Reactive arthritis laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Laboratory findings consistent with the diagnosis of reactive arthritis include elevated erythrocyte sedimentation rate (ESR), elevated C-reactive protein (CRP), and elevated total leukocyte count (TLC) showing increased polymorphonuclear cells (PMNs). Synovial fluid or synovial membrane biopsy for detection of bacterial DNA by polymerase chain reaction (PCR) or immunofluorescence microscopy.

Laboratory findings consistent with the diagnosis of reactive arthritis include:^[1][2]

• Elevated ESR
• Elevated C-reactive protein
• Elevated TLC showing increased PMNs
• Synovial fluid analysis to determine cell count, culture, glucose, and presence of crystals.
• Diagnostic lab evaluations include testing for HLA-B27, PCR or ELISA for reactive arthritis associated microorganisms.
  • Laboratory evaluations required to establish infection with reactive arthritis causing organisms include routine urinalysis, culture of stool and urethral discharge.
  • Synovial fluid or synovial membrane biopsy for detection of bacterial DNA by PCR or immunofluorescence microscopy.
  • IgA antibodies to specific bacterial antigens
• Other test include tuberculin skin test and HIV.

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