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Yang Ya Meng
Rheumatology
About me
Graduated from Anhui Medical University in 2005, working in the Department of General Medicine at the Second People's Hospital of Anhui Province, specializing in the diagnosis and treatment of common and prevalent internal medicine diseases.
Proficient in diseases
Conventional diagnosis and treatment of systemic lupus erythematosus, rheumatoid arthritis, ankylosing spondylitis, and gouty arthritis, as well as regular diagnosis and treatment of prolonged unexplained fever.
Voices
How long will it take for rheumatic fever rash to heal?
Rheumatic fever rash generally improves after seven to ten days of treatment, but this is contingent upon completing a full course of antibiotics. This is because the rash is induced by a streptococcal infection. Therefore, to control the infection by streptococcus, the rash will begin to improve. Moreover, if the rash does not subside over time, it may also be considered to strengthen anti-inflammatory treatment with glucocorticoids and anti-allergy treatments to reduce the rash. Additionally, medications like loratadine dispersible tablets and compound glycyrrhizin can be added to help reduce the occurrence of rheumatic fever rash and accelerate its resolution.
Rheumatoid Arthritis Diagnostic Criteria
The diagnostic criteria for rheumatoid arthritis include the following aspects: The first is symmetrical joint pain, primarily characterized by tenderness and swelling in the metacarpophalangeal joints, proximal interphalangeal joints, and both wrists. Secondly, it also includes abnormalities in inflammation markers, which comprise erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), along with abnormalities in certain antibodies, mainly rheumatoid factor, CCP antibodies, and AKA antibodies. If the above symptoms are present, and these inflammation markers and antibodies are found to be abnormal upon blood testing, a diagnosis of rheumatoid arthritis can be made.
What tests are needed for rheumatic fever?
The examinations for rheumatic fever include laboratory tests and electrocardiograms, as well as imaging studies. Laboratory tests include indicators of streptococcal infection, commonly using throat swab bacterial cultures, which have a positivity rate of about 20% to 25%. They also include anti-streptolysin O tests, generally considered positive if the titer is above 1:400. Secondly, the tests include those for acute inflammatory response, common markers of which are elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Electrocardiograms help in detecting various arrhythmias, such as sinus tachycardia and prolonged PR interval. Echocardiography can be used to detect any abnormalities in the mitral valve of the heart.
Rheumatoid Arthritis Diagnostic Criteria
The diagnostic criteria for rheumatoid arthritis include, first, the presence of swelling and pain in multiple joints, especially characterized and significant in the smaller joints. Second, serological tests show elevated levels of antibodies, commonly rheumatoid factor and anti-CCP antibodies. If both are elevated, it is most meaningful. Third, the duration of joint swelling and pain should be more than six weeks. Fourth, we must also check some inflammatory markers for joints, such as elevated erythrocyte sedimentation rate and C-reactive protein. If these markers are elevated, and the patient has swelling and pain in multiple joints, then we can consider a diagnosis of rheumatoid arthritis.
What are the symptoms of rheumatic fever?
In the early stage of rheumatic fever, most patients show signs of infection, such as pharyngitis or tonsillitis. Patients with rheumatic fever often also experience fever, with body temperatures generally ranging from 38 to 40°C. Additionally, there may be migrating arthritis characterized by redness, swelling, warmth, pain, and limited mobility in the joints. Rheumatic fever patients may also suffer from cardiac valve lesions, primarily manifesting as valvulitis, myocarditis, or pericarditis, with damage to the valves being most common. Skin rashes, mainly presenting as ring-shaped erythema or subcutaneous nodules, can also occur. Some patients with rheumatic fever may experience chorea, which are among the primary symptoms of the condition.
Symptoms and Treatment of Rheumatic Fever
Patients with rheumatism often experience symptoms of upper respiratory tract infections in the early stages of the disease, such as fever and sore throat. Additionally, patients with rheumatism commonly exhibit migratory joint pain, primarily characterized by acute onset of redness, swelling, heat, pain, and limited mobility in the joints, but these can improve on their own. Patients with rheumatic fever often also suffer from carditis, which can include valvulitis, myocarditis, and pericarditis, with damage to the valves being the most common. Rheumatic fever may also present with ring-shaped erythema on the skin or subcutaneous nodules, and it can include chorea. The most common treatment for rheumatic fever is the intramuscular injection of penicillin. (Specific medication use should be carried out under the guidance of a doctor.)
How to cure rheumatoid arthritis?
The treatment methods for rheumatoid arthritis mainly consist of three major categories. The first category is the use of anti-inflammatory and analgesic drugs, commonly including non-steroidal analgesics such as sustained-release diclofenac sodium tablets, and small doses of corticosteroids can also be used. For rheumatoid arthritis, the most important treatment is the choice of immunosuppressants. Commonly used immunosuppressants include methotrexate and leflunomide. After using these medications, it is necessary to regularly monitor blood routine tests and liver and kidney functions to check for possible side effects of the drugs. If the effects of the above oral medications are not satisfactory, the application of biologics can also be considered. (Specific medications should be used under the guidance of a doctor, do not self-medicate.)
Rheumatoid arthritis diagnostic tests
The diagnostic tests for rheumatoid arthritis include blood tests and X-ray examinations. Blood tests include a complete blood count, inflammatory markers, erythrocyte sedimentation rate, C-reactive protein, and screening for various antibodies such as rheumatoid factor, anti-O, anti-CCP antibodies, and anti-AKA antibodies. Additionally, if there is significant pain in the hand joints, an X-ray of the hand joints can be taken. The X-ray can show whether there is any destruction of bone, osteoporosis, or other manifestations of rheumatoid disease. Based on these tests, it is generally possible to diagnose the specific type of rheumatoid disease.
The difference between osteoarthritis and rheumatoid arthritis.
Osteoarthritis is primarily a degenerative joint disease, most commonly occurring in weight-bearing joints and the distal joints of both hands. Therefore, if there is pain in the distal joints of the hands or in joints like the knee, it may be osteoarthritis. Rheumatoid arthritis mainly affects the metacarpophalangeal joints, proximal interphalangeal joints, and both wrists. It is also important to distinguish that in patients with osteoarthritis, inflammation indicators such as sedimentation rate, C-reactive protein, and endocrine factors are usually normal. However, in patients with rheumatoid arthritis, these indicators, including sedimentation rate, C-reactive protein, and rheumatoid factor, are abnormally elevated.
The difference between rheumatic arthritis and rheumatoid arthritis
Rheumatic arthritis is a reactive joint pain that occurs after a streptococcal infection. In addition to joint pain, common symptoms include mitral valve stenosis in some patients, skin erythema, and some patients may also exhibit symptoms such as chorea. Patients with rheumatoid arthritis often show symmetrical swelling and pain in the joints of both hands. Blood tests reveal significantly elevated levels of rheumatoid factor, anti-CCP antibodies, and AK antibodies. Inflammatory indicators such as erythrocyte sedimentation rate and C-reactive protein also tend to be significantly elevated. The main difference between rheumatic arthritis and rheumatoid arthritis is that rheumatic arthritis can involve cardiac and skin pathologies, while rheumatoid arthritis primarily manifests as joint-related pathologies.