Rheumatic classification of rheumatic diseases currently include: autoimmune rheumatic diseases (such as rheumatoid arthritis belongs to this category), endocrine – metabolic rheumatic diseases (such as gout), infectious rheumatic diseases (such as tuberculosis arthritis), degenerative rheumatic diseases (such as osteophytic arthritis), genetic rheumatic diseases (such as brownish yellow disease) and other systemic diseases with arthritis as the main manifestation of signs and symptoms
1, the characteristics of joint performance.
(1) Joint pain.
(2) morning stiffness patients in the morning or after a long rest, the joints are glued stiffness, which can only be relieved or disappear after activity. Morning stiffness is most prominent in rheumatoid arthritis and can last for several hours, while in other arthritis it lasts for a shorter period of time.
(3) Swelling and pressure pain in joints are often present in painful joints and are signs of synovitis or peripheral soft tissue inflammation, the extent of which varies depending on the severity of the inflammation. It can be caused by fluid accumulation in the joint cavity or synovial hypertrophy. Osteophytic hypertrophy is more commonly seen in osteoarthritis.
(4) Joint deformity and dysfunction refers to loss of normal joint shape and limitation of range of motion, such as inability to fully straighten the knee, ulnar deviation of the metacarpophalangeal joint of the hand, and subluxation of the joint. These changes are associated with damage to cartilage and bone. In rheumatoid arthritis is common.
2, the characteristics of systemic symptoms: to catch the performance of other systems outside the joint by Sun to rib diagnosis. Such as cheek butterfly rash and proteinuria suggest systemic lupus erythematosus, psoriatic rash suggests psoriatic arthritis, and a large number of caries suggests dry syndrome.
The patient’s age and gender are also helpful for diagnosis, such as ankylosing spondylitis mostly seen in young men, systemic lupus erythematosus mostly seen in women of childbearing age, gout mostly seen in middle-aged men, and osteoarthritis mostly seen in middle-aged and elderly Common tests.
(1) Routine blood and urine tests, liver function tests: to check for abnormal indicators, to help confirm the diagnosis of the disease and to monitor the adverse effects of drugs.
(2) Erythrocyte sedimentation rate: referred to as blood sedimentation, normal reference value: adult male 0-15mm/h, female 0-20mm/h, high blood sedimentation, indicating that the disease is still in the active stage, the higher the more serious. A decrease in sedimentation indicates that the drug is working and the disease is under control. In rheumatic diseases, a blood sedimentation higher than 25 is meaningful.
(3) C-reactive protein (CRP): normal value ≤ 10 mg/L. High CRP indicates the presence of infection, trauma, inflammation in the body and the disease is still in the active stage.
(4) Anti-streptococcal hemolysin “O”: normal value less than 1:500, positive indicates possible rheumatic fever.
(5) Rheumatoid factor: Rheumatoid factor is commonly found in a variety of rheumatic diseases and acute and chronic inflammatory conditions. Therefore, one should not assume that one has rheumatoid arthritis based on the rheumatoid factor alone. However, if the rheumatoid factor titer is high, positive for multiple determinations, and positive for multiple methods, then the likelihood of having rheumatoid arthritis is higher.
(6) Anti-keratin antibodies, anti-perinuclear factor, anti-RA-33/66, anti-Sa antibodies: Common in patients with rheumatoid arthritis, especially important for the diagnosis of patients with early rheumatoid arthritis.
(7) Anti-CCP antibodies: of greater significance in the diagnosis of early rheumatoid arthritis.
(8) Anti-nuclear antibodies: positivity is common in many diseases. Those who also have signs of SLE are highly suspected of having lupus. Negative almost certainly excludes the diagnosis of lupus.
(9) Anti-ds-DNA antibodies: seen almost exclusively in patients with systemic lupus erythematosus. The higher the titer, the higher the disease activity is indicated.
(10) Anti-Sm antibodies: seen almost exclusively in patients with SLE. However, not all patients with lupus show positivity.
(11) Anti-SSA antibodies and anti-SSB antibodies: have greater significance in the diagnosis of dry syndrome.
(12) HLA-B27: more significant for the diagnosis of ankylosing spondylitis.
(13) Anti-neutrophil cytoplasmic antibodies (ANCA): positive significance for the diagnosis of systemic vasculitis
3, diet attention may aggravate the symptoms of rheumatoid arthritis food
(1) high fat: fat in the body during the oxidation process, can produce ketone bodies, and too much ketone bodies, the joints have a strong stimulating effect, help patients should not eat more high-fat foods, such as milk, fatty meat, etc., frying, soup should also be less oil.
(2) Seafood: Patients should not eat more scaly fish and seafood, such as catfish, loach, eels, kelp, sea cucumber, sea fish, sea shrimp, etc., because they contain uric acid, which is absorbed by the body and can form urate crystals in the joints, making joint symptoms worse.
(3) too acidic, too salty: such as peanuts, white wine, white sugar, as well as chicken, duck, fish, meat, eggs and other acidic food intake, more than the body’s normal pH value, will make the body’s acidity value a transient high, so that lactic acid secretion increased, and consume a certain amount of calcium, magnesium plasma, and aggravate symptoms. Similarly, if you eat too salty food such as salted vegetables, salted eggs, salted fish, etc., it will increase the sodium ion in the body, and aggravate the symptoms of patients.