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*For medical professionals only to read and reference
, keep in mind these 4 points, clinical ingenuity!
The weather is getting cooler, many people have pain and discomfort in knee joints, hand joints and other joints, everyone will guess for themselves, is this the legendary arthritis?
Arthritis generally refers to the occurrence of human joints and their surrounding tissues, by inflammation, infection, degeneration, trauma or other factors caused by inflammatory diseases, arthritis classification is many, common are gouty arthritis, rheumatoid arthritis, rheumatoid arthritis, etc.
, so how to identify them?
.
In addition, the climate suddenly becomes cold, the joints are cold, the local temperature of the joints decreases, and the uric acid in the blood is easy to precipitate in the joints, which will also induce gouty arthritis
.
Rheumatoid arthritis is a manifestation of rheumatic fever, a recurrent acute or chronic systemic connective tissue inflammation caused by infection with group A hemolytic streptococcus group A in the throat, which occurs mostly in the rainy season of winter and spring, where cold and humidity are important triggers
.
Rheumatoid arthritis is a class of autoimmune diseases of unknown etiology, which may be related to genetics, environment, infection, etc.
, and the specific factors caused by autoimmune disorders in vivo need to be further studied
.
7:1
.
Rheumatoid arthritis can occur at any age, most commonly in children and adolescents aged 5 to 15 years, with approximately equal
rates for men and women.
Rheumatoid arthritis is more common in middle-aged and elderly people, in recent years there is a trend of youth, the average age of onset is 45 years old, 50 years old to reach the peak of the onset, female patients are far more than male patients, the ratio of male to female disease is about 1:4
.
Gout is a metabolic disease, closely related to the occurrence and development of a variety of chronic diseases, gout patients often have diabetes, hypertension, obesity and other metabolic problems
.
1~6 weeks before the appearance of typical symptoms of rheumatic fever patients, there are often upper respiratory streptococcal infections such as strep throat or tonsillitis, carditis is also a common manifestation of rheumatic fever, and patients often show palpitations, shortness of breath and other discomfort
.
In addition, some patients with rheumatoid arthritis will be accompanied by skin symptoms, manifested as light red annular erythema, central pallor, and slightly hard and painless small nodules on the extensor side of the joint, which will disappear naturally in 2~4 weeks, and subcutaneous nodules often appear at the same time as carditis, which is one of the manifestations of
rheumatic activities.
Rheumatoid arthritis also appears vasculitis, heart, lung, kidney, nervous system damage, etc.
, subcutaneous nodules will also appear, but not accompanied by annular erythema, subcutaneous nodules are more common in joint bulges and often compressed parts, tough, no tenderness, and exist for a long
time.
In short, rheumatoid arthritis, rheumatoid arthritis and gouty arthritis although they are arthritic diseases, but their treatment is very different, the core of gout treatment is uric acid lowering therapy, rheumatoid arthritis to eliminate streptococcal infection, mainly penicillin and other antibiotic treatment, and rheumatoid arthritis needs to use immunosuppressants, non-steroidal anti-inflammatory drugs, glucocorticoids, etc.
to prevent joint destruction, Protect joint function
.
Therefore, in the process of clinical diagnosis and treatment, we need to identify this type of patient so that patients can be treated in a timely and effective manner
.
Guidelines for the diagnosis and treatment of rheumatic fever[J].
Chinese Journal of Rheumatology,2011,15(7):483-486 [2] Rheumatology Branch of Chinese Medical Association.
2018 Guidelines for diagnosis and treatment of rheumatoid arthritis in China[J].
Chinese Journal of Internal Medicine,2018,57(4):242-251 [3] Chinese Medical Association, Journal of Chinese Medical Association, General Practice Branch of Chinese Medical Association, et al.
Guidelines for primary diagnosis and treatment of gout and hyperuricemia (2019)[J].
Chinese Journal of General Practitioners,2020,19(4):293-303
Where can I see more clinical knowledge about rheumatology? Come to the "Doctor Station" to take a look 👇
at the source of this article: Fosun Health Doctor is responsible for this article: Orange
Clinical practical skills, misdiagnosed cases, clinical medication, and interesting content in rheumatology and immunology; 2.
Interesting diagnosis and treatment stories of rheumatologists; 3.
Heavy progress in the field of rheumatology and immunology; 4.
Others (what rheumatologists are interested in).
Welcome to share! We will provide you with competitive manuscript fees and a platform
to showcase your talents.
Submission email: yanjin@yxj.
org.
cn (must reply to the manuscript) The medical community strives to be accurate and reliable when the published content is approved, but does not make any commitment and guarantee for the timeliness of the published content, as well as the accuracy and completeness of the cited materials (if any), etc.
, Nor does it assume any liability
arising from the fact that such content is out of date or that the information cited may be inaccurate or incomplete.
Relevant parties are requested to check
separately when adopting or using this as the basis for decision-making.
, keep in mind these 4 points, clinical ingenuity!
The weather is getting cooler, many people have pain and discomfort in knee joints, hand joints and other joints, everyone will guess for themselves, is this the legendary arthritis?
Arthritis generally refers to the occurrence of human joints and their surrounding tissues, by inflammation, infection, degeneration, trauma or other factors caused by inflammatory diseases, arthritis classification is many, common are gouty arthritis, rheumatoid arthritis, rheumatoid arthritis, etc.
, so how to identify them?
One.
The causes are different
.
In addition, the climate suddenly becomes cold, the joints are cold, the local temperature of the joints decreases, and the uric acid in the blood is easy to precipitate in the joints, which will also induce gouty arthritis
.
Rheumatoid arthritis is a manifestation of rheumatic fever, a recurrent acute or chronic systemic connective tissue inflammation caused by infection with group A hemolytic streptococcus group A in the throat, which occurs mostly in the rainy season of winter and spring, where cold and humidity are important triggers
.
Rheumatoid arthritis is a class of autoimmune diseases of unknown etiology, which may be related to genetics, environment, infection, etc.
, and the specific factors caused by autoimmune disorders in vivo need to be further studied
.
Two.
The crowd is different
7:1
.
Rheumatoid arthritis can occur at any age, most commonly in children and adolescents aged 5 to 15 years, with approximately equal
rates for men and women.
Rheumatoid arthritis is more common in middle-aged and elderly people, in recent years there is a trend of youth, the average age of onset is 45 years old, 50 years old to reach the peak of the onset, female patients are far more than male patients, the ratio of male to female disease is about 1:4
.
Three.
Joint symptoms are different
| Gouty arthritis | Rheumatoid arthritis | Rheumatoid arthritis | |
| Onset | Onset is rapid, with symptoms peaking within hours | Onset is acute | Onset is slow and progressively worsens |
| duration | The duration of most patients is 3 to 5 days, and some patients can resolve within 1 to 2 days or 24 hours, and may not heal if not treated properly | Usually resolves within 2 weeks and rarely lasts more than 1 month | It can not heal for months or years |
| Joint site | The lower extremities are predominant, with more than half of patients initially occurring in the first metatarsophalangeal joint of the foot, and about 90% of patients are involved in this joint throughout the course of the disease | It is mainly based on large joints such as knees, ankles, elbows, and wrist joints | The small joints of the hands and feet are mainly affected |
| Number of joints | Predominantly uniarticular, it progresses to bilateral involvement, polyarthritis | Migratory and multiple | Symmetry, multiplex |
| manifestation | In the acute stage, the joints and surrounding soft tissues appear obvious redness, swelling, heat and pain, severe pain, and joint exudate can occur when large joints are involved; As the disease progresses, gout nodules or tophi form in the tendon sheath near the joint and in the connective tissue of the skin | There may be local redness, swelling, burning, pain and tenderness, sometimes exudation, but no suppuration; It is often recurrent, and can be aggravated by colder or rainy days | Affected joints can have morning stiffness, pain, swelling, and tenderness |
| Joint deformities | Eventually joint deformities will develop | There is no deformation left after the onset of arthritis | Joint deformities occur late in the affected joint |
Four.
Constitutional symptoms vary
Gout is a metabolic disease, closely related to the occurrence and development of a variety of chronic diseases, gout patients often have diabetes, hypertension, obesity and other metabolic problems
.
1~6 weeks before the appearance of typical symptoms of rheumatic fever patients, there are often upper respiratory streptococcal infections such as strep throat or tonsillitis, carditis is also a common manifestation of rheumatic fever, and patients often show palpitations, shortness of breath and other discomfort
.
In addition, some patients with rheumatoid arthritis will be accompanied by skin symptoms, manifested as light red annular erythema, central pallor, and slightly hard and painless small nodules on the extensor side of the joint, which will disappear naturally in 2~4 weeks, and subcutaneous nodules often appear at the same time as carditis, which is one of the manifestations of
rheumatic activities.
Rheumatoid arthritis also appears vasculitis, heart, lung, kidney, nervous system damage, etc.
, subcutaneous nodules will also appear, but not accompanied by annular erythema, subcutaneous nodules are more common in joint bulges and often compressed parts, tough, no tenderness, and exist for a long
time.
In short, rheumatoid arthritis, rheumatoid arthritis and gouty arthritis although they are arthritic diseases, but their treatment is very different, the core of gout treatment is uric acid lowering therapy, rheumatoid arthritis to eliminate streptococcal infection, mainly penicillin and other antibiotic treatment, and rheumatoid arthritis needs to use immunosuppressants, non-steroidal anti-inflammatory drugs, glucocorticoids, etc.
to prevent joint destruction, Protect joint function
.
Therefore, in the process of clinical diagnosis and treatment, we need to identify this type of patient so that patients can be treated in a timely and effective manner
.
References:
[1] Chinese Medical Association Branch of Wet Diseases.Guidelines for the diagnosis and treatment of rheumatic fever[J].
Chinese Journal of Rheumatology,2011,15(7):483-486 [2] Rheumatology Branch of Chinese Medical Association.
2018 Guidelines for diagnosis and treatment of rheumatoid arthritis in China[J].
Chinese Journal of Internal Medicine,2018,57(4):242-251 [3] Chinese Medical Association, Journal of Chinese Medical Association, General Practice Branch of Chinese Medical Association, et al.
Guidelines for primary diagnosis and treatment of gout and hyperuricemia (2019)[J].
Chinese Journal of General Practitioners,2020,19(4):293-303
Where can I see more clinical knowledge about rheumatology? Come to the "Doctor Station" to take a look 👇
at the source of this article: Fosun Health Doctor is responsible for this article: Orange
Copyright Notice
This article is reproduced, welcome to forward the circle of friends
- End - Call for "Medical Rheumatology and Immunology Channel" long-term recruitment of online invited authors, 1.Clinical practical skills, misdiagnosed cases, clinical medication, and interesting content in rheumatology and immunology; 2.
Interesting diagnosis and treatment stories of rheumatologists; 3.
Heavy progress in the field of rheumatology and immunology; 4.
Others (what rheumatologists are interested in).
Welcome to share! We will provide you with competitive manuscript fees and a platform
to showcase your talents.
Submission email: yanjin@yxj.
org.
cn (must reply to the manuscript) The medical community strives to be accurate and reliable when the published content is approved, but does not make any commitment and guarantee for the timeliness of the published content, as well as the accuracy and completeness of the cited materials (if any), etc.
, Nor does it assume any liability
arising from the fact that such content is out of date or that the information cited may be inaccurate or incomplete.
Relevant parties are requested to check
separately when adopting or using this as the basis for decision-making.
