Syphilis Tests

What are syphilis tests?
Syphilis is one of the most common sexually transmitted diseases (STDs). It is a bacterial infection spread through vaginal, oral, or anal sex with an infected person. Syphilis develops in stages that can last for weeks, months, or even years. The stages may be separated by long periods of apparent good health.

Syphilis usually starts with a small, painless sore, called a chancre, on the genitals, anus, or mouth. In the next stage, you may have flu-like symptoms and/or a rash. Later stages of syphilis can damage the brain, heart, spinal cord, and other organs. Syphilis tests can help diagnose syphilis in the early stages of infection, when the disease is easiest to treat.

Other names: rapid plasma reagin (RPR), venereal disease Research laboratory (VDRL), fluorescent treponemal antibody absorption (FTA-ABS) test, agglutination assay (TPPA), darkfield microscopy

What are they used for?
Syphilis tests are used to screen for and diagnose syphilis.

Screening tests for syphilis include:

Rapid plasma reagin (RPR), a syphilis blood test that looks for antibodies to the syphilis bacteria. Antibodies are proteins made by the immune system to fight foreign substances, such as bacteria.
Venereal disease research laboratory (VDRL) test, which also checks for syphilis antibodies. A VDRL test can be done on blood or spinal fluid.
If a screening test comes back positive, you will need more testing to rule out or confirm a syphilis diagnosis. Most of these follow up tests will also look for syphilis antibodies. Sometimes, a healthcare provider will use a test that looks for actual syphilis bacteria, instead of the antibodies. Tests that look for the actual bacteria are used less often because they can only be done in specialized labs by specially trained health care professionals.

Why do I need a syphilis test?
You may need a syphilis test if your sexual partner has been diagnosed with syphilis and/or you have symptoms of the disease. Symptoms usually appear about two to three weeks after infection and include:

Small, painless sore (chancre) on the genitals, anus, or mouth
Rough, red rash, usually on the palms of the hands or the bottom of the feet
Fever
Headache
Swollen glands
Fatigue
Weight loss
Hair loss
Even if you don't have symptoms, you may need a test if you are at a higher risk of infection. Risk factors include having:

Multiple sex partners
A partner with multiple sex partners
Unprotected sex (sex without using a condom)
An HIV/AIDS infection
Another sexually transmitted disease, such as gonorrhea
You may also need this test if you are pregnant. Syphilis can be passed from a mother to her unborn baby. A syphilis infection can cause serious, and sometimes deadly, complications to infants. The Centers for Disease Control and Prevention recommends that all pregnant women get tested early in pregnancy. Women who have risk factors for syphilis should be tested again in the third trimester of pregnancy (28–32 weeks) and again at delivery.

What happens during a syphilis test?
A syphilis test is usually in the form of a blood test. During a syphilis blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

More advanced stages of syphilis can affect the brain and spinal cord. If your symptoms show your disease might be in a more advanced stage, your health care provider may order a syphilis test on your cerebrospinal fluid (CSF). CSF is a clear liquid found in your brain and spinal cord.

For this test, your CSF will be collected through a procedure called a lumbar puncture, also known as a spinal tap. During the procedure:

You will lie on your side or sit on an exam table.
A health care provider will clean your back and inject an anesthetic into your skin, so you won't feel pain during the procedure. Your provider may put a numbing cream on your back before this injection.
Once the area on your back is completely numb, your provider will insert a thin, hollow needle between two vertebrae in your lower spine. Vertebrae are the small backbones that make up your spine.
Your provider will withdraw a small amount of cerebrospinal fluid for testing. This will take about five minutes.
You'll need to stay very still while the fluid is being withdrawn.
Your provider may ask you to lie on your back for an hour or two after the procedure. This may prevent you from getting a headache afterward.
Will I need to do anything to prepare for the test?
You don't need any special preparations for a syphilis blood test. For a lumbar puncture, you may be asked to empty your bladder and bowels before the test.

Are there any risks to the test?
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

If you had a lumbar puncture, you may have pain or tenderness in your back where the needle was inserted. You may also get a headache after the procedure.

What do the results mean?
If your screening results were negative or normal, it means no syphilis infection was found. Since antibodies can take a couple of weeks to develop in response to a bacterial infection, you may need another screening test if you think you were exposed to the infection. Ask your health care provider about when or if you need to be re-tested.

If your screening tests show a positive result, you will have more testing to rule out or confirm a syphilis diagnosis. If these tests confirm you have syphilis, you will probably be treated with penicillin, a type of antibiotic. Most early-stage syphilis infections are completely cured after antibiotic treatment. Later-stage syphilis is also treated with antibiotics. Antibiotic treatment for later-stage infections can stop the disease from getting worse, but it can't undo damage already done.

If you have questions about your results, or about syphilis, talk to your health care provider.

Is there anything else I need to know about syphilis tests?
If you are diagnosed with syphilis, you need to tell your sexual partner, so he or she can get tested and treated if necessary.

What Is Synovial (Joint) Fluid test?

A synovial (joint) fluid analysis is a group of tests your doctor can use to diagnose problems with your joints.Synovial fluid is the thick liquid that lubricates your joints and keeps them moving smoothly. It’s on all of your joints, including in your knees, shoulders, hips, hands, and feet.
Joint conditions like arthritis, gout, infections, and bleeding disorders can change how your synovial fluid looks and feels. A sample of this fluid taken during a procedure called an arthrocentesis can help your doctor figure out what’s causing your symptoms.

Why You Might Get This Test
If you have joint symptoms like:

Pain
Redness
Swelling
Fluid buildup
You may also get it so your doctor can figure out if you have:

A condition that inflames your joints, like gout, rheumatoid arthritis, and lupus
An infection like septic arthritis
Bleeding disorders like hemophilia or von Willebrand disease
A disease that break down joints over time, like osteoarthritis
Your doctor might also use this test to see if your treatment for your joint condition is working.

If your doctor thinks you need this test, ask them how to prepare. Let them know if you take blood thinners or any other medication.

What Happens During the Test
First, your doctor will give you a local anesthetic to numb your joint. Then, she'll put a needle in and take some fluid out. How much depends on the size of the joint and how many tests you're going to have.

Your doctor will send your fluid to a lab, where a technician will do one or more of these:

Check your fluid's color and thickness
Measure chemicals like glucose, protein, and uric acid
See how many red and white blood cells and crystals your fluid has
Test for bacteria, viruses, or other germs
What Your Results Mean
Normal synovial fluid is:

Clear
Colorless or pale yellow
Stringy
Free of bacteria, viruses, and fungi
Abnormal synovial fluid may be cloudy or thick.

A high white blood cell count can be from infection or another medical condition.
A high red blood cell count may happen when there is blood in the joint from an injury or bleeding disorder.
A high uric acid level and crystals can signal gout.

Overview
A stress test, also called an exercise stress test, shows how your heart works during physical activity. Because exercise makes your heart pump harder and faster, an exercise stress test can reveal problems with blood flow within your heart.

A stress test usually involves walking on a treadmill or riding a stationary bike your heart rhythm, blood pressure and breathing are monitored. Or you'll receive a drug that mimics the effects of exercise.

Your doctor may recommend a stress test if you have signs or symptoms of coronary artery disease or an irregular heart rhythm (arrhythmia). The test may also guide treatment decisions, measure the effectiveness of treatment or determine the severity if you've already been diagnosed with a heart condition.

Why it's done
Your doctor may recommend a stress test to:

Diagnose coronary artery disease. Your coronary arteries are the major blood vessels that supply your heart with blood, oxygen and nutrients. Coronary artery disease develops when these arteries become damaged or diseased usually due to a buildup of deposits containing cholesterol and other substances (plaques).
Diagnose heart rhythm problems (arrhythmias). Heart arrhythmias occur when the electrical impulses that coordinate your heart rhythm don't function properly, causing your heart to beat too fast, too slowly or irregularly.
Guide treatment of heart disorders. If you've already been diagnosed with a heart condition, an exercise stress test can help your doctor find out how well treatment is working. It may also be used to help establish the treatment plan for you by showing how much exercise your heart can handle.

Your doctor may use a stress test to help determine the timing of cardiac surgery, such as valve replacement. In some people with heart failure, stress test results may help the doctor determine whether you need a heart transplant or other advanced therapies.

Your doctor may recommend a test with imaging, such as a nuclear stress test or echocardiographic stress test, if an exercise stress test doesn't pinpoint the cause of your symptoms.

Risks
A stress test is generally safe, and complications are rare. But, as with any medical procedure, there is a risk of complications, including:

Low blood pressure. Blood pressure may drop during or immediately after exercise, possibly causing you to feel dizzy or faint. The problem should go away after you stop exercising.
Abnormal heart rhythms (arrhythmias). Arrhythmias brought on by an exercise stress test usually go away soon after you stop exercising.
Heart attack (myocardial infarction). Although exceedingly rare, it's possible that an exercise stress test could cause a heart attack.
How you prepare
Your doctor will give you specific instructions on how to prepare for your stress test.

Food and medications
You may be asked not to eat, drink or smoke for a period of time before a stress test. You may need to avoid caffeine the day before and the day of the test.

Ask your doctor if it's safe for you to continue taking all of your prescription and over-the-counter medications before the test, because they might interfere with certain stress tests.

If you use an inhaler for asthma or other breathing problems, bring it to the test. Make sure your doctor and the health care team member monitoring your stress test know that you use an inhaler.

Clothing and personal items
Wear or bring comfortable clothes and walking shoes. If you're having a nuclear stress test, don't apply oil, lotion or cream to your skin that day.

What you can expect
Your stress test will take around an hour, including both your prep time and the time it takes to perform the actual test. The actual test takes only around 15 minutes. You may have an exercise stress test in which you walk on a treadmill or pedal a stationary bicycle. If you aren't able to exercise, you'll receive a drug through an IV that mimics exercise by increasing blood flow to your heart.

Before a stress test
First, your doctor will ask you some questions about your medical history and how often and strenuously you exercise. This helps determine the amount of exercise that's appropriate for you during the test. Your doctor will also listen to your heart and lungs for any abnormalities that might affect your test results.

During a stress test
A nurse or technician will place sticky patches (electrodes) on your chest, legs and arms. Some areas may need to be shaved to help them stick. The electrodes have wires connected to an electrocardiogram machine, which records the electrical signals that trigger your heartbeats. A cuff on your arm checks your blood pressure during the test. You may be asked to breathe into a tube during the test to show how well you're able to breathe during exercise.

If you're not exercising, your doctor will inject the drug into your IV that increases blood flow to your heart. You might feel flushed or short of breath, just as you would if you were exercising. You might get a headache.

You'll probably exercise on a treadmill or stationary bike, starting slowly. As the test progresses, the exercise gets more difficult. You can use the railing on the treadmill for balance. Don't hang on tightly, as this may skew the results.

You continue exercising until your heart rate has reached a set target or until you develop symptoms that don't allow you to continue. These signs and symptoms may include:

Moderate to severe chest pain
Severe shortness of breath
Abnormally high or low blood pressure
An abnormal heart rhythm
Dizziness
Fatigue
Certain changes in your electrocardiogram
You and your doctor will discuss your safe limits for exercise. You may stop the test anytime you're too uncomfortable to continue exercising.

After a stress test
After you stop exercising, you may be asked to stand still for several seconds and then lie down for a period of time with the monitors in place. Your doctor can watch for any abnormalities as your heart rate and breathing return to normal.

When your exercise stress test is complete, you may return to your normal activities unless your doctor tells you otherwise.

Results
If the information gathered during your exercise stress test shows your heart function to be normal, you may not need any further tests.

However, if the results are normal and your symptoms continue to worsen, your doctor might recommend a nuclear stress test or another stress test that includes an echocardiogram before and after exercise or medications to increase blood flow to your heart. These tests are more accurate and provide more information about your heart function, but they are also more expensive.

If your stress test results suggest that you might have coronary artery disease or show an arrhythmia, your doctor will use the information to develop a treatment plan. You may need additional tests, such as a coronary angiogram.

If you had a stress test to help determine treatment for a heart condition, your doctor will use the results to plan or change your treatment.

Erection Self-Test
Definition
An erection self-test is a method to determines a man's ability or inability to achieve an erection during sleep.

Alternative Names
Nocturnal penile tumescence (NPT) stamp test; Nighttime penile tape test

How the test is performed
A strip of four to six postage stamps (any kind) is used for each test. The test needs to be done for 3 nights. The man needs to wear brief-type undershorts that have a fly. Place the penis through the fly, leaving most of the pubic hair against the body.

Wrap the strip of stamps snugly around the shaft of the penis. The stamps need to overlap so the overlapped stamp can be moistened to seal the ring. When the stamp has dried, carefully place the penis back inside the shorts and wear them while sleeping. (They help protect the stamps from falling off).

In the morning, check to see if the stamp ring has been broken along the perforations. If the tearing of the stamps awakens the man during the night, check for an erection and how rigid the erection is.

How to prepare for the test
You will need to buy some stamps. Do not drink alcohol or take a sleep-inducing or sedative medication for at least 2 days before the test.

How the test will feel
The stamps may feel unusual. The test should be done until 3 nights of comfortable, uninterrupted sleep is achieved.

Why the test is performed
The test is done to confirm if a man can have an erection at night. All men with normal physiological erectile function will have an erection during normal sleep. The test may help determine if the cause of erectile dysfunction is psychological or physical.

Normal Values
During at least one of the nights, the ring of stamps is broken between any two stamps.

What abnormal results mean
If the stamp ring is broken, it means that erection problems while you are awake may be the result of a psychological cause.

If the stamp ring does not break on any of the 3 nights it may be a sign that the erection problem is related to physical conditions or medications. You should make an appointment to see a doctor. See also: Impotence

What the risks are
There are no risks.

Special considerations
This test is rarely done anymore. It test is not very accurate and there are better tests available to monitor blood flow. This test does not indicate many important factors of sexual dysfunction, such as quality, duration, or number of erections during the night.

What Is a Spinal X-Ray?
If your doctor wants to find out what's causing your back or neck pain, he may ask you to get a spinal X-ray. It uses radiation to make detailed pictures of the bones of your spine.

A technician uses a machine that sends X-ray beams through your body. It records a black-and-white image on a special film or computer. Bones, and other parts of your body that are thick or dense, show up white in the picture. Softer tissue, like fat or muscle, appear in shades of gray.

Your doctor can take separate X-rays that focus on the different parts of the spine, which is made up of 33 small bones called vertebrae.

Your spine is split into sections:

Cervical spine (neck)
Thoracic spine (chest or trunk area)
Lumbar spine (lower back)
Sacral area (base of the spine)
Coccyx (tailbone)
Why Would You Get It?
A spinal X-ray can help your doctor figure out if you have:

Broken bones
Arthritis
Spinal disk problems
Tumors
Osteoporosis (thinning of the bones)
Abnormal curves of the spine
Infection
Spinal problems you were born with
X-rays are the most common tool used to "see" inside your body and take pictures of bones. While X-rays don't show as much detail as other imaging tests, they are often the tests doctors use at first to help them decide on your next steps.

Computed tomography (a CT scan) combines X-rays with computer technology to create a picture that shows a cross-section, or slice, of the bone.

For the most detailed pictures of the spine and all its parts, doctors often suggest magnetic resonance imaging (MRI). It uses powerful magnets, radio waves, and a computer not radiation.

Are Spinal X-Rays Safe?
For most people, X-rays are safe. Some worry that the radiation can cause changes in cells that may lead to cancer. But the amount used in spinal X-rays is small, so the chance is low.

Unborn babies, however, are more sensitive to radiation. Tell your doctor if you're pregnant or think you might be. He may suggest another type of imaging test.

How Do I Prepare for a Spinal X-Ray?
Before your spinal X-ray, besides telling your doctor that you are or might be pregnant, let him know if you have an insulin pump or had any other types of X-rays recently.

You may need to remove your clothes and wear a gown during the test. Also, anything that's made of metal may show up on an X-ray, so remove things like these beforehand:

Jewelry
Hairpins
Eyeglasses
Hearing aids
What Happens During the Test?
You'll lie down on a special exam table. An X-ray machine will be hanging above you. A drawer under the table holds the X-ray film or digital recording plate.

A specially trained technician will position you on the table so that the section of your spine getting X-rayed is between the machine and the drawer with the film. He may cover the other parts of your body with a special apron made of lead that blocks radiation.

The technician will step behind a window barrier and turn on the X-ray machine. You'll need to stay still and hold your breath while the beams pass through your body. This only takes a few seconds. If you move, it may blur the image.

You may hear some clicking or buzzing noises while you get your X-ray, but you won't feel anything. An X-ray is painless.

In some cases, you may need to stand next to the X-ray machine. You doctor may also ask that you get images from the front and the side of your spine, or while you stretch or bend.

An X-ray takes about 5 minutes to complete. But you may in the room for longer, depending on how many images and views your doctor needs.

When your X-ray session is done, the technician will process the images. He may ask you to wait a few minutes to make sure the pictures are clear.