Helping you focus on patients
Working with you to address a growing health concern
We understand that arthritis is one of the main reasons patients may find themselves in your office. In fact, it is one of the most common complaints in the United States—and the leading cause of disability.1,2
That’s why Quest Diagnostics is so committed to helping you quickly identify the source of your patients’ arthritis symptoms.
Arthritis affects more than 20 percent of American adults—over 50 million people.
- 2030 estimate: 67 million
- Disproportionately women and Caucasians
- Nearly 50 percent also have heart disease or diabetes1-3
- Arthritis is not necessarily a disease of old age, as some forms can inflict children and young adults
Signs and symptoms are just the starting point
Swelling is a sign of arthritis, while stiffness and pain in the joints are classic symptoms. Unfortunately, on their own, these indicators offer little help in narrowing an initial differential diagnosis. They must be considered along with a thorough medical history, examination and laboratory testing for arthritis.4
Arthritis: Know the types
Although more than 100 different diseases fall under the umbrella term “arthritis,”4 the most common types are inflammatory, degenerative and metabolic.
Types of inflammatory arthritis
- The most common and potentially devastating
- Affects more women than men
- Typical age of onset: 30s and 40s
- Characterized by symmetrical intense finger and wrist pain5
Help diagnose RA with Quest testing services.
Erosive psoriatic arthritis
- Similar to rheumatoid arthritis (RA)
- More serious because than RA because it extends to joints, ligaments and tendons
- Common among people with psoriasis
Polymyalgia rheumatica (PMR) arthritis
- Common among older Caucasians
- First symptoms appear after age 50
- Marked by aching and stiffness in the upper arms, neck, and lower back
Because PMR is a difficult diagnosis that might require a consultation with a rheumatologist, testing for inflammatory markers is recommended.6
Ankylosing spondylitis, spondyloarthritis and the spondyloarthropathies
- Related diseases of the spine
- Usually affect males in their teens and early 20s
- Typical early symptom: lower back pain
Ankylosing spondylitis is a hereditary disease you may diagnose through a clinical exam and the aid of an HLA-B27 gene test.7
Juvenile idiopathic arthritis (JIA)
- Inflammation of the synovial membrane
- Affects roughly 1 in 1,000 U.S. children
- Characterized by joint pain and swelling, fevers, rash or eye inflammation
- A challenging diagnosis of exclusion—until recently
- The new 14-3-3 eta biomarker helps diagnose JIA in children <178,9
Degenerative arthritis: Osteoarthritis
- The most common form of arthritis
- Affects about 27 million U.S. adults
- Involves damage to the cartilage and underlying bone in joints, especially the knees, hips, fingers and spine
- Specific cause is unknown
- Risk factors: Obesity, occupations requiring repetitive movements, trauma10
Metabolic arthritis: Gout
- Increase in uric acid in the blood
- Causes sudden burning pain, stiffness, and swelling in a joint, usually a big toe
- Associated with hypertension, obesity, metabolic syndrome, type 2 diabetes and chronic kidney disease
Various diagnostic tests are recommended for suspected gout. They include Uric Acid and Synovial Fluid Analysis, both of which are listed in the newly released classification criteria from the American College of Rheumatology (ACR) Board of Directors and the European League Against Rheumatism (EULAR) Executive Committee.11
Quest genotyping for HLA-B*5801 is also recommended for patients being considered for allopurinol, a common gout treatment. The presence of the HLA-B*5801 genotype in high-risk populations is highly associated with severe allopurinol hypersensitivity.12
We’re here to help you manage patients with arthritis
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1. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation—United States, 2010–2012. MMWR Morb Mortal Wkly Rep. 2013 Nov 8;62(44):869-873. http://www.cdc.gov/mmwr/PDF/wk/mm6244.pdf. Accessed September 17, 2015.
2. Prevalence and most common causes of disability among adults—United States, 2005. MMWR Morb Mortal Wkly Rep. 2009 May 1;58(16):421-426. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5816a2.htm?s_cid=mm5816a2_e. Accessed September 17, 2015.
3. Hootman JM, Helmick CG. Projections of US prevalence of arthritis and associated activity limitations. Arthritis Rheum. 2006;54(1):266-229.
4. Arthritis basics. Centers for Disease Control and Prevention website. http://www.cdc.gov/arthritis/basics.htm. Updated August 6, 2014. Accessed September 17, 2015.
5. The primary care physician's guide to inflammatory arthritis: Diagnosis. Rheumatology Network website. http://www.rheumatologynetwork.com/articles/primary-care-physicians-guide-inflammatory-arthritis-diagnosis. Published June 2, 2010. Accessed September 17, 2015.
6. Michet CJ, Matteson EL. Polymyalgia rheumatica. BMJ. 2008;336:765-769. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2287267/pdf/bmj-336-7647-cr-00765.pdf. Accessed September 17, 2015.
7. Spondyloarthritis. American College of Rheumatology website. http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Spondyloarthritis. Updated November 2013. Accessed September 17, 2015.
8. Juvenile arthritis. American College of Rheumatology website.http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Juvenile-Arthritis. Updated June 2015. Accessed September 17, 2015.
9. Ringold S, Weiss PF, Beukelman T, et al. 2013 update of the 2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: recommendations for the medical therapy of children with systemic juvenile idiopathic arthritis and tuberculosis screening among children receiving biologic medications. Arthritis Rheum. 2013;65(10):2499-2512. http://www.rheumatology.org/Practice-Quality/Clinical-Support/Clinical-Practice-Guidelines/Juvenile-Idiopathic-Arthritis. Accessed September 17, 2015.
10. The most common types of arthritis. Centers for Disease Control and Prevention website. http://www.cdc.gov/arthritis/temp/pilots-201208/pilot1/online/arthritis-challenge/01-ArthritisBasics/types.htm. Updated May 17, 2013. Accessed September 17, 2015.
11. 2015 Gout Classification Criteria, Arthritis & Rheumatology, No. 67, No. 10, October 2015, pp 2557-2568.
12. Khanna D, Fitzgerald JD, Khanna PP, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res. 2012;64(10):431-446. http://www.rheumatology.org/Portals/0/Files/ACR%20Guidelines%20for%20Management%20of%20Gout_Part%201.pdf. Accessed September 17, 2015.