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	<title>osteomyelitis</title>
	<link>http://www.artwoo.com</link>
	<description>Returned search results for osteomyelitis</description>
	<copyright>Copyright 2008</copyright>
	<pubDate>Mon, 01 Dec 2008 17:02:43 +0000</pubDate>
	<generator>http://www.artwoo.com/rss/osteomyelitis</generator>

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				<title>Methods Of Preventing Toxic Shock Syndrome</title>
		<link>http://www.artwoo.com/article/methods-of-preventing-toxic-shock-syndrome</link>
		<comments>http://www.artwoo.com/article/methods-of-preventing-toxic-shock-syndrome#comments</comments>
				<pubDate>Tue, 01 Aug 2006 08:27:17 +0000</pubDate>
		<category>symptoms of tss</category><category>toxic shock syndrome</category><category>staphylococcus aureus</category><category>contact</category><category>osteomyelitis</category><category>protective antibodies</category><category>watery diarrhea</category>		<guid>http://www.artwoo.com/article/methods-of-preventing-toxic-shock-syndrome</guid>
		<description><![CDATA[Toxic shock syndrome (TSS) describes a cluster of symptoms that involve many systems of the body. The following bacteria commonly cause TSS:  1. Staphylococcus aureus  2. Streptococcus pyogenes  TSS from Staphylococcus infections was identified in the late 70s and early 80s when highly absorbent]]></description>
    <content:encoded><![CDATA[<a href="http://www.artwoo.com/tag/toxic+shock+syndrome" rel="tag">Toxic shock syndrome</a> (TSS) describes a cluster of symptoms that involve many systems of the body. The following bacteria commonly cause TSS: <br /><br /> 1. <a href="http://www.artwoo.com/tag/staphylococcus+aureus" rel="tag">Staphylococcus aureus</a>  2. Streptococcus pyogenes <br /><br /> TSS from Staphylococcus infections was identified in the late 70s and early 80s when highly absorbent tampons were widely used in menstruating women. Due to manufacturing changes in tampons, the incidence of tampon-induced TSS has diminished by more than 40 percent. <br /><br /> <a href="http://www.artwoo.com/tag/symptoms+of+tss" rel="tag">Symptoms of TSS</a> involve many systems and may resemble other infections. <br /><br /> The symptoms of TSS include sudden high fever, a faint feeling, <a href="http://www.artwoo.com/tag/watery+diarrhea" rel="tag">watery diarrhea</a>, headache, and muscle aches. If your child has these symptoms, it's important to call your child's doctor right away. <br /><br /> TSS can occur whenever a nonimmune person is exposed to a TSS toxin. Illness is said to be andquot;menstrualandquot; if it occurs during the menstrual period and andquot;nonmenstrualandquot; if at other times. Each category accounts for about half of cases. The risk of TSS is greater in younger than in older people, the acquisition of <a href="http://www.artwoo.com/tag/protective+antibodies" rel="tag">protective antibodies</a> being a function of age. <br /><br /> Prevention <br /><br /> The bacteria that cause toxic shock syndrome can be carried on unwashed hands and prompt an infection anywhere on the body. So hand washing is extremely important. <br /><br /> How is toxic shock syndrome transmitted? <br /><br /> 1. Staphylococcus infections <br /><br /> 2. Staphylococcus aureus may normally exist in a person's nose or vagina and does not cause infection. Because it is part of the body's normal bacteria, 90 percent of individuals develop antibodies to prevent infection. S. aureus can be transmitted by direct <a href="http://www.artwoo.com/tag/contact" rel="tag">contact</a> with infected persons. Individuals who develop TSS usually have not developed antibodies against S. aureus. Therefore, it is not usually considered a contagious infection. S. aureus infections may also occur from another infection such as pneumonia, sinusitis, <a href="http://www.artwoo.com/tag/osteomyelitis" rel="tag">osteomyelitis</a> (infection in the bone), or skin wounds such as a burn or surgical site. If any of these areas are infected, the bacteria can penetrate into the bloodstream.  <bio>Can Toxic Shock Syndrome Be Prevented? Find out at <a href="http://ToxicShockSyndrome.ewhy.info" >http://ToxicShockSyndrome.ewhy.info</a> </bio>]]></content:encoded>
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				<title>Strep Throat Affects All Ages</title>
		<link>http://www.artwoo.com/article/strep-throat-affects-all-ages</link>
		<comments>http://www.artwoo.com/article/strep-throat-affects-all-ages#comments</comments>
				<pubDate>Thu, 09 Oct 2008 09:36:28 +0000</pubDate>
		<category>symptoms of strep throat</category><category>pens pencils</category><category>throat doctors</category><category>throat trouble</category><category>scarlet fever</category><category>doctors office</category><category>throat culture</category>		<guid>http://www.artwoo.com/article/strep-throat-affects-all-ages</guid>
		<description><![CDATA[Strep throat is a very common illness that occurs in all humans of all ages most often in the winter months. It is an infection of the pharynx and possibly the larynx and the tonsils. It is a form of group A streptococcal infections. Group A streptococcal infections cause such illnesses as]]></description>
    <content:encoded><![CDATA[Strep throat is a very common illness that occurs in all humans of all ages most often in the winter months. It is an infection of the pharynx and possibly the larynx and the tonsils. It is a form of group A streptococcal infections. Group A streptococcal infections cause such illnesses as pneumonia, tonsillitis, arthritis, meningitis, osteomyelitis, <a href="http://www.artwoo.com/tag/scarlet+fever" rel="tag">scarlet fever</a> and sinusitis. Strep throat is the swelling of the throat and can cause pain when talking or swallowing. Some severe cases cause problems with breathing because the throat swells up so much that it cuts off the airwaves through the mouth.<br><br>The <a href="http://www.artwoo.com/tag/symptoms+of+strep+throat" rel="tag">symptoms of strep throat</a> are rash, hives, nausea, vomiting, abdominal pain, fever, red and enlarged tonsils, sudden and severe sore throat, yellow and white patches in the throat, trouble swallowing and general discomfort. <br><br>Doctors can diagnose strep throat by simply looking at a patient's throat. Doctors will also swab the back of the throat with a stick to pick up some of the mucus and test it for an infection. This is called a <a href="http://www.artwoo.com/tag/throat+culture" rel="tag">throat culture</a>, which is also known as a Rapid Strep Test because the results come back within 10 to 15 minutes and are done within the doctor's office. They are not sent to a nearby medical lab for diagnosis. If the test comes back negative and the patient really isn't feeling well it could suggest that there is a viral infection somewhere else in the body.<br><br>If the throat culture comes back positive the patient will be prescribed antibiotics, which should have the infection cleared up within 36-48 hours. Because strep throat is contagious, patients suffering from the illness should not go to school or work for the duration of treatment. Doctors will write a note to send to school with a younger patient explaining why they missed two days of classes. Some strep throat cases can last as long as eight days. <br><br>Strep throat can be contracted through air-based germs. It can also be on infected pillow cases, toys, utensils, pens, pencils, clothing and even toothbrushes. The main antibiotic prescribed to strep throat patients is Penicillin. Once detected and treated, strep throat is not life threatening but can cause other health problems if left untreated by a patient. If they have symptoms of strep throat they should see a doctor and have antibiotics prescribed to avoid any long term problems.<br><br>Strep throat, which is caused by an infection, can also affect the blood, throat and the skin. It can also flare up herpes if the patient is suffering from herpes as well as causing scarlet fever. Some strains of strep throat can be so severe that they can cause the reduction of blood pressure which in turn can lead to lung injuries and kidney failure. Strep throat cannot be avoided because it is caused by air-born bacteria that is unavoidable and contagious. Even though strep throat is unavoidable it is still treatable. One way to try and avoid strep throat is to constantly keep washing your hands with germ killing soap.<bio><a href="http://www.raleighdentist.com/holly-springs-cosmetic-dentistry.php">Holly Springs Dentistry</a><a href="http://www.raleighdentist.com/holly-springs-cosmetic-dentistry.php">Quality Cosmetic Dentistry</a></bio>]]></content:encoded>
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				<title>Relieve Back Pain Naturally</title>
		<link>http://www.artwoo.com/article/relieve-back-pain-naturally</link>
		<comments>http://www.artwoo.com/article/relieve-back-pain-naturally#comments</comments>
				<pubDate>Wed, 14 Nov 2007 03:15:02 +0000</pubDate>
		<category>chronic back pain</category><category>relieve back pain</category><category>cramp bark</category><category>antispasmodics</category><category>feverfew</category><category>stretching exercises</category><category>saw palmetto</category>		<guid>http://www.artwoo.com/article/relieve-back-pain-naturally</guid>
		<description><![CDATA[ Back pain is one of humanity's most repeated complaints. Back pain is one of the most common medical problems today, affecting 8 out of 10 people at some point during their lives. The pain can range from a dull constant ache to a sudden, sharp pain.  This conditions may be the result of an]]></description>
    <content:encoded><![CDATA[ Back pain is one of humanity's most repeated complaints. Back pain is one of the most common medical problems today, affecting 8 out of 10 people at some point during their lives. The pain can range from a dull constant ache to a sudden, sharp pain. <br /><br /> This conditions may be the result of an infection in the bone(osteomyelitis) or in the spinal cord. Pain in the lower back or low back pain is by far the most common concern, affecting up to 90% of Americans at some point in their lifetime. <br /><br /> Back pain is a common problem most frequently caused by overusing or misusing the muscles of the back. The pain may not be prevented completely, but there are things you can do to reduce the severity or frequency. <br /><br /> Treatment <br /><br /> Treatment of back problems should be directed at the cause. Treatments will range from doing nothing to spinal surgery. Many find relief from back pain through <a href="http://www.artwoo.com/tag/stretching+exercises" rel="tag">stretching exercises</a> or alternative therapies like yoga, but <a href="http://www.artwoo.com/tag/chronic+back+pain" rel="tag">chronic back pain</a> may require medication and treatment that is more intensive. <br /><br /> There are trouble-free home treatment along with proper body mechanics, which will often heal your back within a few weeks and keep it functional for the long haul. <br /><br /> One of the simplest ways to <a href="http://www.artwoo.com/tag/relieve+back+pain" rel="tag">relieve back pain</a> is to use hot and cold compressed. You must be sure alternate the compresses. First do five minutes as hot as you can stand it. Then one minute of an ice cold compress. Repeat this five to seven times. You will be amazed at how well this works. This brings great temporary relief. <br /><br /> Here are some examples of common herbs used to treat back pain: <br /><br /> Some natural pain reliever:  <a href="http://www.artwoo.com/tag/feverfew" rel="tag">Feverfew</a>  Burdock  Stringing Nettle  Willow Bark  Ginger <br /><br /> Here are some natural anti-inflammatory:  <a href="http://www.artwoo.com/tag/saw+palmetto" rel="tag">Saw Palmetto</a>  Rosemary  Bromelain  Cat's Claw  Licorice  Valeria <br /><br /> And here are some <a href="http://www.artwoo.com/tag/antispasmodics" rel="tag">antispasmodics</a>:  Angelica  <a href="http://www.artwoo.com/tag/cramp+bark" rel="tag">Cramp Bark</a>  Black Haw <br /><br /> Exercises <br /><br /> Exercises are important to prevent, reduce, and ultimately get rid of the pain. They must consist of stretching exercises. These include exercised for the back and leg muscles. <br /><br /> Any exercise program must have strength, stamina, and stabilizing exercises also. These include exercises for the back, stomach and leg muscles. There are particular exercises to strengthen and stretch the muscles in the abdomen, buttocks, and back can help stabilize the spine and decrease strain on he disk that cushion the spine and the ligaments that hold it in place. <br /><br /> In conclusion, we must realize that back pain is not a diagnosis, it is a symptom of an underlying condition. Back pain is a symptom that can arise from many causes. Being one of humanity's most frequent complaints, you can be sure though back pain may not be prevented completely, but there are natural things that you can do to reduce the severity or frequency. <br /><br /> Whether you are at work or at home, always practice a good body mechanics that is, bending you knees when picking up something off the floor and not just your hips, as well as avoid twisting your back and pull instead of push.   <bio>Mary Rose Antonio is an owner of two sites that talks about the benefits of drinking green tea and sells organic tea and tea accessories, <a href="http://www.green-tea-expert.com" >http://www.green-tea-expert.com</a> and <a href="http://www.theteaavenue.com/" >http://www.theteaavenue.com/</a>  </bio>]]></content:encoded>
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				<title>Toxic Shock Syndrome Symptoms!</title>
		<link>http://www.artwoo.com/article/toxic-shock-syndrome-symptoms</link>
		<comments>http://www.artwoo.com/article/toxic-shock-syndrome-symptoms#comments</comments>
				<pubDate>Fri, 09 Jun 2006 12:32:05 +0000</pubDate>
		<category>toxic shock syndrome</category><category>streptococcus bacteria</category><category>staphylococcus aureus bacteria</category><category>streptococcal toxic shock syndrome</category><category>absorbency tampons</category><category>tss</category><category>stss</category>		<guid>http://www.artwoo.com/article/toxic-shock-syndrome-symptoms</guid>
		<description><![CDATA[Many people incorrectly believe that TSS only affects women, when in fact it can affect anyone - men, women and children. TSS has occurred in all races, although most cases have been reported from North America and Europe.  What Is Toxic Shock Syndrome?  There are actually two different types of]]></description>
    <content:encoded><![CDATA[Many people incorrectly believe that <a href="http://www.artwoo.com/tag/tss" rel="tag">TSS</a> only affects women, when in fact it can affect anyone - men, women and children. TSS has occurred in all races, although most cases have been reported from North America and Europe. <br /><br /> What Is <a href="http://www.artwoo.com/tag/toxic+shock+syndrome" rel="tag">Toxic Shock Syndrome</a>?  There are actually two different types of this condition. Toxic shock syndrome, which is caused by <a href="http://www.artwoo.com/tag/staphylococcus+aureus+bacteria" rel="tag">Staphylococcus aureus bacteria</a>, has been associated with the use of tampons. (TSS was initially linked to a particular brand of tampons, which have since been taken off the market.) Although the exact connection is still not clear, researchers suspect that certain types of high-<a href="http://www.artwoo.com/tag/absorbency+tampons" rel="tag">absorbency tampons</a> provided a moist, warm home where the bacteria could thrive. <br /><br /> Although TSS usually occurs in menstruating women, it can affect anyone who has any type of staph infection, including pneumonia, abscess, skin or wound infection, a blood infection called septicemia, or a bone infection called Osteomyelitis. <br /><br /> A related infection, <a href="http://www.artwoo.com/tag/streptococcal+toxic+shock+syndrome" rel="tag">streptococcal toxic shock syndrome</a>, or <a href="http://www.artwoo.com/tag/stss" rel="tag">STSS</a>, is caused by <a href="http://www.artwoo.com/tag/streptococcus+bacteria" rel="tag">streptococcus bacteria</a>. Most often STSS appears after streptococcus bacteria have invaded areas of injured skin, such as cuts and scrapes, surgical wounds, and even chickenpox blisters. It almost never follows a simple streptococcus throat infection <br /><br /> Symptoms <br /><br /> Toxic shock syndrome  Toxic shock syndrome from staphylococcus starts suddenly with vomiting, high fever (temperature at least 102 degrees Fahrenheit [38.8 degrees Celsius]), a rapid drop in blood pressure (with lightheadedness or fainting), watery diarrhea, headache, sore throat, and muscle aches. Within 24 hours, a sunburn-like rash appears. There also may be bloodshot eyes and an unusual redness under the eyelids or inside the mouth (and vagina in females). After that, broken blood vessels may appear on the skin. Other symptoms may include: confusion or other mental changes; decreased urination; fatigue and weakness; thirst; weak and rapid pulse; pale, cool, moist skin; and rapid breathing. <br /><br /> Streptococcal toxic shock syndrome (STSS)  Streptococcal toxic shock syndrome can happen following a streptococcus infection in the body, most often a skin infection or an infected wound. Within 48 hours of infection, the person's blood pressure drops dangerously low, and he or she may have fever, dizziness, confusion, difficulty breathing, and a weak and rapid pulse. The skin may be pale, cool, and moist, and there may be a blotchy rash that sometimes peels. The area around an infected wound can become swollen, red, and have areas of severely damaged or dying flesh. The liver and kidneys may begin to fail, and bleeding problems may develop. <br /><br /> If you develop toxic shock syndrome, you'll likely be hospitalized and need antibiotics. Doctors will try to determine the source of the infection. Along with antibiotics, you'll receive supportive care to treat the signs and symptoms of toxic shock syndrome. If your blood pressure begins to drop (hypotension), you'll need medication to stabilize it and fluids to prevent dehydration. The toxins produced by the staph bacteria may result in kidney failure. If your kidneys fail, you may need dialysis.   <bio>Can Toxic Shock Syndrome Be Prevented? Find out at <a href="http://ToxicShockSyndrome.ewhy.info">http://ToxicShockSyndrome.ewhy.info</a> </bio>]]></content:encoded>
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				<title>Heath Dangers Of Work At Home Businesses</title>
		<link>http://www.artwoo.com/article/heath-dangers-of-work-at-home-businesses</link>
		<comments>http://www.artwoo.com/article/heath-dangers-of-work-at-home-businesses#comments</comments>
				<pubDate>Wed, 05 Mar 2008 10:20:01 +0000</pubDate>
		<category>diseases caused by stress</category><category>paravirus</category><category>self actualization</category><category>chronic back pain</category><category>ergonomic keyboard</category><category>rheumatic fever</category><category>better relationships</category>		<guid>http://www.artwoo.com/article/heath-dangers-of-work-at-home-businesses</guid>
		<description><![CDATA[ Most of us never think that working at home can cause health problems. We focus on the freedom of working for ourselves, and the increase self actualization, and the opportunity for enjoying better relationships.  Statistically, most of use work for $25 000 which translates to ..24 an hour after]]></description>
    <content:encoded><![CDATA[ Most of us never think that working at home can cause health problems. We focus on the freedom of working for ourselves, and the increase <a href="http://www.artwoo.com/tag/self+actualization" rel="tag">self actualization</a>, and the opportunity for enjoying <a href="http://www.artwoo.com/tag/better+relationships" rel="tag">better relationships</a>. <br /><br /> Statistically, most of use work for $25 000 which translates to ..24 an hour after we pay for day care, commuting costs, taxes, clothing, lunches, grooming, and equipment. In many cases, a work at home business can generate more revenue than an average office job, by earning only $90 a week. <br /><br /> Doctors and professionals alike are quick to explain how this can benefit our health. With 80% of all American <a href="http://www.artwoo.com/tag/diseases+caused+by+stress" rel="tag">diseases caused by stress</a>, brining home more money, reducing time spent submerged in the rush hour, or dealing with office politics, is a step in the `healthy direction.' <br /><br /> It is also common knowledge that working at home can reduce the chances of contracting Influenza, <a href="http://www.artwoo.com/tag/rheumatic+fever" rel="tag">Rheumatic fever</a>, Epstein-Barr Viral Syntrome, Rubela, Varicella (chicken pox), <a href="http://www.artwoo.com/tag/paravirus" rel="tag">Paravirus</a>, and Osteomyelitis. The US looses billions of work hours a year from these diseases. <br /><br /> What they do not tell us is how working at home can decrease our overall health and even causes serious problems. <br /><br /> Back Problems <br /><br /> <a href="http://www.artwoo.com/tag/chronic+back+pain" rel="tag">Chronic back pain</a> is one of the most debilitating, and most common problems. It is usually suffered by people who spend more than 5 hours a day on a computer, have a manger's chair instead of a secretary's chair, and do not use an <a href="http://www.artwoo.com/tag/ergonomic+keyboard" rel="tag">ergonomic keyboard</a>. Sitting slumped in a chair can cause long term problems, because It slows the flow of blood through the spine. Remarkably, stress can also slow the flow of blood through muscles and the spine. <br /><br /> Stress can tighten the muscles in the back. To see if this is your problem then take your fingers and press firmly on the back of your skull. You will find 2 or 3 places where a firm push will cause serious pain. Following the `pain spot' down will reveal a thread or rope like muscle. <br /><br /> The cure is easy. Get up and walk around for two or three minutes every hour. Take a lunch break away from the computer. Do not work longer than 5 hours without a break. And, eat well. <br /><br /> Food <br /><br /> The computer can leave us feeling stressed without recognizing the problem. The number one problem is caused by lack of water. This can cause severe pains in the legs. Coffee, or other hot beverages will not solve the problem. A work at home business owner should drink one bottle of water a day. <br /><br /> There has been a proven problem between food coloring and eye site. <br /><br /> "The use of this feed additive is purely cosmetic, to colour food and reduced levels of it will not adversely affect the taste or quality of our food", said European Health Commissioner, David Byrne. <br /><br /> A work at home business should provide the owner with a better diet. This is rarely true. Without friends to dine with, a much needed excuse to leave the office, or the business lunch, the business owner ends up grazing on pre processed food that includes, excessive sugar and salt, but also more food coloring than is found in most restaurant meals. <br /><br /> Computers <br /><br /> There are risks associated with jobs that force workers to sit in front of that computer: <br /><br /> Eye strain  RSI (Repetitive Stress Syndrome)  Carpal Tunnel Syndrome  Constant Head Aches  Dizziness  Breathing Problems  Difficulty Concentrating  Most of these problems are easy to solve  Use a foot rest  Have a `pad' heater under the desk in the winter  Only use an ergonomic keyboard  Change position every few minutes. <br /><br /> Buy a monitor larger than 17", has an anti glare coating, and tilts so it is in line with your eyes =96 instead of you needing to bend or twist to be in line with the computer. <br /><br /> While protecting your portfolio, and revenue generating streams, don't forget to protect your health.   <bio>Mark Walters is a third generation entrepreneur and author. He offers free training and investing videos designed to speed you towards financial independence at <a href="http://www.CashFlowInstitute.com" >http://www.CashFlowInstitute.com</a>  </bio>]]></content:encoded>
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				<title>I Have Arthritis And I Want To Know What Tests My Rheumatologist Is Going To Order</title>
		<link>http://www.artwoo.com/article/i-have-arthritis-and-i-want-to-know-what-tests-my-rheumatologist-is-going-to-order</link>
		<comments>http://www.artwoo.com/article/i-have-arthritis-and-i-want-to-know-what-tests-my-rheumatologist-is-going-to-order#comments</comments>
				<pubDate>Thu, 06 Dec 2007 00:35:01 +0000</pubDate>
		<category>crp crp</category><category>crp test</category><category>rheumatoid arthritis</category><category>inflammation increases</category><category>inflammation causes</category><category>acute inflammation</category><category>inflammatory arthritis</category>		<guid>http://www.artwoo.com/article/i-have-arthritis-and-i-want-to-know-what-tests-my-rheumatologist-is-going-to-order</guid>
		<description><![CDATA[ There are a number of laboratory tests that a rheumatologist may order when seeing a patient for the first time. This is particularly true if rheumatoid arthritis (RA) is suspected. The reason so many laboratory tests are needed is because of the complexity involved in arriving at the correct]]></description>
    <content:encoded><![CDATA[ There are a number of laboratory tests that a rheumatologist may order when seeing a patient for the first time. This is particularly true if <a href="http://www.artwoo.com/tag/rheumatoid+arthritis" rel="tag">rheumatoid arthritis</a> (RA) is suspected. The reason so many laboratory tests are needed is because of the complexity involved in arriving at the correct diagnosis. Oftentimes, diseases can look similar. Disease may evolve over time and sometimes they overlap. <br /><br /> The following is a rundown of the different tests that can be ordered and why. <br /><br /> Erythrocyte Sedimentation Rate (ESR). This test-also known as the "sed rate" measures how fast the red blood cells settle to the bottom of a tube in 1 hour. <a href="http://www.artwoo.com/tag/inflammation+causes" rel="tag">Inflammation causes</a> the red cells to clump together and therefore settle faster. The rate in normal individuals is up to 20 mm in 1 hour. <a href="http://www.artwoo.com/tag/inflammation+increases" rel="tag">Inflammation increases</a> this rate so that a patient with a disorder such as active rheumatoid arthritis will often have a sed rate much higher than 20mm. <br /><br /> C-Reactive Protein (CRP). CRP measures a protein produced by the liver that is present during <a href="http://www.artwoo.com/tag/acute+inflammation" rel="tag">acute inflammation</a> or infection. The <a href="http://www.artwoo.com/tag/crp+test" rel="tag">CRP test</a> can be used to monitor the effectiveness of treatment as well as to monitor disease flares. <br /><br /> Both of these tests correlate with x-ray damage due to RA and long-term disability; persistent elevations of these blood markers suggest a poor prognosis. <br /><br /> ESR is usually elevated in <a href="http://www.artwoo.com/tag/inflammatory+arthritis" rel="tag">inflammatory arthritis</a>, but can be less useful than the CRP, because the ESR rises more slowly and falls to normal more slowly once inflammation is controlled. The CRP tends to rise faster and go down faster than the sed rate in response to inflammation. Also, in very early inflammatory disease, both the ESR and CRP may not be elevated, so normal levels do not rule out the presence of significant disease. These tests are essential to get at baseline, because there is evidence they may be useful in predicting disease severity or response to therapy. <br /><br /> Rheumatoid Factor (RF). RF is an immunoglobulin. It is in the IgM category of antibodies and is directed against another type of antibody type called IgG. It is present in about 70% of patients with RA. Unfortunately, an elevated level of RF can be seen in about 10% of normal people. Additionally, in roughly 20% of patients with RA, the RF is not elevated, and so a negative test result does not rule out RA as a cause of the patient's symptoms. The presence of RF correlates with aggressive and erosive disease. And high levels of RF appear to suggest a worse prognosis. RF can take months to develop, and some RA patients remain negative for RF throughout the course of their illness. <br /><br /> Other autoimmune diseases that can be associated with a positive RF include systemic lupus erythematosus, Sjogren's disease, polymyositis, dermatomyositis, scleroderma, and mixed connective tissue disease. Infections and other diseases can also be associated with a positive RF. These include sarcoidosis, tuberculosis,endocarditis, hepatitis (especially hepatitis C), syphilis, osteomyelitis, infectious mononucleosis, and cirrhosis. A positive RF would not usually be seen in types of arthritis such as gout, osteoarthritis, ankylosing spondylitis, and psoriatic arthritis,. <br /><br /> Anticyclic Citrullinated Peptide Antibody (anti-CCP). This is a relatively new blood test thaqt helps to confirm a diagnosis of RA. Anti-CCP appears to be more specific for RA. Anti-CCP antibody is present in approximately 30% of RF negative RA (seronegative RA). Testing with the combination of anti-CCP antibody and RF may be better for ruling out RA than using either test alone. <br /><br /> High levels of anti-CCP are seen in severe and progressive disease. <br /><br /> Antinuclear Antibody (ANA). The ANA test can help detect SLE. However, an elevated ANA is not specific, and can be seen in disorders other than lupus, including a significant percentage of patients with RA. More than 95% of patients with lupus have a positive ANA test. A more specific test for SLE is the presence of antibodies to DNA (anti-DNA). It is unusual to find antibodies to DNA (anti-DNA) in people who do not have lupus. Levels of anti-DNA vary with disease activity. <br /><br /> Antibodies to Sm, RNP, Ro (SSA), La (SSB). Lupus patients also have other antibodies to different cell nuclear components. Antibodies to Sm occur only in patients with lupus while antibodies to RNP occur in patients with mixed connective tissue disease, and antibodies to Ro and La may occur in patients with Sjogren's disease. <br /><br /> Creatine phosphokinase (CPK). CPK is a muscle enzyme that is elevated in a number of types of inflammatory conditions, particularly inflammatory muscle diseases such as polymyositis and dermatomyosotis. Since these conditions can also present with arthritis, a CPK is a good test to order. <br /><br /> Thyroid function tests. Thyroid disease often is present in patients with inflammatory arthritis. It is because autoimmunity seems to be involved in the development of both of these problems. An underactive thyroid (hypothyroidism) can also cause aches and pains and "muddy the diagnostic waters". With severe thyroid disease, elevations in CPK may be seen. <br /><br /> Complete Blood Cell Count (CBC). Chronic inflammation can lead to an anemia. This is a common occurrence in patients with rheumatoid arthritis. Also, some of the non-steroidal anti-inflammatory drugs (NSAIDS) which patients with RA take can cause ulcers which can lead to blood loss. Also, a low white blood cell count may be a sign of drug toxicity or another disease process such as lupus. Also, it is good to have a baseline result to help with drug monitoring <br /><br /> Chemistry Panel. Viral hepatitis can present with inflamed joints. It is important to make sure that liver function test results are normal. It is a good idea to have a baseline in case potentially liver damaging medications such as non-steroidal anti-inflammatory drugs or methotrexate are used. Another organ system, the kidney can also be affected not only by diseases such as lupus or Sjogren's disease but also is a target for drug toxicity. NSAIDS are the chief culprits. Also, if a patient's kidney function isn't normal it will affect the rate of elimination of some drugs that are used to treat rheumatoid arthritis. Drug toxicity then becomes an issue. <br /><br /> Viral Hepatitis Panel. As mentioned above, viral hepatitis can present with an inflammatory form of arthritis. Prior to starting any medicine that can adversely affect the liver, it is important to have a baseline in regard to chronic hepatitis B and C infections. Before using anti-TNF medications and rituximab (Rituxan), the rheumatologist must check hepatitis status, especially in regards to hepatitis B because these drugs can cause aggravation of hepatitis B. <br /><br /> Urinalysis. A urine sample is studied for protein, red blood cells, white blood cells, or casts. These abnormalities may indicate kidney damage due to lupus or vasculitis. Use of some medications, because they can injure the kidneys, require initial as well as ongoing screening for urinary abnormalities. <br /><br /> Complement levels. Complement is a serum protein that is important in the assessment and monitoring of different types of autoimmune disease. Lowered levels of complement (C3, C4) are indicative of immune complex formation (where an antibody binds to an antigen- a foreign protein) and complement binding. Lupus patients often show decreased levels of total complement, which may be helpful in tracking disease activity. <br /><br /> X-rays. X-rays of hands, wrists, feet, and knees are useful for detecting the presence of erosions. If erosions are seen, especially in early disease, this suggests the diagnosis of RA or other erosive diseases, and can indicate a more aggressive disease process. <br /><br /> Magnetic Resonance Imaging (MRI). MRI is more sensitive than x-rays for detecting inflammation within the joint and also for detecting early erosions in RA. <br /><br /> Diagnostic Ultrasound (DUS). Ultrasound is a relatively new technology in the realm of musculoskeletal diseases. It is an effective, fast, and cost-effective means of detecting early inflammation and damage in patients with different types of arthritis. <br /><br /> Chest X-ray. A chest x-ray (CXR) in patients with early RA will likely be normal. However, because RA-related lung disease can be present early and may be difficult to detect on physical exam, it is reasonable to obtain a baseline CXR to evaluate if signs of lung disease are present. In addition, because some agents, such as methotrexate and anti-TNF drugs, which are used to treat RA can lead to lung toxicity, getting a baseline CXR before starting medication therapy is reasonable. <br /><br /> Not all of the above tests will necessarily be ordered at the first visit. But this is a good basic list that will give the reader a good idea of what to expect. <br /><br /> Another issue is the laboratory. If the rheumatologist has his or her own specialty laboratory and it is state-certified as a reference lab, I would highly recommend that a patient get their lab tests done at that office. A rheumatologist will have the best idea as to lab test interpretation and the rheumatologist's lab will be experienced in dealing with arthritis. They will provide the most accurate and believable results. All too often, large commercial labs are not used to dealing with the complexity of arthritis testing. A correct diagnosis is key!   <bio>Nathan Wei, MD FACP FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine. For more info: <a href="http://www.arthritis-treatment-and-relief.com/arthritis-treatment.html" >http://www.arthritis-treatment-and-relief.com/arthritis-treatment.html</a>  </bio>]]></content:encoded>
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