Rheumatoid arthritis (rheumatoid arthritis for short) is a common disease that causes joint dysfunction and even disability in young adults. Some patients pessimistically believe, “If you have rheumatoid arthritis, you will be disabled nine times out of ten, so it is the same whether you treat it or not.” For most patients, if regular combined Chinese and Western medicine treatment and follow-up are taken at the early stage of the disease, their joint deformation rate is extremely low, and patients can maintain a better quality of life and work ability. Whether or not a patient with rheumatoid arthritis will become disabled is related to the severity of the disease, but also to whether or not the patient is seen early and adheres to regular treatment.
What is rheumatoid arthritis
Dr. Le said rheumatoid arthritis is a chronic systemic autoimmune disease characterized by synovitis of the joints. The persistent and recurrent attacks of synovitis can lead to destruction of cartilage and bone in the joints, joint dysfunction and even disability. Its cause is unknown and is closely related to environmental, bacterial, viral, genetic, sexual stimulation and neuropsychiatric factors. It is most common in young adults, accounting for about 80% of those aged 20-45 years, and is more common in women than men, with a male to female ratio of 1:3.
Clinical manifestations of rheumatoid arthritis
Common clinical symptoms of rheumatoid arthritis.
Morning stiffness: refers to morning stiffness of the joints after waking up or waking up, which usually lasts for about an hour and gradually improves after activity. It may be related to the increase of tissue fluid gathering in the synovial membrane and peri-articular tissues during sleep. After waking up in the morning, the tissue fluid flows back into the blood with joint and muscle activities, which reduces the edema of synovial membrane and periarticular tissues and relieves morning stiffness.
Pain and tenderness: This is the most common clinical manifestation in patients with P. aeruginosa. The degree of pain varies from person to person, and is to some extent related to the site of inflammation, the rate of fluid formation and the amount of fluid.
Swelling: Clinical involvement of the proximal interphalangeal joints, metacarpophalangeal joints and wrist joints of both hands is most common. The swelling of the joints in patients with P. aeruginosa is mainly due to fluid accumulation in the joint cavity, synovial hyperplasia and intertissue edema.
Joint deformity: The incidence of joint deformity increases with the duration of the disease. It occurs due to synovial inflammation caused by proteases and complement kinase in the synovial tissue and the subsequent combination of cartilage destruction, atrophy of the supporting muscles around the joint and ligamentous traction, which can cause joint subluxation or dislocation.
Rheumatoid nodules: 20%-25% of rheumatoid factor-positive patients have rheumatoid nodules, while rheumatoid factor-negative patients rarely have rheumatoid nodules. The nodules are round or oval in shape, hard in texture, ranging from a few millimeters to several centimeters in diameter, one or several located under the skin, mostly in the joint bulge and frequently pressured areas.
Vasculitis: clinically, it may manifest as erythema and ulcerative necrosis at the tips of the fingers (toes); skin ulcers; peripheral neuropathy; visceral arteritis; and osteolysis of the extremities.
Hematological manifestations: most of them are anemia, and some patients may have thrombocytosis and eosinophilia.
Visceral manifestations: pulmonary manifestations are interstitial pulmonary fibrosis, pleurisy, and nodular lung disease. Cardiac manifestations are pericarditis, myocarditis, endocarditis, and occasional conduction disturbances. The kidney manifests as microscopic hematuria or proteinuria or both, and occasionally nephrotic syndrome. Liver manifestations are increased liver enzymes (especially elevated glutamic aminotransferase and alkaline phosphatase) during the active phase of rheumatoid off.
Treatment goals for rheumatoid arthritis
Dr. Le points out that because the cause of rheumatoid arthritis is unknown, the mode of origin is diverse, the severity of the disease varies widely, and the prognosis and regression vary greatly, there is no cure. The goals of current treatment are to relieve pain, reduce and control inflammation, protect muscle and joint function, control or delay progression, and actively treat and prevent serious complications in order to restore patients to a satisfying and colorful life.
Patients with P. aeruginosa generally require lifelong treatment, but the vast majority of patients find it difficult to accept this reality and are often misled by some misinformation. Lured by illegal advertisements, they often go to this doctor today, another doctor tomorrow, and the day after tomorrow, they go to the gods and goddesses, eventually delaying their precious treatment time, and even seeking specialist treatment only when their joints are deformed. Therefore, Dr. Le hopes that the patients with “Wind-like Pass” will insist on receiving regular treatment with a combination of Chinese and Western medicine, and never believe in the lies that “the cure is guaranteed”.
The key points to avoid the disability of “wind-like disease”
Dr. Le believes that it requires the joint efforts of physicians and patients to avoid disability.
From the physician’s point of view, misdiagnosis and misdiagnosis should be avoided, and those who experience stiffness and pain in the morning after waking up or after resting should be considered to have a wind-like disease.
From the patient’s point of view, morning stiffness symptoms should be promptly seen by a rheumatologist. Since joint damage can occur at an early stage in rheumatoid arthritis, 30% of patients have bone erosion at the time of diagnosis. Therefore, early diagnosis and treatment are essential to prevent disability and improve quality of life.
Dr. Le cautioned that patients with P. aeruginosa should not treat hormones as a “tiger” and should respect the decision of the specialist whether hormones are needed. Only by insisting on long-term regular treatment with a combination of Chinese and Western medicine can the disease be controlled. Do not reduce the medication on your own, but follow up regularly, review regularly, build up the confidence to win the disease, and live an active and optimistic life.