Patient: Description of condition (onset, main symptoms, hospital visited, etc.): Joint pain for 2 years, joint swelling for 8 months, related to weather changes, normally normal, wandering Diclofenac pain tablets, proprietary Chinese medicine, traditional Chinese medicine Diagnosis and treatment
Drolma Tsetan, Department of Medicine Bath, Qinghai Tibetan Hospital.
Hello! Normal IGA and IGM cannot exclude rheumatoid. The most important thing to diagnose rheumatoid is symptoms, and then it is to check anti-CCP and AKA (early rheumatoid), RF, C-RP, ESR, etc. The following are the criteria for diagnosing rheumatoid rheumatism, please refer to them. Drolma Tsetan, Department of Medicine Bath, Qinghai Tibetan Hospital
1. Morning stiffness: stiffness in and around the joints for at least 1 hour when waking up in the morning (disease duration of 6 weeks or more). 2. Multi-regional arthritis: arthritis in 3 or more regions (interphalangeal joints, metacarpophalangeal joints, wrists, elbows, knees, ankles and metatarsophalangeal joints) with soft tissue swelling, fluid accumulation or pain. 3. arthritis of the hand: swelling and pain in at least one of the wrist, metacarpophalangeal or proximal interphalangeal joints (6 weeks or more). 4. Symmetrical arthritis: both joints are involved at the same time (not necessarily symmetrical when bilateral proximal interphalangeal joints, metacarpophalangeal joints and metatarsophalangeal joints are involved), and the disease lasts for 6 weeks or more. 5. Rheumatoid nodules: The doctor can observe subcutaneous nodules on the bony prominence, extensor surface or around the joint. 6. Positive rheumatoid factor: any test proving abnormal serum rheumatoid factor level (less than 5% positive rate in normal population). 7. X-ray examination: early arthritis X-ray shows swelling of soft tissues around the joint and mild osteoporosis near the joint; middle and late stages may show joint space narrowing, joint destruction, joint dislocation or fusion, and bone erosion or clear bone decalcification of the diseased joint. Rheumatoid can be diagnosed if four of the above seven items can be satisfied and other arthritis is excluded.