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Rheumatoid Arthritis
The difference between arthritis and rheumatoid arthritis
The difference between arthritis and rheumatoid arthritis is significant. Arthritis is a degenerative lesion caused by factors such as obesity, overuse, and trauma, which lead to the degeneration of joint cartilage. Rheumatoid arthritis is caused by acute or chronic inflammation of the connective tissue, commonly referred to as rheumatic fever. Clinically, it is mainly characterized by migratory pain, redness and swelling in the joints and muscles. The cause of rheumatoid arthritis is not yet definite in clinical practice, and the treatments are different. Osteoarthritis mainly results from cartilage degeneration and can be managed with conservative treatment in its early stages, while surgery might be required in the later stages. The treatment for rheumatoid arthritis primarily relies on medications to alleviate symptoms, and this condition may eventually lead to significant deformities of the hands and feet. Therefore, the differences between these two diseases are considerable.
The difference between osteoarthritis and rheumatoid arthritis
The so-called osteoarthritis often occurs as the patient ages, featuring localized bone hyperplasia and degenerative changes, leading to the destruction of cartilage. This results in congested and swollen synovium, manifesting as clear local symptoms of swelling and pain. Rheumatoid arthritis, on the other hand, mainly occurs due to a streptococcal infection, causing localized pain and swelling, thus forming rheumatoid arthritis. This is the difference between the two. There are also differences in treatment. Early osteoarthritis can be treated with oral non-steroidal anti-inflammatory and analgesic drugs, as well as medications that nourish the cartilage. For rheumatoid arthritis, symptomatic treatment is often necessary, and active anti-rheumatic treatment can be completely effective.
How is rheumatoid arthritis treated?
The treatment of rheumatoid arthritis is divided into general treatment and pharmacological treatment. General treatment mainly involves avoiding overexertion, having a light diet, and not staying up late. Pharmacological treatment is mainly divided into treatment during the acute flare-up phase and the remission phase. The acute phase focuses on anti-inflammatory and pain relief treatments, with non-steroidal anti-inflammatory drugs (NSAIDs) as the first choice, such as etoricoxib, meloxicam, or celecoxib. If the effect is not satisfactory, low-dose corticosteroid therapy may be combined. In the remission phase, slow-acting anti-rheumatic drugs are preferred, such as methotrexate, leflunomide, or sulfasalazine. If the slow-acting anti-rheumatic drugs are not effective, biologic agents such as tumor necrosis factor antagonists or JAK inhibitors may be combined.
How is rheumatoid arthritis treated?
The treatment of rheumatoid arthritis mainly falls into three categories: The first category includes anti-inflammatory and pain-relief medications, which are further divided into non-steroidal pain-relief drugs and low-dose corticosteroids. For rheumatoid arthritis, the most crucial treatment involves the choice of the second category: slow-acting drugs. Common drugs used in treating the key aspects of rheumatoid arthritis include immunosuppressants such as methotrexate and leflunomide. If the patient does not respond well to the above two conventional treatments, a third option that can be considered is treatment with biological agents. Commonly used biological agents include tumor necrosis factor antagonists. Before using biological agents, it is necessary to strictly rule out hepatitis, tuberculosis, and neoplastic diseases. (Please use medication under the guidance of a doctor)
Rheumatoid arthritis skin manifestations
Rheumatoid arthritis does not have specific skin manifestations. Rheumatoid arthritis is an immune-mediated erosive arthritis, clinically characterized by systemic symmetrical multiple joint swelling and pain, accompanied by morning stiffness, often lasting for more than an hour. Rheumatoid arthritis can affect the proximal interphalangeal joints and middle joints of both hands, as well as both wrists, elbows, shoulders, ankles, knees, and other joints. Some patients may experience involvement of the temporomandibular joint. Rheumatoid arthritis can also have extrarticular manifestations, such as affecting the hematological system, which may result in mild to moderate anemia, or affecting the lungs, which can lead to interstitial pneumonia or pulmonary fibrosis.
How is rheumatoid arthritis diagnosed?
Rheumatoid arthritis examinations include blood tests and imaging studies. The blood tests include complete blood count, erythrocyte sedimentation rate, rheumatoid factor, C-reactive protein, anti-streptococcal antibodies, ANA, anti-CCP antibodies, and anti-AKA antibodies. Imaging studies involve X-ray examinations of the hand joints. If the patient has significant increases in erythrocyte sedimentation rate and C-reactive protein, positive CCP and AKA antibodies, and the X-rays show bone destruction, then rheumatoid arthritis can be considered as a diagnosis.
How should rheumatoid arthritis be treated?
The treatment of rheumatoid arthritis includes several aspects. First, general treatment: keep a light diet, avoid spicy and stimulant foods, ensure joints are kept warm, and avoid excessive fatigue. Second, medication treatment: during acute flare-ups, non-steroidal anti-inflammatory drugs such as diclofenac sodium or etoricoxib can be used, possibly combined with low doses of corticosteroids. During stable phases, immunosuppressants such as methotrexate or leflunomide are needed. If conventional treatments are ineffective, biological agents like adalimumab or tofacitinib can be combined. Most patients can effectively control their condition after combined treatment. Third, traditional Chinese medicine: alongside Western medicine, Chinese herbal medicine such as total glucosides of paeony or tripterygium wilfordii polyglycoside can be used.
Is rheumatoid arthritis serious?
Patients with rheumatoid arthritis, if treated reasonably and formally, can achieve clinical remission, so in this sense, rheumatoid arthritis is not severe. However, if patients do not adhere to formal treatment for a long time, after a long period, they may develop joint deformities and ankylosis, resulting in disability. From this perspective, rheumatoid arthritis should be taken seriously. Commonly used drugs for treating rheumatoid arthritis include anti-inflammatory pain relievers, with non-steroidal pain relievers being the most commonly used, such as sustained-release diclofenac sodium tablets. The most important step in treating rheumatoid arthritis is the selection of immunosuppressants, with common immunosuppressants including methotrexate and leflunomide. (Medication should be used under the guidance of a doctor based on specific circumstances.)
Characteristics of rheumatoid arthritis in the hand
The key hand features of rheumatoid arthritis primarily manifest as symmetrical joint swelling and pain in both hands in the early stages. These swollen and painful joints include both wrist joints, bilateral metacarpophalangeal joints, and bilateral proximal interphalangeal joints. Rheumatoid arthritis rarely affects the distal interphalangeal joints of the hands. In the later stages of rheumatoid arthritis, due to the destruction of the hand joints by synovitis, some patients may develop deformities in the hand joints, commonly including ulnar deviation, swan neck deformities, or boutonniere deformities. Some patients may experience significant stiffness leading to limited mobility of the hand joints.
What causes rheumatoid arthritis?
The causes of rheumatoid arthritis are mainly classified into four categories, First, environmental factors, such as living in dark, damp conditions for a long period, may trigger the onset of rheumatoid arthritis. Second, genetic factors, the probability of developing rheumatoid arthritis significantly increases if a parent has the condition. Third, rheumatoid arthritis often relates to estrogen, thus it is more commonly seen in female patients clinically. Fourth, rheumatoid arthritis is also associated with certain infections, including some viral and bacterial infections.