The Sedimentation Rate of the Erythrocytes in Chronic Arthritis

Abstract

Since the original observations of Fahraeus on the variation in the sedimentation rate of erythrocytes in health and disease the phenomenon has been studied in a wide variety of pathological conditions.

We have been interested in the reaction in only one class of cases—patients suffering from chronic multiple arthritis. Employing Westergren's 1 modification of Fahraeus' technique we have made approximately 300 observations on 200 patients who sought treatment at the Arthritic Clinic of the Presbyterian Hospital.

Our results suggest that in this limited group of patients the determination of the sedimentation rate of the red blood cells is of distinct value. Our findings may be summarized as follows:

(1) In active cases of rheumatoid (chronic infectious) arthritis the sedimentation rate is greatly increased, usually attaining values above 40 mm. in one hour.

(2) In cases of osteo (hypertrophic) arthritis the sedimentation rate, while, as a rule, slightly elevated, rarely attains values greater than 30 mm. in one hour.

(3) Cases of so-called myositis, fibrositis and neuritis have almost invariably shown a normal sedimentation rate.

(4) In cases of rheumatoid (chronic infectious) arthritis the sedimentation rate parallels to an extraordinary degree the activity of the process.

The test as applied solely to arthritic patients is therefore of considerable value: (1) In differentiating the two great groups of arthritic patients—the rheumatoid or chronic infectious and the osteo or hypertrophic variety. (2) In differentiating between chronic multiple arthritis on the one hand and fibrositis, myositis and neuritis on the other hand. (3) In following the course of the disease and evaluating the results of therapeutic measures instituted.