Erythrocyte Sedimentation Rate

Updated: Nov 22, 2019
  • Author: Christopher P Kellner, MD; Chief Editor: Thomas M Wheeler, MD, FCAP  more...
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Reference Range

Normal values for the erthyrocyte sedimentation rate (ESR), as derived using the Westergren method, are as follows [1] :

  • Male: ≤15 mm/hr
  • Female: ≤ 20 mm/hr
  • Child: ≤10 mm/hr
  • Newborn: 0-2 mm/hr




Conditions that may be associated with a highly elevated ESR (>100 mm/hr) include the following:


Collection and Panels

Specifics for collection and panels are as follows:

  • Specimen type: Whole blood

  • Container: Vacutainer, lavender top or black top

  • Collection method: Venipuncture

  • Specimen volume: 4 mL

Related tests

See the list below:




The rate at which red blood cells settle out when anticoagulated whole blood is allowed to stand is known as the erythrocyte sedimentation rate. The ESR is affected by the concentrations of immunoglobulins and acute phase proteins (fibrinogen, C-reactive protein, alpha-1 antitrypsin, haptoglobin), and is a sensitive, but nonspecific, indicator of inflammation and tissue damage. [2, 3, 4]


The ESR is a nonspecific test that is often used as a screening test for patients with unexplained fevers, certain types of arthritis, muscle symptoms, or other vague symptoms of unknown origin.

Significant specific indications for ESR testing include the following:

  • Diagnosis and monitoring of giant cell arteritis

  • Diagnosis and monitoring of polymyalgia rheumatic [5]

  • Monitoring of rheumatoid arthritis


Other conditions that may be associated with an elevated ESR include the following: