Whether in the ward or outpatient clinic, I often encounter many patients asking me: Doctor, do I have rheumatism? Does my high anti-“O” mean rheumatism? Am I rheumatoid arthritis or rheumatoid arthritis? I think this misunderstanding is too deep and needs to be understood by more people, not only patients, but also all non-rheumatology professionals. For nearly 2000 years, the concept of “rheumatism” was first used to describe the aches and pains of the body. The concept of rheumatism as a systemic musculoskeletal syndrome was introduced in the 16th century and included all diseases affecting bones, joints and surrounding soft tissues such as tendons, bursae and fascia, with arthrosis as one of its main clinical manifestations. With the progress of pathology, people gradually realized that “rheumatism” is actually a systemic disease, which can involve all parts of the body. Later, after years of practice, the rapid development of biochemistry, immunology, immunohistochemistry and molecular biology, the field of rheumatic diseases has been expanded and deepened, especially the concept of “autoimmune reaction” has been introduced to some rheumatic diseases. Therefore, we need to understand the following points: First of all, we need to recognize rheumatic diseases as musculoskeletal system diseases mainly treated by internal medicine, which include: diffuse connective tissue diseases and diseases of joints and soft tissues around joints, including muscles, tendons, ligaments, etc. caused by various reasons. There are more than 120 kinds of rheumatic diseases, the common ones are rheumatoid arthritis (RA), osteoarthritis (OA), systemic lupus erythematosus (SLE_, polymyositis/dermatomyositis (PM/AM), dry syndrome (PSS), leukoarthrosis (BD), vasculitis, spondyloarthropathy, ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis (ReA) The first edition of Internal Medicine was published in the sixth edition. The name rheumatoid arthritis is no longer mentioned in the sixth edition of internal medicine, and some experts even propose to abolish the name rheumatoid arthritis, so the name rheumatoid arthritis is no longer used in clinical diagnosis. Secondly, a high anti-“o” (ASO) can only indicate that one has been infected with group A hemolytic streptococci, but it does not mean that one is a rheumatic fever or rheumatic disease patient. The use of long-acting penicillin does not make sense. If the serum ASO potency is increasing, it only indicates a recent septic streptococcal infection and needs to be combined with clinical decision to use antibiotics. Third, rheumatoid factor (RF) positive is not the same as rheumatoid arthritis, RF in rheumatoid arthritis positive rate of about 80%, is an important serological marker for the diagnosis of rheumatoid arthritis, but not the only marker, because 5% of the normal elderly can also be RF positive, with the increase in age, the positive rate can increase, the age of more than 75 years old, RF positive rate of 2%-25 The rate of RF positivity varies from 2% to 25% in elderly people over 75 years of age; and is seen in many other diseases, such as autoimmune diseases: primary dry syndrome (50%), SLE (30%), SSC (20-30%), PM/AM (5-10%), MCTD (47%), etc., infectious diseases: bacterial endocarditis, tuberculosis, leprosy, infectious hepatitis, schistosomiasis, etc.; non-infectious diseases: diffuse interstitial lung fibrosis, cirrhosis, chronic active hepatitis, nodular disease, macroglobulinemia, etc. Persistent and highly valent RF often elevates disease activity in RA and has a high incidence of bone erosion. If rheumatoid arthritis is suspected in addition to RF must also be checked for rheumatoid arthritis autoantibody profile (AKA, APF, alpha-CCP) to determine. In addition, the rheumatoid triple/tetralogy is often referred to as C-reactive protein (CRP), rheumatoid factor (RF) and anti-streptococcal hemolysin “O” (ASO), and the rheumatoid tetralogy is based on this plus blood sedimentation, which is an assessment of the disease activity of patients with rheumatoid arthritis, but is not a disease-specific indicator. It is not a disease-specific indicator and cannot be used as a diagnostic indicator.