관절염의 검사실 소견
Laboratory Findings in the Patients with Arthritis
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초록
관절염 환자에서 검사실 소견은 질환의 진단, 특히 류마티스 관절염의 질병의 활성도 및 예후 평가에 어느 정도 역할을 할 수 있다. 또한, 감염성 관절염이나 통풍 관절염의 경우 활막액의 검사를 통하여 진단이나 치료에 상당한 도움을 얻을 수 있다. 그러나 관절염에 있어 단일 검사 소견만으로 진단하여서는 안되며, 임상양상, 이학적 검사, 영상학적 검사 및 검사실 소견 등을 포괄적으로 종합하여 진단하여야 한다.
Abstract
Arthritis is caused by various diseases including rheumatoid arthritis (RA), osteoarthritis, gout and trauma, and joint involvement also occurs in some autoimmune diseases, such as systemic lupus erythematosus and Sjögren’s syndrome. Some laboratory tests provide useful information in both diagnosis and prognosis. RF and anti-CCP (cyclic citrullinated peptide) antibody are detected in approximately 70-80% of patients with RA, and often associated with a worse prognosis (e.g., bony erosion and joint deformity). Acute phase reactants, such as erythrocyte sedimentation rate and C-reactive protein, parallel the activity of RA, and their persistent elevation are also associated with a poor prognosis. Crystal examination in synovial fluid is essential to confirm the diagnosis of gout and pseudogout, and the synovial fluid culture is also important in septic arthritis. Anti-nuclear antibody helps to distinguish non-immune arthritis from systemic rheumatic diseases. However, arthritis cannot be diagnosed only with laboratory findings, and physician should consider comprehensive physical examination, clinical findings, and imaging findings as well as laboratory findings. In this topic review, laboratory tests useful for diagnosis of arthritis will be discussed and summarized. (Korean J Med 2012;83:174-177)
참고문헌 (15)
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