays (OA) |
Myalgia + polymyalgia |
- FBC, ESR/CRP/RF/ANA/Thyroid screen/CK |
Connective tissue disorders: |
- RF and ANA |
