CurrentOscar HealthPolicy N/A

General Inflammation Testing

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Coverage criteria for CRP and ESR testing in members with diagnosed or suspected inflammatory conditions, subject to benefit coverage, medical-necessity requirements, and state of residence.

Policy Summary

PayerOscar Health

PolicyGeneral Inflammation Testing

Policy CodePolicy N/A

Change TypeNo material clinical or coverage change

Effective DateJan 1, 202757d

Last ReviewSep 28, 2026

Next Review DateN/A

Key ActionDocument the diagnosed or suspected inflammatory condition and support whether CRP, ESR, or both are indicated.

SourceLink

POLICY UPDATE CHANGES

The policy was updated on September 28, 2026, including revisions to the policy background, guidelines, evidence-based references, and notes in the indications and limitations of coverage section.

2Inflammatory markers addressed

CRPPreferred biomarker when either marker qualifies

4Applicable procedure codes listed

Every 2–3 daysEarly-course CRP monitoring for pediatric osteomyelitis

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CurrentOscar HealthPolicy N/A

General Inflammation Testing

Customize your policy alerts

Sign up for all Oscar Health policy alerts

Know when Oscar Health releases new policies or updates existing guidance.

Monitor payer policy activity

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Coverage criteria for CRP and ESR testing in members with diagnosed or suspected inflammatory conditions, subject to benefit coverage, medical-necessity requirements, and state of residence.

Policy Summary

PayerOscar Health

PolicyGeneral Inflammation Testing

Policy CodePolicy N/A

Change TypeNo material clinical or coverage change

Effective DateJan 1, 202757d

Last ReviewSep 28, 2026

Next Review DateN/A

Key ActionDocument the diagnosed or suspected inflammatory condition and support whether CRP, ESR, or both are indicated.

SourceLink

POLICY UPDATE CHANGES

The policy was updated on September 28, 2026, including revisions to the policy background, guidelines, evidence-based references, and notes in the indications and limitations of coverage section.

2Inflammatory markers addressed

CRPPreferred biomarker when either marker qualifies

4Applicable procedure codes listed

Every 2–3 daysEarly-course CRP monitoring for pediatric osteomyelitis

General Coverage Criteria

General inflammatory marker coverage

Covered when the applicable inflammatory condition-specific criteria are met.

General coverage requirements

Qualifying condition: The individual has a diagnosed or suspected inflammatory condition listed in the condition-specific coverage criteria.
Qualifying marker: The ordered test matches the condition-specific requirement: CRP, ESR, either CRP or ESR, or both CRP and ESR.
Either conventional CRP or hsCRP may be used to measure CRP. When either CRP or ESR meets criteria, CRP is the preferred biomarker.

Condition-specific indications and frequency

Covered for the listed condition-specific indications using the specified test and frequency or clinical purpose.

Condition-specific indication

Acute hematogenous osteomyelitis: CRP to confirm diagnosis; repeat 2–3 days during the early therapeutic course and weekly until normalization or a clear trend toward normalization.
Large vessel vasculitis: CRP and ESR during initial assessment to confirm diagnosis; repeat every 1–3 months during the first year and every 3–6 months thereafter.
Polymyalgia rheumatica: CRP or ESR at initial diagnosis and every 3 months during long-term steroid therapy.
Rheumatoid arthritis: CRP or ESR before treatment, every 1–3 months during active disease, and annually when disease is inactive.
Systemic lupus erythematosus: CRP or ESR at initial assessment, every 1–3 months during active disease, every 6–12 months during stable disease, and during pregnancy.

Pediatric chronic nonbacterial osteomyelitis

All entry criteria must be met.

Pediatric CNO entry criteria

Bone pain and/or musculoskeletal functional limitation for six or more weeks.
Onset before 18 years of age.
Abnormal radiograph or advanced imaging findings at nonarthritic bone sites.
Advanced imaging may include MRI, CT, or bone scintigraphy.

ESR measurement does not meet criteria for individuals who do not have a diagnosed or suspected inflammatory condition. Coverage requires an applicable inflammatory condition and the condition-specific marker selection identified in the policy.

Measurement of CRP and/or ESR does not meet criteria when performed during a general examination without abnormal findings. The testing must instead be supported by a diagnosed or suspected inflammatory condition and the applicable condition-specific requirements.

When a condition meets criteria for only CRP or only ESR, ordering both tests at the same time does not make both tests eligible. When CRP or ESR is the qualifying alternative, CRP is the preferred biomarker and only CRP meets criteria.

Testing in the absence of a diagnosed or suspected inflammatory condition is not medically necessary under this policy. In this circumstance, ESR measurement does not meet coverage criteria.

Testing performed as part of a general examination without abnormal findings is not medically necessary under this policy. This applies to measurement of CRP and/or ESR when no abnormal finding or qualifying inflammatory condition supports the order.

Covered Conditions and Clinical Uses

Acute and chronic urticaria

Covered when clinically indicated; frequency is not specified.

Qualifying test: CRP or ESR for acute or chronic urticaria.

Acute phase inflammation

Covered when clinically indicated; frequency is not specified.

CRP for acute phase inflammation.

Acute hematogenous osteomyelitis

Covered for diagnosis and therapeutic-course monitoring.

ALL of the following

Testing Frequency and Monitoring Intervals

CRP for acute hematogenous osteomyelitis

Diagnostic useCRP to confirm acute hematogenous osteomyelitis

Early therapeutic courseMeasure every 2–3 days

Later monitoringMeasure weekly until normalization or a clear trend toward normalization

Large vessel vasculitis

TestCRP and ESR

First yearEvery 1–3 months

ThereafterEvery 3–6 months

Coding and Clinical Thresholds

Applicable CPT/HCPCS Procedure CodesCPT

85651	Sedimentation rate, erythrocyte; non-automated.
85652	Sedimentation rate, erythrocyte; automated.
86140	C-reactive protein.
86141	C-reactive protein; high sensitivity (hsCRP)

Hodgkin lymphoma ESR prognostic threshold

MarkerESR

ThresholdAt or above 50

Hodgkin lymphoma significanceConsidered an early-stage unfavorable factor

Markedly elevated CRP

MarkerCRP

Marked elevationEspecially above 200

Clinical considerationGive more consideration to infection or malignancy

Documentation, Billing, and Denial Risks

Documentation Required

Accurate Service Documentation

Submit accurate documentation of the services performed and code claims appropriately in accordance with applicable industry-standard coding guidelines and current reimbursement policies.

Documentation Required

Document Condition and Test Rationale

Document the diagnosed or suspected inflammatory condition and the clinical rationale for each inflammatory marker ordered. The applicable criteria depend on the condition and may support CRP, ESR, either test, or both; when either CRP or ESR meets criteria, CRP is the preferred biomarker.

Identify the diagnosed or suspected inflammatory condition.
Explain the rationale for ordering CRP, ESR, or both.
Either conventional CRP or high-sensitivity CRP may be used to measure CRP levels.

Laboratory Ordering Requirements

Billing Rule

Specify hsCRP for cardiovascular-risk stratification

If high-sensitivity CRP is desired for cardiovascular-risk stratification, specifically request hsCRP on the laboratory requisition.

Documentation Required

Identify hsCRP on the requisition

When hsCRP is desired for cardiovascular-risk stratification, include the specific hsCRP request on the laboratory requisition rather than relying on a general CRP order.

Documentation Required

Include a written indication for ESR

Provide a written indication on the laboratory requisition when ESR is ordered. The cited laboratory guidance states that ESR is performed only when a written indication is provided.

Clinical Background

Inflammation may result from tissue injury, infection, arthritis, lupus, and other disorders. C-reactive protein (CRP) is an acute-phase protein produced by hepatocytes that can increase substantially after tissue injury or infection and may be used to monitor inflammation. Erythrocyte sedimentation rate (ESR) is a blood test used as a general inflammatory marker; ESR may remain elevated longer than CRP after the inflammatory source resolves.

Definitions and Abbreviations

CRP

AbbreviationCRP

Expanded termC-reactive protein

Clinical categoryInflammatory marker

ESR

AbbreviationESR

Expanded termErythrocyte sedimentation rate

Clinical categoryInflammatory marker

Services Not Covered Under This Policy

ESR without a diagnosed or suspected inflammatory condition is not covered because it does not meet the policy's coverage criteria.

CRP and/or ESR during a general examination without abnormal findings is not covered because the testing does not meet the policy's coverage criteria.

Policy Summary

PayerOscar Health

PolicyGeneral Inflammation Testing

Policy CodePolicy N/A

Change TypeNo material clinical or coverage change

Effective DateJan 1, 202757d

Last ReviewSep 28, 2026

Next Review DateN/A

Key ActionDocument the diagnosed or suspected inflammatory condition and support whether CRP, ESR, or both are indicated.

SourceLink

On This Page

Other listed conditions: Acute or chronic urticaria, acute phase inflammation, ankylosing spondylitis, Castleman disease, Hodgkin lymphoma, nonradiographic axial spondyloarthritis, pediatric chronic nonbacterial osteomyelitis, periprosthetic joint infection, multisystem inflammatory disease, and T-cell lymphomas meet criteria using the condition-specific CRP and/or ESR selection and frequency or purpose stated in the policy.

Use CRP to confirm or evaluate acute hematogenous osteomyelitis.

Repeat CRP 2–3 days during the early therapeutic course, then weekly until normalization or a clear trend toward normalization.

Ankylosing spondylitis and nonradiographic axial spondyloarthritis

Covered in patients with active symptoms and for regular-interval monitoring.

Use CRP or ESR at regular intervals for ankylosing spondylitis or nonradiographic axial spondyloarthritis with active symptoms.

Testing is not required at every clinic visit.

Castleman disease

Covered for condition-specific evaluation and monitoring.

Castleman disease context

Use CRP for Castleman disease when evaluating general inflammation; frequency is not specified.
For arthritis Castleman disease, use CRP initially every 1–3 months and later every 6–12 months.

Hodgkin lymphoma

Covered for evaluation of Hodgkin lymphoma; frequency is not specified in the general coverage table.

Use CRP and ESR for Hodgkin lymphoma.

Large vessel vasculitis, including giant cell arteritis and Takayasu arteritis

Covered for initial assessment and longitudinal monitoring.

ALL of the following

Use CRP and ESR during the initial assessment of large vessel vasculitis, including giant cell arteritis and Takayasu arteritis, to support diagnosis.
Repeat every 1–3 months during the first year and every 3–6 months thereafter.

Multisystem inflammatory disease

Covered to establish the diagnosis.

Use CRP to establish multisystem inflammatory disease, including multisystem inflammatory syndrome in children associated with SARS-CoV-2.

Elevated CRP is the preferred and most consistently supported inflammatory marker for MIS-C.

Pediatric chronic nonbacterial osteomyelitis

Covered when all pediatric CNO entry criteria are met.

ALL of the following

The individual meets all pediatric CNO entry criteria: bone pain and/or musculoskeletal functional limitation for at least six weeks, onset before age 18, and abnormal radiograph or advanced imaging findings at nonarthritic bone sites.
Use CRP and ESR to confirm the diagnosis.

Periprosthetic joint infection

Covered as supportive laboratory evaluation when periprosthetic joint infection is suspected.

Use CRP and ESR for suspected periprosthetic joint infection; frequency is not specified.

Results are supportive and must be interpreted cautiously because false-negative results occur.

Polymyalgia rheumatica

Covered at diagnosis and during long-term steroid therapy.

ALL of the following

Use CRP or ESR at initial diagnosis.
Repeat every 3 months during long-term steroid therapy.

Rheumatoid arthritis

Covered before treatment and for disease-activity monitoring.

ALL of the following

Use CRP or ESR before treatment.
Repeat every 1–3 months during active disease.
Repeat annually when disease is inactive.

Systemic lupus erythematosus

Covered for baseline assessment, disease-activity monitoring, stable disease, and pregnancy.

ALL of the following

Use CRP or ESR at initial assessment.
Repeat every 1–3 months during active disease.
Repeat every 6–12 months during stable disease.
Use during pregnancy when clinically indicated.
CRP may remain normal or only modestly elevated despite severe SLE; ESR may be elevated for reasons other than active lupus.

T-cell lymphomas

Covered for evaluation of T-cell lymphomas; frequency is not specified.

Use CRP and ESR for T-cell lymphomas.

Hodgkin lymphoma staging, risk classification, treatment selection, and follow-up

Covered for adult Hodgkin lymphoma diagnostic workup, risk classification, treatment selection, and follow-up.

ALL of the following

Use ESR as part of the adult Hodgkin lymphoma diagnostic workup, within six months of diagnosis.
Use ESR for stage and risk classification and to inform treatment algorithms; ESR below 50 mm/hr and ESR at or above 50 mm/hr are used in treatment stratification.ESR ≥50 mm/hr
ESR ≥50 mm/hr is an unfavorable risk factor.
During follow-up after treatment, obtain ESR every 3–6 months for 1–2 years, every 6–12 months until year 3, and annually thereafter; include ESR when it was elevated at initial diagnosis.

Systemic lupus erythematosus: interpretation of CRP and ESR

Use CRP and ESR as laboratory markers interpreted with clinical assessment rather than as direct measures of lupus progression.

ALL of the following

CRP may be normal or only modestly increased despite severe systemic lupus erythematosus.
ESR is often elevated but may reflect persistent polyclonal hypergammaglobulinemia and is not a reliable standalone marker of disease activity.
Interpret a significantly elevated CRP particularly as a reason to assess for infection; an elevated ESR does not reliably distinguish active lupus from infection.

Periprosthetic joint infection: supportive biomarker use, false negatives, and interpretation

Use CRP and ESR as adjunctive, not standalone, tests.

ALL of the following

CRP and ESR may be used as supportive biomarkers when a definitive periprosthetic joint infection diagnosis is not established.
Do not use CRP or ESR as the sole diagnostic tests or to identify the infecting organism.
False-negative results occur, including with low-virulence organisms; interpret levels cautiously with clinical findings and other diagnostic studies.

Inflammatory bowel disease evaluation

Use CRP only as an adjunct to clinical and endoscopic evaluation.

ALL of the following

CRP may support evaluation of suspected inflammatory bowel disease together with clinical and endoscopic findings.
Do not exclude inflammatory bowel disease solely because CRP is normal.

Large-vessel vasculitis, polymyalgia rheumatica, and active arthritis monitoring

Use inflammatory markers with clinical assessment and disease-activity measures.

Guideline-supported use

Use ESR and/or CRP to support monitoring of large-vessel vasculitis, with frequency determined by disease activity and treatment phase.
Use ESR and/or CRP for baseline evaluation and monitoring of polymyalgia rheumatica, including before long-term steroid therapy.
Use ESR and/or CRP as components of validated disease-activity monitoring for active inflammatory arthritis.

Multisystem inflammatory syndrome in children associated with SARS-CoV-2

Covered to support establishment of the diagnosis.

Use elevated CRP as the preferred and most consistently supported inflammatory marker when evaluating multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection.

Polymyalgia rheumatica: baseline evaluation and treatment or disease-activity monitoring

Use inflammatory markers for baseline evaluation and treatment or disease-activity monitoring.

ALL of the following

Use ESR and/or CRP before initiating long-term steroid therapy for polymyalgia rheumatica.
Use ESR or CRP to monitor treatment response and disease activity during steroid therapy, generally every three months.

Giant cell arteritis

Use CRP with ESR or plasma viscosity and CBC around diagnosis and follow-up.

ALL of the following

At or near diagnosis, obtain CRP plus either ESR or plasma viscosity, with a complete blood count.
During follow-up, obtain inflammatory markers and CBC with clinical history and examination.
Interpret marker results with clinical findings; lower inflammatory-marker levels do not exclude giant cell arteritis.

Rheumatoid arthritis and other inflammatory arthritis

Use CRP or ESR within validated disease-activity measures and according to clinical status.

ALL of the following

Use CRP or ESR to support validated disease-activity measures such as DAS28 or SDAI in rheumatoid arthritis and other inflammatory arthritis.
Monitor more frequently during active disease, usually every 1–3 months until the treatment target, remission, or low disease activity is achieved.

Systemic lupus erythematosus: baseline and follow-up monitoring

Use CRP and/or ESR for baseline and follow-up monitoring, with particular attention to possible infection.

ALL of the following

Include CRP and/or ESR in baseline and follow-up laboratory monitoring when clinically indicated.
Use CRP particularly when infection is suspected; a significantly elevated CRP should prompt assessment for infection.

Prosthetic joint infection

Use ESR and CRP as adjunctive preoperative tests.

ALL of the following

Use ESR and CRP to aid preoperative evaluation for prosthetic joint infection.
Do not use either marker as a sole diagnostic test or as a test to identify microbiology.

Pediatric acute hematogenous osteomyelitis

Use serum CRP for initial evaluation and as a baseline for sequential monitoring after confirmation.

ALL of the following

Obtain serum CRP during the initial evaluation of suspected pediatric acute hematogenous osteomyelitis.
When acute hematogenous osteomyelitis is confirmed, use the initial CRP as the baseline for sequential monitoring.

Suspected inflammatory or infectious condition without an established diagnosis

Use CRP as the preferred first test when an inflammatory or infectious condition is suspected without an established diagnosis.

ALL of the following

A specific inflammatory or infectious diagnosis has not been established effectively by other means.
The individual has unexplained symptoms or deterioration in health status and an inflammatory or infectious disease is suspected.
Order CRP as the preferred first test rather than ESR.
There is no indication for ordering ESR when CRP is elevated.

Unexplained symptoms or deterioration when inflammatory or infectious disease is suspected

CRP is covered as the preferred first test when clinical features support suspected inflammation or infection.

ALL of the following

The patient has unexplained symptoms or deterioration in health status.
An inflammatory or infectious disease is suspected.
A specific diagnosis cannot be effectively made by other means.
Use CRP as the preferred first test rather than ESR.

Routine monitoring of inflammatory arthritis and other rheumatic conditions

Repeat CRP testing when clinically indicated by disease status.

ALL of the following

The patient has inflammatory arthritis or another rheumatic condition requiring clinical monitoring.
Repeat CRP according to the patient's clinical status.
Repeat CRP is generally not indicated for routine follow-up of most infections.

Cardiovascular risk stratification in asymptomatic individuals with intermediate risk

Covered as one tool for selected cardiovascular-risk assessment.

ALL of the following

The individual is asymptomatic and has intermediate cardiovascular risk.
Use hsCRP as one of several tools to help determine whether statin therapy should be initiated.
hsCRP must be specifically requested on the laboratory requisition.

Initial evaluation and sequential monitoring of confirmed or suspected pediatric acute hematogenous osteomyelitis

Use serum CRP for initial evaluation and sequential monitoring of confirmed or suspected pediatric acute hematogenous osteomyelitis.

ALL of the following

Obtain serum CRP on initial evaluation of suspected pediatric acute hematogenous osteomyelitis.
After confirmation, use the initial CRP as the baseline for sequential monitoring.
During the early therapeutic course, measurement every 2–3 days, followed by weekly or other periodic measurement until normalization or a clear downward trend, is acceptable.

Polymyalgia rheumatica

TestCRP or ESR

DiagnosisAt initial diagnosis

Long-term steroid therapyEvery 3 months

Rheumatoid arthritis

TestCRP or ESR

Before treatmentMeasure prior to treatment

Active diseaseEvery 1–3 months

Inactive diseaseAnnually

Systemic lupus erythematosus

TestCRP or ESR

Initial assessmentMeasure at initial assessment

Active diseaseEvery 1–3 months

Stable diseaseEvery 6–12 months

PregnancyMeasure during pregnancy

Ankylosing spondylitis and nonradiographic axial spondyloarthritis

TestCRP or ESR

Clinical statusUse at regular intervals in patients with active symptoms

FrequencyThe policy does not specify a fixed interval

Hodgkin lymphoma

TestESR

Diagnostic workupTest within six months of diagnosis

Follow-up, years 1–2Every 3–6 months

Follow-up through year 3Every 6–12 months

After year 3Annually; include ESR if elevated at initial diagnosis

Inflammatory-marker monitoring

TestESR and CRP

First yearEvery 1–3 months

Subsequent monitoringEvery 3–6 months afterward

Active arthritis monitoring

TestESR and CRP

Until treatment targetEvery 1–3 months

After target is reachedPotentially every 6–12 months

Steroid therapy monitoring

TestESR or CRP

Treatment phaseDuring long-term steroid therapy

FrequencyEvery three months

Disease-activity monitoring

TestESR and/or CRP

Active diseaseUsually every 1–3 months

Monitoring endpointContinue until treatment target, remission, or low disease activity is achieved

Systemic lupus erythematosus

TestCRP

Active diseaseEvery 1–3 months

Stabilized diseaseEvery 6–12 months

Pediatric osteomyelitis

TestCRP

Early treatmentEvery 2–3 days

Subsequent monitoringWeekly or periodically until normalization or a clear downward trend

General inflammatory or infectious conditions

TestCRP

Repeat testingAccording to the patient’s clinical status

Most infectionsGenerally not indicated for routine follow-up

Serum CRP in pediatric osteomyelitis

Available evidenceNo data support a particular CRP monitoring frequency during pediatric acute hematogenous osteomyelitis

Early therapeutic courseEvery 2–3 days rather than daily is an acceptable approach

Until response is evidentFollow with weekly or other periodic measurement until normalization or a clear trend toward normalization

Hodgkin lymphoma ESR risk threshold

Lower-risk categoryESR below 50 mm/hr

Higher-risk categoryESR at or above 50 mm/hr

Clinical useThe threshold is used in Hodgkin lymphoma treatment algorithms and risk classification

ESR/CRP ratio for periprosthetic joint infection

MetricESR/CRP concentration ratio

Chronic infectionA ratio above 0.96 predicts chronic periprosthetic joint infection

Acute infectionA ratio below 0.96 predicts acute periprosthetic joint infection

Castleman disease inflammatory markers

ConditionIdiopathic multicentric Castleman disease

CRP thresholdAbove 10 mg/L

ESR thresholdAbove 15 mm/h

PMR inflammatory-marker elevation

Marker optionsESR or CRP

ESR thresholdMore than 30–40 mm/hour

PrevalenceAn elevated ESR or CRP is present in approximately 90% of patients with PMR

GCA ESR elevation

MarkerESR

Typical elevationMarked elevation of 40–60 mm/hour

FrequencyElevated ESR is present in most cases of giant cell arteritis

Pediatric AHO CRP monitoring

Initial monitoringUse the initial serum CRP as a baseline after acute hematogenous osteomyelitis is confirmed

Early courseMeasure every 2–3 days rather than daily

Later courseMeasure weekly or periodically until normalization or a clear trend toward normalization

Pediatric chronic nonbacterial osteomyelitis entry criterion

Symptom criterionBone pain and/or musculoskeletal functional limitation for six or more weeks

Age criterionOnset before 18 years of age

Imaging criterionAbnormal radiograph or advanced imaging at nonarthritic bone sites

Pediatric chronic nonbacterial osteomyelitis exclusion criterion

ConditionPediatric chronic nonbacterial osteomyelitis

Exclusion thresholdPlatelet count below 100,000/mm3

RequirementNo exclusion criterion should be present for the classification criteria

Denial Risk

No Inflammatory Condition

For individuals without a diagnosed or suspected inflammatory condition, measurement of ESR does not meet criteria and may be denied under the policy.

Denial Risk

Routine Exam Without Abnormal Findings

Measurement of CRP and/or ESR during a general examination without abnormal findings does not meet criteria.

Billing Rule

Avoid Unnecessary Concurrent Testing

Ordering both CRP and ESR at the same time does not establish coverage for both tests when the condition's criteria support only one marker. In that situation, only the qualifying test meets criteria; when either test qualifies, CRP is preferred.

Denial Risk

Inaccurate Documentation or Coding

Claims may be denied and/or payment may be recouped when documentation is inaccurate or coding and billing guidelines or current reimbursement policies are not followed.

Use accurate diagnosis and procedure coding.
Follow applicable industry-standard coding and billing guidelines.

AbbreviationhsCRP

Expanded termHigh-sensitivity C-reactive protein

Ordering noteSpecifically request hsCRP when it is desired for cardiovascular-risk stratification

CLIA

AbbreviationCLIA

Expanded termClinical laboratory improvement act

ContextThe policy identifies CLIA in its terminology table

CNO

AbbreviationCNO

Expanded termChronic nonbacterial osteomyelitis

Population contextThe entry criteria address pediatric onset before 18 years of age

C-reactive protein

TypeAcute-phase protein

SourceProduced by hepatocytes

ResponseCan increase substantially after tissue injury or infection

Measurement noteConcentration and units may vary by patient population and laboratory methodology

Erythrocyte sedimentation rate

TypeBlood test used as an inflammatory marker

Westergren assayUses venous whole blood

ResolutionMay remain elevated longer than CRP after an inflammatory source resolves

ESR/CRP ratio

DefinitionRatio of ESR to CRP concentration

Potential useMay help distinguish chronic from acute periprosthetic joint infection in uncertain cases

Chronic-infection thresholdAbove 0.96 predicts chronic infection

Acute-infection thresholdBelow 0.96 predicts acute infection

DAS28

Expanded term28-Joint Disease Activity Score

Measure typeComposite rheumatoid arthritis disease-activity measure

Inflammatory-marker inputCan use either CRP or ESR data

Inflammation markers

MarkersCRP and ESR

Clinical useUsed as inflammation markers for giant cell arteritis monitoring

InterpretationAn isolated increase may be nonspecific and does not by itself warrant escalation of immunosuppressive therapy

High-sensitivity CRP

AssayA specifically requested high-sensitivity CRP assay

Clinical useOne tool for cardiovascular-risk stratification

Applicable populationAsymptomatic individuals at intermediate cardiovascular risk

OrderingSpecifically request it on the laboratory requisition