In the clinical process of various peripheral arthritis, arthralgia and ankylosing spondylitis, it is found that many patients and friends have such confusion: when their spine or other joint pain, often the first choice is to go to the orthopaedic department of the hospital, some patients and friends have run to the orthopaedic department of a number of hospitals, and the condition has not yet been brought under control, and often have to put up with the pain brought by the disease. Some people’s condition is delayed for decades, which is really regrettable and painful. This is all the result of not knowing enough about their diseases and not seeking proper medical treatment. However, with these diseases, if you go to the rheumatology and immunology department at an early stage, you may be able to take a more correct internal medicine treatment, and there will not be so many patients with deformities of bones and joints, and there will not be so many patients who are in pain for a long time. Why does this happen? How should patients and friends with joint pain, joint swelling and ankylosis of the spine seek medical attention? Do you have to have surgery to treat the symptoms of the joints, and is there a way to treat them without surgery? Why do many patients fail to choose the right clinic at the beginning? One important reason is that there is still no “orthopedics” in the medical profession. When you go to the hospital, you will often find: generally speaking, for a certain type of disease hospitals will have a corresponding internal medicine and surgery for non-surgical treatment and surgical treatment, such as for pulmonary diseases, respiratory medicine and thoracic surgery, for cardiovascular diseases, cardiovascular medicine and cardiovascular surgery, for abdominal gastrointestinal diseases, gastroenterology and general surgery, liver and gallbladder surgery, and anorectal surgery, for urological diseases, nephrology and nephrology, and for urology, gastrointestinal diseases. For diseases of the urinary system, there are nephrology and urology, and so on. Therefore, once there are diseases of the above systems, patients often go to the internal medicine department first to see if there is any medicine can be treated, and usually only when the internal medicine treatment effect is not good, then they will consider the surgical treatment. However, when patients and friends have bone and joint diseases, they go to the hospital and see: “There is no “orthopedic internal medicine”, but only “orthopedics”! Therefore, they have to go to the Department of Orthopedics to register for consultation. However, the hospital does not have “orthopedic internal medicine”, patients and friends and what to do? The answer is to go to the “rheumatology and immunology department” for treatment. In fact, the rheumatology and immunology department is in a way the “bone and joint internal medicine department”, of course, rheumatism and immunity diseases may have other manifestations in addition to bone and joint manifestations. When patients have joint pain, swelling, stiffness and other symptoms, it is the right choice to go to the rheumatology and immunology department first, because: Firstly, when rheumatism and immunity disease, the performance of joints is especially prominent. Rheumatologic diseases are mainly caused by the abnormal activation of the immune system in the body. The immune system is the system in the body that prevents bacteria, viruses, molds, etc. from damaging the body. Normally, when these “little bad guys” enter the human body, they will activate our immune system, and once the immune system is mobilized, these bacteria and viruses can be killed completely, and the human body will be healthy. However, with rheumatoid immune disease, the immune system has a problem, their cells and tissues as bacteria and viruses and other “enemies”, the immune system work harder, the more damage to the body. And the immune system harms the main object is our joints, so rheumatic immune disease people have joint pain, joint swelling, arthritis or joint deformity is not surprising at all. Secondly, why do many rheumatoid immune diseases have arthritis, or even arthritis as the main symptom? This is a long story, simply put, the immune system is like our army, of course, the army’s mission is to eliminate the enemy, to protect their own people. But one of the first tasks of the army is to distinguish “who is our enemy and who is our friend”. If we do not distinguish between our enemies and our friends, we will not be able to fight our enemies correctly, nor can we protect our friends well, and therefore we are bound to fail. And how do you distinguish between enemy and self? As an army, probably the most important distinction is “who is harming our interests and who is protecting our interests”. In fact, the immune system is similar, when bacteria and viruses enter our body, if they do not cause damage to our tissues, our immune system will not harm these bacteria and viruses, for example, in our gastrointestinal tract there are a large number of bacteria, but we and their “peace of mind”. Bacteria and viruses that destroy our cells and tissues and cause us fever and discomfort are, of course, the enemy. However, there are times when our body can be harmed without the invasion of bacteria and viruses, and this harm is caused by “wind and dampness” to the body. People in the north may have experienced or seen the cold weather on our body caused by “frostbite”. In fact, this kind of injury also exists in normal times, but this time the earliest and most important injury is mainly joints. This is because the joints, which exist mainly to facilitate the movement of the various parts of the body, can be described as “skin and bones”: there are no muscles, no blood vessels, and even no fluids in the joints. Since there is no blood circulation at a body temperature of 37℃, the joints are the hardest place to keep warm. As soon as the air is humid, the wind blows, or you touch cold water, the cells in the joints freeze and wail. When the cells in the joints are harmed by moisture and cold air, the immune system is not smart enough to mistake it for bacteria or viruses coming in and attacking us, so it can’t wait to jump in, but the “angry immune system” shoots indiscriminately because it can’t find the bacteria or viruses, and so it hurts our joints and other organs even more. But the “angry immune system” shoots indiscriminately because it can’t find the bacteria and viruses, thus causing more damage to our joints and other organs. We clinicians can’t condone the “errant immune system” without hitting it too hard. Thus, this has led to our current treatment principle: control, educate and guide the immune system. Most of the clinicians apply immune agents to suppress the function of the immune system, but not too heavily, and at the same time, different immunosuppressants should be used according to the specific conditions of the patient, sometimes multiple immunosuppressants should be used at the same time, so as to enhance the effect and reduce the toxic side effects. However, in the whole process of treatment, it is necessary to hold a good, not too heavy, not too light, this is the experience of the rheumatology and immunology clinicians. Although rheumatology and immunology is a young discipline, with a history of only about ten years in our country, the discipline of rheumatology and immunology can be said to be advancing by leaps and bounds due to the recent increase in awareness, with the number of doctors practicing in the past ten years having increased by more than ten times, and a lot of new therapeutic drugs and treatments having been invented, which should be said to be a boon for the majority of patients. Third, it can be seen that many patients with arthritis, joint pain, joint swelling in fact do not need surgical treatment of rheumatic immune diseases, should go to the Department of Rheumatology and Immunology for consultation and treatment, which will be more professional, the results will be better, of course, for those who still need surgery, rheumatology and Immunology Department of the patient, the doctor will be timely communication with orthopaedic doctors, orthopaedic doctors will be asked to consult the consultation, so that you can get the best possible treatment. Rheumatology is in a way orthopedics, so if you have joint pain or arthritis, please consider visiting a rheumatologist.