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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.
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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.
The difference between rheumatic fever and rheumatoid arthritis
The main difference between rheumatic fever and rheumatoid arthritis is that in addition to symptoms of arthritis, rheumatic fever also presents with elevated anti-streptolysin O levels and valvular heart disease, with some patients displaying subcutaneous erythema and chorea-like symptoms. Rheumatoid arthritis, on the other hand, primarily manifests as joint pain, and rarely involves heart valve issues. Additionally, rheumatoid arthritis is characterized by elevated rheumatoid factor, anti-CCP antibodies, and anti-AkA antibodies as its main clinical features. Patients with rheumatoid arthritis also exhibit increased inflammatory markers. The key differences between rheumatic fever and rheumatoid arthritis lie in the different antibodies involved and the general association of rheumatic fever with cardiac involvement.
The Difference Between Rheumatic Fever and Rheumatoid Arthritis
Most patients with rheumatoid arthritis primarily exhibit symptoms related to the joints. Mainly affected are the symmetrical small joints of both hands, including both wrists, both palmar digital joints, and both proximal interphalangeal joints. In addition, patients with rheumatoid arthritis often have elevated rheumatoid factor, anti-CCP antibodies, and AKA antibodies. During the acute phase of joint disease, there is a marked increase in inflammatory markers, which is a major manifestation of rheumatoid arthritis. Patients with rheumatic fever, aside from joint pain, may also have heart valve disorders, such as mitral stenosis, and some patients may develop skin lesions, commonly erythema nodosum. Most importantly, patients with rheumatic conditions often show a significant increase in anti-streptolysin O.
Can you soak your feet if you have rheumatic fever?
Patients with rheumatic fever can relieve some joint pain by soaking their feet, but this does not fundamentally solve the problem. Rheumatic fever is often caused by streptococcal infection, which leads to diseases such as arthritis. Therefore, antibiotics should be used at the source to eliminate streptococcal infection and hence prevent the recurrence of rheumatism. Additionally, we can use anti-inflammatory and analgesic drugs to control joint pain. Commonly used anti-inflammatory analgesics include non-steroidal pain relievers, such as diclofenac sodium sustained-release tablets. If there is inflammation in the heart due to rheumatic fever, corticosteroid treatment should be considered. (Medication should be used under the guidance of a doctor.)