Prescreening Blood Tests

Please remember to bring all your test results with you on your appointment day.

Suggested investigations

Before your clinic appointment

In order to help prioritise and make the best possible use of your appointment / your patients’ clinic appointment , it would be really helpful if some investigations could be done in anticipation of the clinic appointment.

Suggested investigations where the following conditions are suspected are listed below.

set of blood vials
set of blood vials

Inflammatory Arthritis

Rheumatoid arthritis, psoriatic arthritis, reactive arthritis, undifferentiated arthritis

Tests
FBC, ESR, Full biochemical screen, CRP, Rheumatoid Factor, CCP antibodies, Antinuclear factor

Note

  • ESR or CRP can both be normal in up to 1/3 of patients at presentation
  • Rheumatoid factor (and CCP antibodies) will be negative in 1/3 of patients.

Steroids
If you need to put your patient on steroids while waiting for assessment, please send sample to lab before starting and try and taper steroids in anticipation of appointment.

Ankylosing Spondylitis

Blood test screening can be very useful in determining prognosis.

Tests
FBC, ESR, U+E, LFT’s, CRP, HLA B-27 (where available), Xray Sacroiliac joints (MRI more sensitive though if you have access)

Note

  • ESR and CRP normal in 50% of patients with Ankylosing Spondylitis,
  • 5% of healthy adults will be HLA B-27 positive and up to 20% of AS patients have a negative test.

If requesting MRI make sure you request scans of Sacroiliac joints. Lumbar spine scan relatively insensitive to AS (although may exclude other pathology).

Generalised Myalgias

e.g. suspected Fibromyalgia / Polymyalgia / Polymyositis

Tests
FBC, ESR, CRP, U+E, LFT’s, CPK, ANF, TFT’s, Myeloma screen if relevant.

Raynaud’s phenomenon

Most patients with Raynauds have it in isolation but this is a useful screen where connective tissue disease suspected

Tests
FBC, ESR, CRP, U+E, LFT’s, TFT’s, Antinuclear factor (request scleroderma screen where suspected).

Osteoporosis

This is a useful screen for secondary causes of osteoporosis.

Tests
FBC, ESR, Full biochemical screen (including Bone profile), TFT’s, Vit D levels, Anti gliaden antibodies, myeloma screen.

Note
Where hypercalcaemia or elevated Alk Phos present, check PTH levels (check with lab)

Gout

In addition to Uric acid test always a good idea to screen for metabolic syndrome / diabetes / hyperlipidaemia

Tests
FBC, ESR, CRP, Full biochemical screen, Uric acid (not routinely done in some labs as part of biochemical profile so needs to be requested specifically), Lipid profile, Fasting blood sugar / HbA1C.

Drug safety monitoring tests

Although recommended frequency can vary from drug to drug, most patients will require FBC, SMAC (liver and kidney tests) and a CRP is always useful.

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Dr Kavanagh has an interest in the management of inflammatory arthritis, osteoporosis.

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