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INTRODUCTION

Laboratory tests for rheumatic disease are performed for various reasons: to diagnose, to clarify whether a condition is inflammatory or noninflammatory, to establish a prognosis, to monitor disease activity, to assess the extent or severity of organ involvement, to predict efficacy and toxicity of therapies, and to monitor treatment side effects. In addition, there may be administrative indications for laboratory testing, for example, to qualify for a specialty medication, to qualify a patient for a clinical trial, to determine if a patient satisfies classification criteria for a disease, and to include a patient in data registries and repositories. To support a clinical diagnostic impression, laboratory tests are most effective when used in conjunction with data from the history and physical examination. Laboratory tests for autoimmune rheumatic diseases nearly always lack sufficient sensitivity and specificity to establish diagnoses independently and therefore should be considered “probabilistic” rather than diagnostic tests. Table 3–1 summarizes laboratory and other tests commonly used to help clarify the diagnosis in typical presentations of patients with rheumatic diseases.

Table 3–1.Laboratory tests frequently ordered for typical clinical presentations.

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