According to Western medicine, rheumatism is not a single disease, but a large group of diseases that include rheumatism. Any disease that affects the musculoskeletal system, such as joints, muscles, ligaments, tendons, bursae, etc., and has pain as its main manifestation, regardless of its cause, belongs to the category of rheumatism. The autoimmune disorders, which produce pathogenic autoantibodies and lead to discomfort and organ damage, are called autoimmune rheumatic diseases, and can invade almost all organ systems, including the brain and nervous system, respiratory system, cardiovascular system, digestive system, genitourinary system, etc. Accordingly, it is easy to see that the scope of rheumatic diseases is very wide. When people experience joint pain, numbness, stiffness, and unfavorable flexion and extension, they often think about whether they have “rheumatism”, but rheumatic immune diseases do not only have these symptoms, but also have a variety of manifestations. When joint swelling, muscle pain and weakness, Raynaud’s phenomenon (limb discoloration), dry mouth, dry eyes, low back pain, alternating hip pain, heel pain, recurrent mouth ulcers, various rashes, erythema, photosensitivity, auricular swelling and pain, local or generalized skin swelling and tightening and hardening, generalized pain with insomnia, unexplained fever, etc., they may all be manifestations of some rheumatic immune disease. Some patients may not have any of the above symptoms, but have organ systemic damage as the main manifestation, such as: blood tests showing leukopenia, thrombocytopenia, anemia; urine tests with positive urine protein, urine occult blood or pathological tubular pattern; non-infectious pneumonia or interstitial lung lesions; multiple plasma cavities (pericardial effusion, pleural effusion, peritoneal effusion); liver function abnormalities of unknown origin; unexplained seizures, or cerebrovascular lesions. The rheumatologic disease is often associated with multiple plasma effusions (pericardial effusion, pleural effusion, abdominal effusion); liver function abnormalities of unknown origin; unexplained seizures, demyelination or cerebrovascular disease (especially in young patients); recurrent ophthalmia (keratoconjunctivitis, sclerositis, iritis, uveitis, etc.); recurrent miscarriage or unexplained intrauterine death; recurrent thrombosis, etc. In short, there is a reason why rheumatic immune diseases are often suspected in hospitals. So, what tests are needed for suspected rheumatic immune disease? 1, blood tests include: routine blood, blood sedimentation, liver function, kidney function, blood glucose, C-reactive protein, electrolytes for routine differential diagnosis and treatment monitoring; suspicion of myositis to check the myocardial enzyme spectrum; routine screening of hepatitis B three pairs, hepatitis C antibody, syphilis, HIV to exclude infection and assess the risk of medication to guide the use of drugs; fever blood culture; suspected viral infections need TORCH virus The coagulation function can assess the patient’s coagulation status and monitor anticoagulation therapy; calcitoninogen, IL-6, lactate dehydrogenase, adenosine deaminase, Mycobacterium tuberculosis antibodies, tumor markers, nail function, calcium and phosphorus metabolism, and 25OH vitamin D determination are often helpful for differential diagnosis. 2, rheumatic immune disease relatively special blood tests include: anti-nuclear antibody spectrum 18 items (including anti-nuclear antibody, anti-ds-DNA antibody, anti-ENA antibody spectrum, can also be examined separately, suspicion of diffuse systemic rheumatic immune disease or the need for differential exclusion need to check the full set), anti-neutrophil cytoplasmic antibodies 8 items (recommended when there is suspicion of vasculitis need differential diagnosis. Especially when there is unexplained lung, kidney, vascular and other systemic damage), rheumatoid markers (including rheumatoid factor, anti-cyclic citrullinated peptide antibodies, anti-O), humoral immunity (including IgG, IgA, IgM, C3, C4, CH50, most rheumatic immune diseases may have abnormalities, for lupus is an important item for differential diagnosis and treatment monitoring), autoimmune liver disease 11 items of related antibodies (recommended when there are unexplained liver function abnormalities), lymphocyte immunoassay, anticardiolipin antibody, antiperinuclear factor, anti-keratin antibody, human leukocyte antigen HLA-B27, etc. 3, imaging examinations: chest X-ray is a routine examination is very important to help differential diagnosis, assessment of organ involvement and guide the use of drugs, when the lung lesions are difficult to specify or suspected of interstitial lung disease or mediastinal lesions need to perform chest CT examination; involved joint X-ray, especially double-handed X-ray is more significant for diagnosis and differential diagnosis, sacroiliac joint CT in the differential diagnosis of spondylolisthesis is of great significance, if necessary, need to perform CT examination of the head is often the choice for assessing neurological involvement, but MRI is often required to detect neurological lesions in patients with rheumatologic diseases; abdominal ultrasound can be used for initial assessment of solid abdominal organs, and CT or MRI is required for differentiation when necessary; cardiac and vascular ultrasound is important for the assessment of cardiovascular system involvement, and cardiac ultrasound is also a noninvasive monitoring tool for patients with pulmonary arterial hypertension; cardiac ultrasound is also a non-invasive monitoring tool for patients with pulmonary arterial hypertension. Other examinations, such as joint ultrasound, angiography, bone scan, dual-energy CT, PET/CT, etc., are also very important in rheumatic diseases. 4. Pathological examinations related to rheumatic immune diseases: skin and muscle biopsy, kidney biopsy (immunohistochemistry), labial gland biopsy, vascular biopsy, lymph node biopsy, synovial biopsy, liver puncture biopsy, etc. are all very important. The pathological changes seen in tissue examination, such as lupus bands for systemic lupus erythematosus, rheumatoid nodules for rheumatoid arthritis, labial adenitis for dry syndrome, synovial lesions for different etiologies of Arthritis due to different etiologies are of great significance. 5, other related tests: urine routine is almost mandatory, suspected of kidney damage in the early sensitive kidney function urine three (urine β2 microglobulin, urine immunoglobulin, urine microalbumin) and urine protein quantification is also very important. Bone marrow aspiration may be required when there is an abnormal blood count to aid in differential diagnosis and to assess bone marrow hematopoietic function and guide immunosuppressive applications. Stool routine + occult blood tests are also necessary, especially if there are gastrointestinal symptoms or use of hormones and anti-inflammatory and analgesic drugs, and gastroscopy is required if necessary. Pulmonary function tests are also necessary to assess the condition of those with Raynaud’s phenomenon or suspected respiratory system involvement, and bronchoscopy, etc., if necessary. In addition, bone density, corneal fluorescence staining, tear film rupture test, Schirmer’s test, saliva flow, joint fluid examination, and arthroscopy are also important in the diagnosis and treatment of patients with rheumatic immune diseases. In conclusion, rheumatic immune diseases are a very complex group of diseases, divided into 10 categories of more than 260 kinds, and the doctor arranges the corresponding examination items according to the initial impression after the consultation. The diagnosis of rheumatologic immune diseases is not determined by any abnormality alone and excluded if it is normal, but requires a comprehensive analysis by a rheumatologist based on the patient’s clinical symptoms and signs, combined with the corresponding tests, and even then, it is sometimes difficult to make a clear diagnosis, and regular follow-up and treatment observation are required. For safe and effective treatment and early recovery, please go to the rheumatology department of a regular hospital for consultation.