Case History:
89 yo male with pain, stiffness and tightness in his cervical and upper thoracic spine
Contributed By:
Paul Sherman, DC
Case Presentation: Page 5 of 7 The following laboratory tests were ordered to further evaluate the patient?s symptoms and findings of the plain film x-rays.
  • Chem-screen
  • Arthritic panel
  • HLA B-27 antigen
  • HLA B8 antigen
  • CBC with Diff
  • UA
Of these lab tests, special attention was focused on the glucose levels, RA factor, CRP, ESR, HLA B27 and HLA B8 for the following reasons.
  • Up to 32% of patients diagnosed with DISH (Diffuse Idiopathic Skeletal Hyperostosis) may have adult onset of diabetes mellitus
  • 70% of patients diagnosed with RA (Rheumatoid Arthritis) have a positive RA latex fixation
  • CRP if positive usually indicates tissue damage
  • ESR if elevated usually indicates inflammation
  • 90% of patients diagnosed with Ankylosing Spondylitis have a positive HLA B27
  • Approximately 40% of patients with DISH may have a positive HLA B8 antigen
Note: In this case, the patient?s glucose levels happened to be normal and his CRP, HLA B27 and HLA B8 antigen levels were negative. The patients RA and ESR were positive.

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