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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Erythrocyte Sedimentation Rate


- Discussion:
    - measurement of the increased rate of settling of erythrocytes is an important laboratory test in evaluation of disease activity in patients with
            connective-tissue diseases, certain infections, and neoplastic diseases;
    - a useful measure to follow the course of previously diagnosed specific illnesses;
    - westergren method;
          - normal values are 0-9 mm per hour for men & 0-20 mm/hr for women;
    - conditions which increase sed rate:
          - infection
                  - orthopaedic Infections
                  - sed rate in THR
                  - sed rate: osteomyelitis of the spine

          - inflammatory conditions (polymyalgia rheumatica)
          - cancer (lymphoma, multiple myeloma)
          - pregnancy (third month to 1-month post partum);
          - surgery:
                - in routine orthopaedic procedures maximum of 25 to 100 mm / hour is reached at 4 days, which gradually decreases to nl over 1-2 weeks;
                - w/ more extensive surgery (THR) mild elevation may perist for upto one year;
          - heparinized blood;

    - conditions that decrease the sed rate:
          - rate may be "falsely low" in conditions in which red blood cells do not undergo rouleaux formation;
          - sickle cell anemia
          - hereditary spherocytosis;
          - cold agglutinin disease;
          - cachexia




Clinical significance of the erythrocyte sedimentation rate in orthopaedic surgery.

Use of erythrocyte sedimentation rate and C-reactive protein level to diagnose infection before revision total knee arthroplasty. A prospective evaluation.




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Clifford R. Wheeless, III, MD on Sunday, August 11, 2013 10:57 am