It is usually a visual diagnosis; the presence of Heberden’s nodes is characteristic.
2nd-order laboratory parameters-depending on the results of the history, physical examination, and obligatory laboratory parameters-for differential diagnostic clarification.
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
- Uric acid – if gout is suspected.
- Renal parameters – creatinine, urea.
- Arthritis diagnostics
- Blood: CRP, RF, anti-CCP, uric acid, ACE, Ca, parathyroid hormone; heparin blood: HLA-B27, HLA-DR4.
- Punctate: synovial analysis, RF, cytology, if necessary Borrelia immunoblot, Yersinia immunoblot.
- If para- or postinfectious arthritis is suspected: serology: AK against Borrelia, Campylobacter, Chlamydia, Hepatis B virus, Parvovirus B19, Rubella virus, Salmonella, Streptococcus (ASL), Yersinia.
- Pathogen detection (cultural): stool for Campylobacter, parasites, Salmonella, Shigella, fungi (Candida), Yersinia.
- If a consequence of an autoimmune disease is suspected: ANA, if positive: anti-ds-DNA-AK, ANCA, ENA, histones.
