FOAM4GP - By Doc Rob / July 29, 2015
CRP and ESR are useful tests used in the correct context. The RCPA article “making sense of inflammatory markers” 2014 has a great list of chronic diseases where ongoing monitoring of disease activity can be useful e.g. Sarcoidosis, pancreatitis, vasculidities, crohn’s disease etc.
In acute diagnoses it has limited use. I think the common sense blow torch should be applied when you order it – “Will it change my management?” If you are uncertain and think a high CRP may sway you to consider sending a patient to hospital then this could be appropriate use. If you are doing it ‘just to be safe’ then I would rethink your diagnosis and management and be more certain of your own skills – rather than relying on a possibly unhelpful test. Also, finally before ordering the test think to yourself “What if the result is NOT what I am expecting. What will I do then?”
Important to have these little mental reminders prior to ordering inflammatory markers so you don’t shoot yourself in the foot (I can tell you YOUR inflammatory markers will be up if that happens…)
http://foam4gp.com/2015/07/29/foam4gp-map-my-esr-is-bigger-than-your-crp-or-do-we-care-not/