Do you know what these joint examinations need to be done for rheumatic patients?

In the past, everyone's understanding of rheumatism is actually joint swelling and pain, with the advancement of medical technology, we slowly understand that rheumatism is actually a kind of autoimmune disease, but it is undeniable that joint problems are still bothering many rheumatism friends, so in clinical diagnosis and treatment, joint examination is essential, so what joint examinations should be done for different rheumatism? What role do these joint examinations play?

Joint ultrasound can penetrate articular cartilage, joint spaces, and dissolved or destroyed bone tissue, can observe intra-articular lesions, and dynamically observe changes in
joint activity.
It is currently widely used in patients with
early rheumatoid arthritis and gout.

Many patients with rheumatoid arthritis in the early stage of the disease, when the joint swelling and pain are not obvious, in fact, synovitis already exists, but this synovial lesion is often difficult to detect
through the naked eye.
Under the examination of joint ultrasound, the doctor can observe the joint and surrounding soft tissue lesions in detail through the probe, identify the bursa lesions and synovial hyperplasia of each joint, dynamically monitor the change of joint effusion volume and synovial blood flow, combined with hemosedimentation rate, C-reactive protein and other laboratory indicators, can effectively improve the detection rate of early rheumatoid arthritis, and avoid being misdiagnosed as damaging tenosynovitis, bursitis, etc
.

In the process of treatment, joint ultrasound examination can also help doctors predict the efficacy and imaging progress of drugs, so that doctors can more accurately understand disease activity, closely monitor disease changes, evaluate efficacy and judge prognosis, providing an important basis
for formulating reasonable rheumatoid treatment plans.

Patients with gout can also be monitored for urate deposition
at the joints by joint ultrasound.
Studies have shown that joint ultrasound can detect biorbital signs, gout nodules and other specific imaging manifestations, for the early differential diagnosis of acute gouty arthritis, so that patients can obtain targeted treatment plays an important role, in addition, joint ultrasound can also dynamically monitor the treatment effect of gout patients, through blood uric acid value and ultrasound follow-up, dynamic evaluation of the efficacy of gouty arthritis, has good clinical application value
.

X-ray examination is an examination method
that applies the characteristics of X-rays to display normal and abnormal images on a fluoroscopic phosphor screen or photograph after the human body, combined with the knowledge of basic medicine and clinical medicine, and analyzes and summarizes them to make a diagnosis.
It is not only used to diagnose diseases, but also to observe the clinical treatment effect, in clinical use is very extensive, for rheumatism friends, joint invasion diseases, such as rheumatoid arthritis, gout, ankylosing spondylitis, osteoarthritis, etc
.
, will be used.

In the rheumatology department, many doctors will recommend patients with ankylosing spondylitis to do X-ray lumbar orthograph, lumbar lateral radiograph and pelvic orthograph, because the lesion of the sacroiliac joint is one of the main symptoms in the early stage of ankylosing spondylitis, and hip involvement is the most common risk factor for poor prognosis in patients with ankylosing disease, so through the X-ray examination of the sacroiliac joint, it can help doctors observe the degree of joint fusion of the sacroiliac joint, the change of the hip space and the destruction of bone.
It provides an important basis for
formulating reasonable treatment plans and judging prognosis.

However, X-ray examination also has obvious shortcomings, it for early bone erosion and soft tissue lesions diagnostic sensitivity and specificity are very low, can not directly observe synovium, cartilage and bone marrow edema, can not be used as the basis for early diagnosis of rheumatism, when X-ray examination has specific performance, most patients have entered the middle and advanced stages of the disease, missed the best period
of treatment.
Ultrasonography is preferred in rheumatoid patients early in the disease, and MRI should be prioritized in patients with tonic rigidity when financial resources permit
.

MRI is a multi-parameter, multi-plane imaging non-invasive examination, can effectively show fat deposition, articular cartilage signal changes and bone marrow edema and other abnormalities, and MRI has high sensitivity to early inflammation, can see the presence of local inflammation before joint destruction, is the "gold standard" for the early diagnosis of ankylosing spondylitis, can greatly improve the detection rate of early rigidity, and it can also be used for the detection
of osteoarthritis and rheumatoid arthritis.

END

In summary, different diseases need to do joint examination is not the same, in the clinic, we need to choose the appropriate examination method according to our own situation and the doctor's clinical experience, only the examination is clear, in order to carry out more targeted treatment
.