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What laboratory tests are routinely required for patients with rheumatic diseases scheduled for elective surgery?
There is no consensus on preoperative screening evaluations. Specific clinical scenarios such as patients on anticoagulation or certain disease-modifying antirheumatic drug (DMARD) therapy may justify a selected set of laboratory and imaging evaluations.
The below table outlines potential preoperative evaluations for patients with rheumatic disease.
Potential Preoperative Evaluations
| Test | Consider in a Patient with |
|---|---|
| Liver function tests | Nonsteroidal anti-inflammatory drug, methotrexate, leflunomide use |
| Prothrombin time/partial thromboplastin time | Liver disease or bleeding disorder Antiphospholipid antibody syndrome |
| Chest x-ray | Acute pulmonary symptoms, abnormal examination Pulmonary disease or cardiovascular disease Thoracic surgery |
| Pulmonary function tests | Same as chest x-ray |
| Cervical spine x-ray (flexion and extension views) | Rheumatoid arthritis, juvenile idiopathic arthritis, axial spondyloarthritis |
