1. ESR ( Erythrocyte Sedimentation Rate)- This is the test used to detect the collection of the RBC at the bottom of the glass tube which is filled with a test sample of blood. In people suffering from arthritis there is high ESR rate with inflammation. Note- High ESR rate is also found in some diseases like TB and few other types of cancer).

2. TOTAL BLOOD COUNT- It includes counting of all the blood cells RBC, WBC, and blood platelet count. Haemoglobin % , total proteins with albumin and globulin levels, c-reactive protein (or CRP) value estimation.

3. RF TEST (Rheumatoid factor Test)- There is a antibody called RF antibody which is abnormal. In this test this antibody is checked in blood. In more than 70% of Rheumatoid arthritis patients RF is present in a quantity higher than 80 I.U.

4. ANA TEST (Anti nuclear antibody test)- This test is used to determine another type of abnormal antibody called Anti DNA type or ANA.

5. VDRL TEST- This test is suggested for patients suffering from syphilis and shows symptoms of arthritis.

6. Non- IMMUNOLOGICAL TEST- It is used for estimation of serum enzyme levels.

7. TISSUE BIOPSY (Synovial fluid Analysis) - In this test the synovial fluid is drawn out from the joint. This test is specially useful in the diagnosis of infective and gouty arthritis.

8. X-RAY, CT, MRI- X-rays of the effected joints including imaging techniques like isotope scanning, CT and MRI scan is also helpful for doctors to diagnosis.

9. DIAGNOSTIC ARTHROSCOPY- Through this procedure a doctor can directly view the inside of the joints. The orthopaedic surgeon can do it by inserting an arthroscope, which diameter is as small as that of a drinking straw into the joint through a small hole and move it around to examine the joint tissues such as the cartilage and the extent of damage to the joint can be determined.

The clinical characteristics of inflammation are redness, pain, heat, swelling and few other features are loss of mobility or stiffness, instability and deformity.

PHYSIOLOGY OF ARTHRITIS

The meeting point of two bones is at joint and they are connected in a way that permits each bone to move in relation to the other. A smooth white cartilage cap is present at the end of each bone and it is a tough tissue acting like a cushion when the joint is in use, thus preventing the bone to bone rubbing and consequent wear and tear of bone.

There is a membrane called synovial membrane and it contains liquid called synovial fluid which lubricates the cartilage. The synovial membrane is delicate and it is protected by a strong, fibrous layer called the capsule.

If there is sluggish circulation of blood and lymphatic fluid in the joint and the synovial fluid grows stagnant, the waste products and poisons of cellular metabolism build up in lubricating fluid (synovial fluid) of the joint rather than being efficiently transported to the skin and kidneys for elimination from the body. The acidic wastes and the toxins which get accumulated in the joint fluid irritate the sensitive nerve fibers in the joint which causes pain and stiffness. The structure of the joint begins to degenerate if such situation persists for a long time. The joint fluid starts drying up and the soft cartilage lining corrodes away and the bones start accumulating large amount of calcium which leads to formation of new bone growth limiting the movement of the joint. Slowly the whole joint is destroyed and the movement becomes impossible.

A careful examination and analysis of the synovial fluid can provide a clue to determine the type and extent of arthritis. The other causes and types of arthritis will be discussed in the coming posts.