Normal CRP or ESR does not settle every inflammatory joint question
Inflammatory arthritis can be present despite modest or normal inflammatory markers; examination matters.
Several explanations may be worth exploring
- Early inflammatory arthritisJoint swelling and inflammatory stiffness may precede strongly abnormal routine tests.
- Psoriatic arthritisNail changes, psoriasis or enthesitis may accompany joint symptoms even without obvious plaques.
- SpondyloarthritisBack or heel pain, uveitis and bowel inflammation can cluster in some cases.
- Tendinopathy or bursitisPain near rather than inside a joint requires different examination and sometimes ultrasound.