Добре дошли в сайта на д-р Севдалина Ламбова, дм, ревматолог





            The diagnostic of rheumatic diseases includes detailed history, physical examination as well as routine and specialized laboratory, immunological and instrumental investigations.

            The history and the physical examination encompass all the organ and systems, because a number of rheumatic disease differ with multiorgan involvement. In addition, the complex concomitant pathology in a part of the cases modify the clinical picture and the therapeutic approach is unique in every individual case. Thus, when you present for rheumatological consultation in our center take the consultations from other specialists, which you have been performed, discharge summaries, the results from laboratory and instrumental investigations (including X-rays, pictures/discs from computed tomography etc.), prescription book.


            Main diagnostic tests in patients with rheumatic disease:

  1. Blood tests (complete blood count, markers of inflammation),biochemistry – liver, renal parameters, metabolism evaluation, bone markers.
  2. Urine analysis – protein, sediment, calcium excretion, uric acid in 24 hour urine
  3. Immunologic tests (antinuclear antibodies, antibodies against extractable nuclear antigens – анти-dsDNA, Sm, cardiolipin etc., complement fractions).
  4. Microbiological tests – urine culture, blood culture, nose and throat culture
  5. Arthrocentesis and analysis of joint fluid (cytological, biochemical and microbiological analysis, polarizing microscopy).  
  6. Nailfold capillaroscopy
  7. Joint X-rays, lung X-ray, computed tomography of structures of musculoskeletal system and internal organs
  8. Joint ultrasonography
  9. Abdominal sonography, echocardiography when indicated
  10. Measurement of bone mineral density. Nowadays, the gold standard is dual energy xray absorptiometry (DEXA)
  11. If indicated in patients with rheumatic disease, highly specialized investigations are ordered such as functional breathing tests, angiographies, right heart catheterization