Introduction to the diagnosis and treatment of rheumatoid arthritis

  As more patients have recently consulted rheumatoid arthritis, the following is a brief summary in the hope of popularizing the role of science and education.  1, rheumatoid arthritis definition: rheumatoid arthritis is a systemic autoimmune disease with erosive arthritis as the main manifestation. The disease is more prevalent in women, 30-50 years old for the peak incidence.  2, clinical manifestations: symmetric, persistent joint swelling and pain, often accompanied by morning stiffness. The most commonly affected joints are the proximal interphalangeal joints, wrist joints, elbow joints and toe joints.  Most patients may have positive autoantibodies such as rheumatoid factor and anti-cyclic citrullinated polypeptide antibody.  4.Imaging: X ray shows joint surface destruction and joint deformity, MRI shows synovial thickening in early stage.  5, diagnostic criteria: the following conditions meet 4 or more, the disease excludes other arthritis can be diagnosed rheumatoid arthritis, conditions 1-4 must last at least 6 weeks.  (1) morning stiffness; (2) arthritis in more than 3 joint areas; (3) hand arthritis; (4) symmetric arthritis; (5) rheumatoid nodules; (6) positive rheumatoid factor; (7) imaging changes.  6, treatment: rheumatoid arthritis treatment aims to control the disease, improve joint function and prognosis.  (1) General treatment includes appropriate rest, physical therapy, proper joint activity and muscle exercise.  (2) Drug therapy, commonly used drugs include: non-steroidal anti-inflammatory drugs, methotrexate, leflunomide, anti-abuse drugs (hydroxychloroquine, chloroquine), penicillamine, jinolfine, azathioprine, cyclosporin A, cyclophosphamide, TNF-alpha antagonist, IL-6 antagonist, IL-1 antagonist, anti-CD20 monoclonal antibody, abciap, glucocorticoids, leucovorin, total glucosamine.  (3) Surgical treatment: synovectomy, artificial arthroplasty, soft tissue surgery.  7. Prognosis: The prognosis of rheumatoid arthritis is related to the duration of the disease, the degree of the disease and the treatment. For patients with multiple joint involvement, extra-articular manifestations, high titers of autoantibodies in the serum. Patients with early bone destruction should be given active treatment. The majority of patients can be remitted with medical therapy.