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Arthritis: SED Rate

Posted Aug 24 2008 1:49pm
DAVID MARKS, MD: Hi and welcome to our webcast. I'm Dr. David Marks. Thank you all for sending in your questions about arthritis. We're going to try to answer them today.

Joining me to do that is Dr. Allan Gibofsky, Professor of Medicine and Public Health at Cornell, and a rheumatologist at the Hospital for Special Surgery. Thanks for helping us out.

DAVID MARKS, MD: "Why do they take a SED rate with arthritis? Does it always prove or disprove you have arthritis?"

ALLAN GIBOFSKY, MD: An excellent question. The SED rate, the erythrocyte sedimentation rate or ESR is a nonspecific index of inflammation. When it is elevated, when it is abnormal, we know that there is inflammation in the body. When it is not elevated, assuming that there are no things to falsely lower its value, we know that there is no inflammation in the body.

Merely because the SED rate is elevated, that does not mean that the patient has arthritis. So it is not a diagnostic tool. The SED rate can be elevated in anything from athlete's foot to terminal cancer. Indeed, there are studies that show that women at certain times in their normal menstrual cycle may have an elevated SED rate.

We use the SED rate as gauge, as a guide to how much inflammation there is, and whether the therapy we're prescribing is reducing that inflammation. We do not use it diagnostically because it cannot make the diagnosis for us.

DAVID MARKS, MD: So it's used as a guide for the physician?

ALLAN GIBOFSKY, MD: That's correct. It's an index of whether what we're giving is working, and it's also an index as to how much inflammation is going on in that patient. A patient who comes in with multiple complaints and a very high SED rate, is a patient with something that that we need to look to find out further. A patient with multiple complaints and a normal SED rate kind of sets the stage that we may have more time to watch something evolve if anything will evolve at all.

DAVID MARKS, MD: Thank you for your questions, and thank you for joining our webcast. I'm Dr. David Marks. Goodbye.

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