RHEUMATIC DISEASE - CHOOSING THE MOST USEFUL DIAGNOSTIC-TESTS

Many tests are available for evaluating older patients with suspected rheumatic disease. Factors that help you determine which tests would b e most helpful are the individual history and physical exam plus your knowledge of how likely a particular disease is in that population. Th e clinical utility of common tests such as the ESR, rheumatoid factor, and antinuclear antibody is quite limited. Radiographic evaluation is useful when particular problems are suspected but is rarely helpful a s a diagnostic test in older patients with recent onset of symptoms an d no history of trauma. In select situations, other specific diagnosti c testing (eg, for bony pain, neuropathies, and vasculitides) is indic ated.