Rheumatoid arthritis is a systemic inflammatory disease with predominant involvement of the synovial joints.1 The current therapeutic focus in the management of RA is to reduce the overall inflammatory burden and to keep the synovitis as low as possible and to reduce the impact of the disease on overall morbidity and improve the quality of life.2 Early introduction of Disease Modifying anti-rheumatic drug (DMARD), good compliance, appropriate follow-up with continued disease activity measures to maintain a tight control of the disease will improve the out-come.3, 4, 5, 6 In our previous publication when we attempted to analyze the role played by various core set criteria on the measure of change in a patient of RA, three parameters like Swollen joint count (SJC), Visual analogue scale (VAS) pain scale and a measure of inflammation (ESR) had a greater influence on changes observed on feeling of improvement from both patients as well from physician point of view.

7 Recent publications suggest that a significant difference can be observed in disease activity of RA by use of clinical measures between active drug and controls even, without the use of laboratory inflammatory parameters such as ESR and CRP.

8 However contrary to this, there are multiple studies which suggest that laboratory inflammatory parameters like ESR and CRP serve as more useful predictor for disease outcome variables such as joints erosion; and inflammatory parameters have stronger correlation than clinical variables such as Tender joint count (TJC) and SJC.9, 10, 11 With the current understanding of the disease process, it is clear that the key to successful management of RA is to reduce the inflammation to minimum and thereby reduce the impact of the disease.9, 12 The variables like TJC, SJC, pain measures and physician and patients assessment closely reflect the clinical manifestations of the inflammatory process and may not be reflect the burden of inflammation in totality. In addition the evaluation of TJC and SJC is time consuming and often influenced by observers bias.13 Observable difference exists even when DAS is calculated based on ESR and CRP. However, Cynthia et al8 argue with elegant demonstration that well measured CRP should be a reasonable good marker in the follow-up of an RA patient in day to day clinical practice.

The question that arises is which of these inflammatory parameters should be preferred to use. Cheaper establishment (or Cost factors), general availability and reasonable association with other disease parameters make the case for ESR against CRP, though several studies have suggested CRP to be superior to ESR.8 Most of these studies have attempted to correlate the measures which suggest a possible relationship between the parameters rather than their overlapping powers. Correlation depends on the range of the true quantity in the sample.14 The test of significance by correlation may show that the two methods are related, but not overlapping or can replace one with other.15 In this study we have attempted to see how much agreement occurs as a measure for inflammation between these clinical variables such as TJC, SJC and VAS scale and the laboratory inflammatory variables ESR and CRP by mountain plot analysis.16 We hypothesize that, as a measure, CRP supersedes ESR in its power to replace other clinical measure. This study was undertaken to find out how much ESR and CRP as test parameters, overlap with the TJC, SJC and VAS pain scale in a routine clinical practice.


ESR and CRP are two commonly used laboratory inflammatory parameters. The controversy remains which of the two is a better measure to use and which parameter closely reflects the clinical measures of inflammation as well the disease process in Rheumatoid arthritis.


We used mountain plot analysis to find out the congruency of ESR and CRP individually with clinical measures namely Tender joint count (TJC), Swollen joint count (SJC) and Visual analogue scale for Pain (VAS). 303 RA patients who are in our regular follow-up were included in the study. There TJC, SJC and VAS pain and ESR and CRP were retrieved.


242 were female and 61 were male patients. The mean age was 46.8 years (17-79 years), mean duration of illness was 70.81 (3-307) months. All of them were on conventional DMARD with majority on combination of methotrexate, Hydroxychloroquine and/or leflunomide. Both ESR and CRP correlated with all three measures such as TJC, SJC and VAS. The correlation was stronger with ESR than CRP. When the effectiveness of ESR vs CRP was compared for their overlapping on the clinical parameters TJC, SJC and VAS by using mountain plot method, CRP performed better than ESR and coincided with all three clinical parameters of the disease RA.


Our study emphasizes the fact that CRP is a better measure of inflammation than ESR and represents the information on the inflammatory component provided by both TJC and SJC, as appreciated by the close overlap. The CRP can replace the clinical measures (joint counts and Pain scale) more effectively than ESR, provided other causes for elevation of CRP are excluded.

About the author:


blood test for rheumatoid arthritis results

16 thoughts on “Blood Test For Rheumatoid Arthritis Results

  1. monkey_moo_moo

    Does anyone know why I would need to have a full blood count test repeated in 2 weeks?
    I’ve just been diagnosed with arthritis (I have the bone growths in my joints) and now the doctor is trying to find out what type. I had lots of blood tests yesterday (including the rheumatoid factor, enthrocryte sedimentation, c-reactive protein etc). The doctor’s called today to say they had some of the results back and I need to have another full blood count done in two weeks time. Why is this?

    I’m 25.

    1. Harry S

      Talking to your doctor would probably be the best source of information. That said, they could be making sure that any unusual levels or results are consistent, and not the result of a temporary aggravating factor. Things such as a very active day or a cold could cause some tests to read a different way, but if they get consistent results they can be more sure that the tests are pointing towards the same diagnosis. I hope they can give you some answers.

  2. Lanae

    What is it called when you have high white blood cells?
    I’ve been hospitalized twice for high white blood cells. They diagnosed it before but I forgot the name of it. My white count was like 22,000

    1. rosieC

      WBC count is a blood test to measure the number of white blood cells (WBCs)

      Alternative Names
      Leukocyte count; White blood cell count

      Normal Results
      4,500-10,000 white blood cells per microliter (mcL). So your result of 22,000 is unusually high

      A high number of WBCs is called leukocytosis. It may be due to: Anemia. Infectious diseases; Inflammatory disease (such as rheumatoid arthritis or allergy); allergic or toxic reaction to medicines or chemicals; Leukemia ;Severe emotional or physical stress and Tissue damage (for example, burns); • Trauma • Use of certain medications, such as corticosteroids, antibiotics or anti-seizure drugs
      • Allergy • Chronic bone marrow diseases such as a myeloproliferative disorder
      • Acute or chronic leukemia; • Diverticular Disease and Intense exercise.

      It is important to note that high white blood cell count would be considered normal in certain situations:
      • Pregnancy in the final month and labor may be associated with increased WBC levels.
      • Spleen removal could grant persistent mild to moderate increased WBC count.
      • Normal newborns and infants have higher WBC counts than adults
      • Too much smoking could also cause an increased WBC count

  3. Anonymous

    What sorts of things could you be asked to have checked through a blood test?
    I know you can have them check for anemia, for hormone levels, for cholesterol, for blood type…are there other things (besides looking for specific diseases)?

    1. gillianprowe

      Usually the GP will do a CBC or Full Blood Count, white cells, red cells, platelets, oxygen, iron, the results may be normal or not and if not then can point the GP in the right direction. Then you usually get a LFT or Liver Function Test, liver enzymes just to see if that is normal. Then U & E for kidney function. Those 3 are the normal ones but if anything shows up, they can then order others. Obviously much will depend on your symptoms, for example if you have red hot swollen joints, the GP might do a Rheumatoid Factor test just to rule in or out Rheumatoid Arthritis.

  4. jcastel

    Can someone give me advice on what sport to try out?
    I’ve been getting checked for JRA (juvenille rheumatoid arthritis) and the results turned out negative(i had blood tests done) so i was thinking of joining a sport that doesn’t put too much strain on my knees, ankles, wrists, ect.. I was thinking of doing swimming or tennis. Any advice?

  5. StormXibalba

    What does it mean if someone has a higher than average level of platelets in their blood?
    What are the causes and what does it mean. Someone has mentioned Leukemia to me and now I’m panicking a little. The doctor has said to go back in 6 weeks for another blood test.

    1. gallop

      Elevated numbers of platelets is called thrombocytosis (platelets are also called thrombocytes).
      They are tiny clotting cells found in blood (red blood cells, white blood cells, platelets, and plasma form whole blood). Here is an exerpt from the Mayo Clinic site on the many possible causes…………………………….

      Causes (of thrombocytosis)

      “Bone marrow — spongy tissue inside your bones — contains stem cells that can become red blood cells, white blood cells or platelets. Platelets travel through your blood vessels. They stick together to form clots (thrombi) to stop bleeding that occurs when you damage a blood vessel, such as when you cut yourself. A normal platelet count ranges from 150,000 to 450,000 platelets per microliter of blood.

      If you have thrombocytosis, your bone marrow overproduces the cells that form platelets (megakaryocytes), releasing too many platelets into your blood. If your blood test results show you have a high platelet count, it’s important for your doctor to determine whether you have thrombocythemia or reactive thrombocytosis to know how to treat your condition.

      Reactive thrombocytosis causes include:

      Recent surgery
      Removal of your spleen
      Acute blood loss
      Iron deficiency anemia
      Hemolytic anemia — a type of anemia in which your body destroys red blood cells faster than it produces them, often due to certain blood diseases or autoimmune disorders
      Inflammation, such as from rheumatoid arthritis, connective tissue disorders or inflammatory bowel disease “

  6. staravia

    How high can a CRP (blood test) reading go?
    I have the results for my rheumatoid arthritis, it has gone down from 72 to 8 since starting meds! I know I was pretty grotty at 72 but wondered how much higher it could go.
    Also, can anyone tell me, does this mean my ‘flare up’ has gone?


    1. icechelly24

      The CRP “normal” varies from lab to lab. I’m guessing the normal for your test was less than 8. The highest I have seen was 176. Far and away the highest…no one has ever come close to that.

      If you are feeling better, then your flare is probably under control. The CRP responds to inflammation. When you are having a flare, your have a lot of inflammation going on and thus your CRP goes up. The meds help with the inflammation, which brings the CRP down. Going from 72 to 8 would suggest that your flare is gone, but it all depends on how you are feeling.

      Hope that helps 🙂

  7. Baby #3 Due 6/28/11

    Blood test results for rheumatoid arthritis?
    I went to the doctor Monday and she thinks i am have RA so she had blood work done. I was wondering how long it takes to get the results back? Are should i call them?

    1. Jacob

      While there are several tests that can be preformed to help detect Rheumatoid Arthritis, such as a complete blood count or checking C-Reactive Protein levels, it is important to note that these are not always effective at diagnosing arthritis. This is because there is no test, blood or otherwise, that can detect arthritis 100% of the time. So, while blood tests and x-rays are a good place to start, they do not always provide a definitive answer.

      As far as a time frame goes, this can vary greatly on the lab doing the work and the doctor. However, it shouldn’t take more than a week and I would imagine if you call your doctors office, the receptionist should be able to give you a better time frame.

  8. Case

    Do you think this could be pseudo-gout? And how would I reduce the pain?
    I’m only 19 years old and this condition seems to strike more upon the elderly, but I have almost all the symptoms. My hip hurts mostly at night. It is sharp and abrupt and it feels swollen and its warm to touch. Blood test results were normal, so this rules out gout because there would be increased concentration of uric acid. But pseudo gout has similar symptoms. It’s probably not rheumatoid arthritis either because that would show up on the blood test too. Ibuprofen isn’t effective.

  9. Patrice

    What are the causes of a low Red Blood Cell Count? My Doctor has already ruled out Vitamin D and B12 and Iron?
    My red Blood Cell count is at 3.8, the normal is 4.2..Does anyone know the ailments that could cause this?

Leave a Reply

Your email address will not be published. Required fields are marked *