Which ESR/CRP pattern is suggestive of active inflammatory arthritis compared with osteoarthritis?

Which ESR/CRP pattern is suggestive of active inflammatory arthritis compared with osteoarthritis?

• A. Normal ESR/CRP with inflammatory-type symptoms.
• B. Elevated ESR/CRP with OA symptoms.
• C. Elevated ESR/CRP with inflammatory-type symptoms; OA often normal ESR/CRP.
• D. ESR/CRP is not helpful.

Answer: (C)

ESR and CRP rise with inflammation, so they help tell apart inflammatory arthritis from wear-and-tear osteoarthritis. In active inflammatory arthritis, you usually see elevated ESR or CRP along with inflammatory-type symptoms such as joint swelling, warmth, redness, and prolonged morning stiffness. Osteoarthritis, on the other hand, is degenerative and typically doesn’t cause a systemic inflammatory response, so ESR/CRP are usually normal or only mildly elevated. Therefore the pattern of elevated ESR/CRP with inflammatory-type symptoms fits active inflammatory arthritis, while OA often shows normal inflammatory markers.