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Labs and Misc

ESR is dictated by characteristics of the erythrocytes themselves and by the presence of specific plasma proteins that alter the normal repulsive forces between erythrocytes and influence their ability to aggregate, form rouleaux, and sediment more quickly. These plasma proteins include acute phase reactants (such as fibrinogen) produced by the liver in response to proinflammatory cytokines occurring in rheumatologic disease, infection, and malignancy that neutralize these negative surface charges and increase ESR. Noninflammatory conditions causing elevated fibrinogen, including kidney disease, diabetes, pregnancy, and obesity, can also result in an elevated ESR. Normal aging can also cause an elevated ESR; for this female patient, an equation to find the estimate of the maximal expected ESR is (age in years + 10)/2, resulting in 42 mm/h

Misc (Need more references)
  • Inflammatory Osetoarthritis
    • Mostly in Middle aged women
    • PIP and DIP mostly involved
  • DISH
  • Late Onset Spondyloarthopathy
    • Differentiated from PMR by the presence of enthesitis, dactylics, anterior uveitis, Sacrolieitis on imaging, or HLA - B27
  • Remitting Seronegative Symmetric Synovitis with pitting edema syndrome (RS3PE Syndrome)
    • Extensor muscle Senovititis is very prominent compared to the flexor muslce synovitis
    • May respond to low dose steroids
    • Could progress to RA 
  • Inflammatory Myopathy
Systemic Disease with Arthritis as a symptom
  • GI Diseases
    • Autoimmune hepatitis 
    • Primary biliary cirrhosis 
    • Pancreatitis-arthritis syndrome 
    • Whipple’s disease
    • Gluten-sensitive enteropathy
    • Inflammatory bowel disease 
    • Hepatitis B/hepatitis C
    • Intestinal bypass arthritis
  • Hematological Diseases
    • Hemophilia 
    • Hemoglobinopathies 
    • Hypogammaglobulinemia 
    • Plasma cell dyscrasias
  • Endocrinal Diseaseas
    • Diabetes mellitus 
    • Thyroid disorders 
    • Parathyroid disorders 
    • Acromegaly 
    • Hyperlipoproteinemia 
    • Paget’s disease
  • Malignant Disorders
    • Hypertrophic osteoarthropathy 
    • Leukemia and lymphoma 
    • Carcinomatous polyarthritis 
    • Palmar fasciitis and arthritis 
  • Misc
    • Hemochromatosis
    • Multicentric reticulohistiocytosis Sarcoidosis
    • Alkaptonuria
    • Fabry’s disease
    • Relapsing polychondritis
    • Cystic fibrosis
    • Pigmented villonodular synovitis 
    • Systemic infections
Temporomandibular Disorders
Further reading 

Recent Publications in Rheumatology