Rheumatoid arthritis, often referred to as rheumatoid, is a relatively common arthritic disease with an incidence of about 0.4% in China. Although we often hear this term, many patients and people still lack sufficient knowledge and have some misconceptions about this disease. Therefore, I hope that through this short article to enable you to further understand some of the basic knowledge of rheumatoid arthritis. 1.What is rheumatoid arthritis? Rheumatoid arthritis is a chronic systemic inflammatory disease whose etiology is not yet known, mostly in middle-aged women. The disease often involves the small joints of the hands and feet, but the large joints of the shoulder, elbow, hip, and knee can also be involved, mostly symmetrically distributed from left to right. The early stage of rheumatoid disease is characterized by redness, swelling, pain and dysfunction of the joints, and in the late stage, the joints may have different degrees of deformity and skeletal muscle atrophy, resulting in a high disability rate. In addition to joint lesions, rheumatoid arthritis can also have fever, fatigue and weakness, subcutaneous nodules, pericarditis, pleurisy, arteritis, peripheral neuropathy and other extra-articular manifestations. 2.What is the difference between rheumatoid and rheumatism? People often confuse “rheumatism” with “rheumatoid”, which are actually two different concepts. The people speak of rheumatism is the concept of traditional Chinese medicine, its explanation is the wind and dampness of the two types of pathogenic factors jointly caused by the disease, but do not confuse with the modern Western medicine in the concept of rheumatism. Western medicine has the concept of “rheumatic diseases”, which is a general term for all diseases affecting bones, joints and their surrounding soft tissues, such as muscles, bursae, tendons, fascia, etc. Rheumatic diseases include more than 300 kinds of diseases in total, and “rheumatoid arthritis” is only one of them. Rheumatoid arthritis is only one of them. The history of rheumatic diseases can be traced back to more than 3,000 years ago, when the word “rheumatism” was first mentioned in the Hippocrates’ Complete Works as a general term for pain of variable location. The name rheumatoid arthritis was first used by the British doctor Garrod in 1858, and in 1896 Schafer and Raymond designated the disease as an independent disease. 3, do not think that “anti-O” elevated is suffering from rheumatoid arthritis or rheumatoid arthritis Many people and even medical personnel see anti-streptococcal hemolysin O (often referred to as “anti-O”) elevated, it is thought to be suffering from rheumatoid arthritis or rheumatoid arthritis. This is wrong. Rheumatoid arthritis”, the exact name of which should be “rheumatic fever”, is an immune disease that occurs after streptococcal infection, mostly in adolescents, and can manifest itself as arthritis. The patient may present with arthritis, and the blood “anti-O” level is often elevated. However, it is very common to have high “anti-O” in adults, which only indicates that there has been a streptococcal infection, and it is never the case that high “anti-O” means rheumatic fever. In addition, “anti-O” high and rheumatoid arthritis is not related to each other. 4, the correct distinction between rheumatoid arthritis and osteoarthritis? Osteoarthritis, also known as degenerative osteoarthropathy, is mainly characterized by osteophytes and is closely related to the aging of the human body, so it is the most common disease in the elderly. Clinical data shows that the prevalence of osteoarthritis in people under 45 years of age is only 2%, while the prevalence in people over 65 years of age is as high as 68%. In the opinion of doctors, all people suffer from different degrees of osteoarthritis in old age. And rheumatoid arthritis mainly manifests itself as swelling and pain in small joints (finger joints, wrist joints, etc.), with similar symptoms often found in the left and right hands or feet. Most patients suffering from rheumatoid arthritis are between the ages of 35-50. 5.How is rheumatoid arthritis treated? It has been confirmed that rheumatoid arthritis progresses rapidly within the first 1-2 years of its onset and is most likely to develop bone destruction, which is irreversible once it occurs. Therefore, early diagnosis and early treatment are very important for rheumatoid arthritis to delay the occurrence of joint deformation and disability in patients. Early diagnosis and treatment of rheumatoid arthritis is an important topic of clinical exploration, which can greatly improve the prognosis and the quality of life of patients. Mini-arthroscopic subluxation biopsy combined with MRI technology and serological tests are now internationally recognized methods for early diagnosis of rheumatoid arthritis. It is understood that the early diagnosis rate of rheumatoid arthritis has been greatly improved by using these diagnostic methods in rheumatology departments such as the First Hospital of Peking University in China. The main goal of rheumatoid arthritis treatment is to reduce pain, delay bone destruction and reduce the occurrence of disability. Anti-inflammatory and analgesic drugs can reduce the patient’s pain, but cannot control the progress of the disease. Anti-rheumatic drugs must be taken at the same time to improve the condition, such as methotrexate, leflunomide, salazosulfapyridine, hydroxychloroquine sulfate, etc. These are the most fundamental and important drugs for the treatment of rheumatoid arthritis, but they are slow to take effect and should be used actively in the early stage of the disease. Since rheumatoid arthritis is a chronic disease, in order to improve the quality of life of patients, they need to take long-term treatment. Depending on the severity of the patient’s disease, they choose to use a single drug or a combination of several drugs, including the application of glucocorticoids in small doses, to control the disease as early as possible and delay the onset of bone destruction. In the process of combined treatment, rheumatologists also adjust the medication according to the patient’s condition and the effect of the medication on other organs, and there is no major difference in the principle of medication, but the practice and skill of medication are very strong. Therefore, some people jokingly refer to rheumatologists as “masters of using hormones and anti-rheumatic drugs to improve the condition”. Biologic agents have emerged in the last decade or so as very effective drugs for the treatment of rheumatoid arthritis, and their introduction has been revolutionary for the treatment of rheumatoid arthritis. Large-scale clinical trials have shown that tumor necrosis factor antagonists are superior to the above-mentioned traditional drugs in terms of anti-inflammatory and analgesic effects, especially in delaying disease progression and bone destruction. More and more patients in China have chosen to use biologics, which can be said to be a blessing for patients with rheumatoid arthritis. Although the treatment of rheumatoid arthritis has made great progress, the time to develop joint deformity has been significantly longer and the proportion of patients has decreased significantly, so that fewer and fewer patients need surgical orthopedics. Follow-up has revealed that more than 80% of patients with rheumatoid arthritis are depressed, and 15% of them have severe depression. Therefore, while actively carrying out treatment for arthritis, rheumatologists should also pay attention to psychotherapy to help patients build up confidence and treat the disease optimistically. The patient’s family members should understand the patient and care and help the patient to overcome the disease from both physical and mental aspects.