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Rheumatic Arthritis
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.)
The difference between rheumatoid arthritis and osteoarthritis
Rheumatic arthritis is an inflammatory connective tissue disease caused by infection with Group A beta-hemolytic streptococcus. It is primarily characterized by migratory pain in the major joints of the limbs and may also present with fever, rash, erythema annulare, subcutaneous nodules, chorea, and carditis. Osteoarthritis mainly affects the major joints such as the hands, knees, shoulders, and lumbar spine, often without migratory symptoms. This condition is a degenerative change, primarily seen in middle-aged and elderly individuals. The treatment of this disease mainly includes calcium supplementation, keeping the joints warm, taking non-steroidal anti-inflammatory drugs, and medications that improve the condition, mainly glucosamine sulfate and diacerein.
How is rheumatoid arthritis treated?
Rheumatoid arthritis, also commonly referred to as internal rheumatoid arthritis, primarily has three major categories of treatment. The first category is anti-inflammatory and pain relief. The medications for anti-inflammatory pain relief include two types: the first type is non-steroidal pain relievers; for patients with very severe pain, a low dose of corticosteroids can be considered. The second category, which is also the most important treatment, involves the use of immunosuppressants. These immunosuppressants include drugs such as methotrexate and leflunomide. If the patient does not respond well to anti-inflammatory pain relief and immunosuppressants, treatment with biologics can also be considered.
Can people with rheumatoid arthritis drink alcohol?
Patients with rheumatoid arthritis can drink a small amount of alcohol, but long-term heavy drinking is not recommended. This is mainly because patients with rheumatoid arthritis need to take non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief due to joint pain. The most significant side effect of these painkillers is their impact on the gastrointestinal tract. As alcohol is known to be harsh on the stomach, patients who take NSAIDs while drinking alcohol are at a higher risk of developing complications such as gastrointestinal bleeding. Therefore, it is advised that patients with rheumatoid arthritis should not engage in long-term heavy drinking. (Medication should be used under the guidance of a doctor.)
Can people with rheumatoid arthritis drink alcohol?
Patients with rheumatoid arthritis should avoid drinking alcohol. Due to joint pain, patients with rheumatoid arthritis inevitably consume anti-inflammatory pain relievers or steroids for pain relief. These anti-inflammatory drugs are already harsh on the stomach, and alcohol is similarly harmful. Consuming both anti-inflammatory pain relievers and alcohol can easily lead to gastrointestinal bleeding. Some patients may even develop complications such as gastric ulcers or severe gastrointestinal bleeding. Therefore, it is not recommended for patients with rheumatoid arthritis to drink alcohol. (Medication should be used under the guidance of a doctor.)
Treatment of Acute Flare-ups of Rheumatoid Arthritis
During the acute phase of rheumatoid arthritis, typical treatment includes absolute bed rest and avoiding intense physical activities, followed by a diet rich in fresh fruits and vegetables containing vitamins. Medication-wise, sodium diclofenac or meloxicam are used, which are non-steroidal drugs that relieve joint pain. If these drugs are not effective, steroids such as methylprednisolone are administered, initially at doses of 20 mg or 40 mg, until the pain eases, then gradually reducing the steroid dosage. During steroid treatment, it's also important to prevent side effects, namely, by supplementing with calcium and incorporating drugs that protect the stomach lining. (The above medications should be used under medical supervision.)
Is the ankle pain due to gout or rheumatoid arthritis?
In clinical practice, the first reason for ankle pain is rheumatic or rheumatoid arthritis, which mainly involves the synovium of the joint in the early stages, causing synovial hyperplasia and effusion leading to pain. The second cause is gout, which is due to dietary habits, such as frequent consumption of greasy or seafood-based foods, and a preference for beer, leading to increased uric acid levels and gout. The third cause is osteoarthritis in middle-aged and elderly people, which leads to degeneration of joint cartilage and pain. The fourth cause is sprains, which can lead to damage to cartilage and ligaments within the joint, causing pain. To determine whether ankle pain is caused by gout or rheumatic arthritis, one can simply visit a hospital for a checkup, such as a uric acid test to see if there is a significant increase in gout uric acid levels. If the uric acid level is significantly elevated, it is likely caused by gout. Additionally, one can check for a rheumatism panel to see if the anti-O test is positive; if it is, it may suggest that rheumatic factors are causing the pain.