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Rheumatic Arthritis
Difference between arthritis and rheumatoid arthritis
Arthritis is typically osteoarthritis, a chronic inflammation characterized primarily by degenerative changes in joint cartilage, followed by bone proliferation, making it a chronic disease. Early pathological changes include alterations in joint cartilage, such as subchondral bone extrusion, followed by changes in the muscles surrounding the periosteum and joint capsule. Early radiographic examinations can provide a definitive diagnosis. Its symptoms primarily manifest as pain. For rheumatoid arthritis, it generally presents as morning stiffness and joint swelling and pain more severe than in the surrounding area, which can essentially confirm a diagnosis. It usually affects large joints such as the knee, shoulder, or wrist joints, typically presenting as migratory pain. A definitive diagnosis can usually be made by testing for rheumatoid factor, with an anti-O level exceeding 500 units. Additionally, there may be a slight increase in white blood cells, accelerated erythrocyte sedimentation rate, and elevated C-reactive protein. Examination of the synovial fluid shows increased white blood cells and neutrophils. In such cases, using anti-rheumatic drugs might suffice, but it’s also crucial to ensure rest and local heat application. These two types of arthritis fundamentally differ.
Can rheumatoid arthritis be cured through exercise?
Rheumatoid arthritis can be somewhat alleviated by exercise in terms of disease recovery. Rheumatoid arthritis primarily manifests as migratory swelling and pain in the major joints throughout the body. The onset of the disease is somewhat associated with streptococcal infections. In recent years, due to the widespread use of penicillin, rheumatoid arthritis has become very rare in clinical settings. Since the onset of rheumatoid arthritis is related to infections, long-acting penicillin is generally used for treatment if there is no accompanying carditis. Joint pain can be treated with non-steroidal anti-inflammatory drugs such as etoricoxib or sustained-release capsules of diclofenac sodium; if carditis is present, corticosteroids can be used. Patients with rheumatoid arthritis can engage in gentle aerobic exercises like swimming, yoga, jogging, Tai Chi, etc.
What should be avoided with rheumatoid arthritis?
Patients with rheumatoid arthritis should avoid the following three categories of food: The first category includes foods that can easily trigger photosensitivity, such as celery, coriander, shiitake mushrooms, seaweed, and leeks; these should be avoided. The second category includes overly warming and tonifying foods, such as dog meat, lamb, and longan; it is best to consume these sparingly. The third category includes high-protein seafood, such as shrimp and crab; these should be consumed in limited quantities because they may exacerbate rheumatoid arthritis symptoms and potentially trigger allergic reactions.
How long does it take to cure rheumatoid arthritis?
The symptoms of rheumatic arthritis, such as joint swelling and pain, generally improve on their own within about two weeks, with the longest duration not exceeding one month. However, since rheumatic arthritis is triggered by a Streptococcus infection, if the Streptococcus infection is not actively controlled, it is easy for the arthritis to relapse after the joint pain has improved. Therefore, for patients with rheumatic arthritis, it is essential to treat the Streptococcus infection early. Treatment with second-generation cephalosporin antibiotics for 10-14 days is recommended, followed by regular long-acting benzathine penicillin treatment at outpatient clinics to achieve a complete cure of rheumatic arthritis. (Specific medications should be used under the guidance of a doctor.)
Foods to Avoid with Rheumatoid Arthritis
Patients with rheumatoid arthritis should adhere to a light diet and avoid spicy foods, overly nourishing and greasy foods. Specifically, the following foods should be avoided: vegetables such as celery, coriander, shiitake mushrooms, leeks, and seaweed. In terms of meat, one should reduce consumption of warming foods like lamb, beef, and dog meat. Also, it is advisable to limit intake of high-protein seafood such as shrimp, crab, and sea cucumber. Regarding fish, preference should be given to freshwater fish, while the consumption of sea fish should be minimized. These are the foods that should be avoided by those suffering from rheumatoid arthritis.
Do you need to take X-rays for rheumatoid arthritis?
Rheumatoid arthritis requires imaging, especially of the affected joints. It is typically necessary to do this routinely. The main purpose is to check for any bone damage, primarily to differentiate it from rheumatoid arthritis. Because rheumatoid arthritis generally does not leave joint deformities, while rheumatoid arthritis, if not treated properly, can lead to bone destruction and in severe cases, joint fusion. In addition to imaging, rheumatoid arthritis also requires complete blood count, erythrocyte sedimentation rate, C-reactive protein, anti-streptolysin O, and echocardiography among other tests to comprehensively assess the condition and determine the treatment plan.
How is rheumatoid arthritis diagnosed?
The diagnosis of rheumatoid arthritis primarily relies on blood tests, radiological examinations, and the patient's own symptoms. Rheumatoid arthritis is often referred to as internal rheumatoid arthritis. For a definitive diagnosis: Firstly, the patient must exhibit symmetrical swelling and pain in the joints of both hands, including the small joints. Further screening through blood tests shows elevated erythrocyte sedimentation rate (ESR) and C-reactive protein, which are two inflammatory markers. Additionally, the presence of rheumatoid factors, anti-CCP antibodies, and AKA antibodies being positive also play a role. Simultaneously, if radiological imaging suggests joint space narrowing and bone damage, this further supports the diagnosis of rheumatoid arthritis.
Rheumatoid arthritis should be seen in the rheumatology department.
Patients with rheumatoid arthritis should visit the department of rheumatology and immunology, as it is an immune-related disease. The primary mechanism of the disease involves the production of abnormal antibodies in the body, which attack the joints themselves, leading to symptoms such as joint swelling and pain. Additionally, rheumatoid arthritis can also manifest symptoms outside of the joints. The most common of these is interstitial lung disease in some patients, primarily presenting as asthma. Furthermore, some patients may experience kidney involvement, mainly characterized by significant proteinuria.
What medicine should be taken for rheumatoid arthritis?
Medications for rheumatoid arthritis firstly include some anti-inflammatory and analgesic drugs, commonly used are non-steroidal pain relievers such as Diclofenac Sodium Sustained Release Tablets and the like. The second, and most important, are what we call slow-acting drugs, which are often immunosuppressants, commonly used ones include Methotrexate, Leflunomide Tablets and the like. If the patient does not respond well to conventional oral medications, we can also use biologic treatments. Before using biologics, we need to strictly rule out hepatitis, tuberculosis, tumors, and some common infections. Commonly used biologics include tumor necrosis factor antagonists and similar drugs. (The use of medications should be conducted under the guidance of a professional doctor.)
How is rheumatoid arthritis treated?
The treatment methods for rheumatoid arthritis mainly fall into three categories: The first category is anti-inflammatory analgesics, which include non-steroidal analgesic drugs such as slow-release diclofenac sodium. For patients with especially high inflammatory indicators, low-dose corticosteroids may also be considered. The second category of drugs includes slow-acting drugs commonly used in the treatment of rheumatoid arthritis, such as methotrexate and leflunomide, which are immunosuppressants. If the patient does not respond well to non-steroidal analgesic drugs or immunosuppressants, biological agents can be considered as a treatment option. Common biological agents include tumor necrosis factor antagonists. (Specific medications should be taken under the guidance of a physician.)