Erythrocyte Sedimentation Rate Measurement in Clinical Practice
Summary
The erythrocyte sedimentation rate (ESR) remains one of the most enduring laboratory tests for assessing systemic inflammation and monitoring disease activity. Grounded in the principle that red blood cells settle at a rate proportional to plasma viscosity and the concentration of acute-phase proteins, ESR measurement provides a simple, cost-effective index of inflammatory burden. In routine practice, venous blood is drawn into anticoagulated tubes and allowed to sediment in a vertical column, with the distance travelled by erythrocytes in one hour recorded in millimetres. Despite the rise of more specific biomarkers, ESR retains value in screening for rheumatological conditions, infections and malignancies, as well as in longitudinal monitoring of chronic inflammatory diseases. Standardisation of pre-analytical factors—including sample handling, temperature control and timing—has evolved to reduce variability. Recent advances in automated analysers and point-of-care devices have shortened turnaround times and improved precision, while efforts to harmonise reference ranges account for age, sex and comorbidities. ESR measurement thus continues to bridge the needs of high-throughput laboratories and bedside assessment, offering a versatile tool in global clinical practice.
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Erythrocyte Sedimentation Rate Measurement in Clinical Practice publication trend
The graph below shows the total number of articles in erythrocyte sedimentation rate measurement in clinical practice across all publications each year (not limited to Nature Index journals).
Technical terms
Erythrocyte sedimentation rate (ESR): The distance red blood cells fall in anticoagulated blood over one hour, reflecting plasma viscosity and protein concentrations.
Westergren method: The gold-standard procedure for ESR measurement, using a calibrated vertical tube and standard anticoagulant.
Acute-phase proteins: Plasma proteins, such as C-reactive protein and fibrinogen, whose concentrations rise in response to inflammation, affecting ESR.
Reference interval: The range of ESR values observed in a healthy population, adjusted for age, sex and other factors to enhance clinical interpretation.
References
- Evaluation of Stability and Accuracy Compared to the Westergren Method of ESR Samples Analyzed at VES-MATIC 5. Diagnostics (2024).
- Factors influencing erythrocyte sedimentation rate in adults. Medicine (2019).
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