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VALUE OF ROUTINE BLOOD COUNTAND ESR IN THE DIAGNOSIS OF ARTHRITIS
OP Kapoor
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
Osteo-arthritis of the knees is an extremely common condition and is easily diagnosed in middle aged and overweight patients complaining of pain in the knees while climbing up or down the stairs, while sitting on the toilet early morning and while praying (namaaz).
I am drawing the attention of the GPs to the patients who come with any other painful swollen joints in the body with no other physical signs. In these patients a routine blood count or an ESR can give away the diagnosis. History taking may be misguiding. For example, presence of severe anaemia in a female and mild anaemia in a male patient favours the diagnosis of tuberculosis of the joints (which is usually a single joint and rarely two joints).
More important is detection of the blood Leukaemias (Cancers) and connective tissue disorders from a report of routine blood count and ESR, specially the former.
I have seen family physicians asking for tests like Blood Uric Acid, HIV test, Rheumatoid factor and ANA test routinely which are much more costly and do not give a "throw away" diagnosis, unlike the above tests which are very cheap.
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