What is rheumatoid arthritis?
Rheumatoid arthritis is an inflammatory, progressive, symmetrical and destructive autoimmune disease, which is extremely harmful to human body. It was once called "immortal cancer", which seriously caused lifelong disability. At present, there is no clear conclusion about its pathogenesis. It is generally believed that it is related to infection (bacteria, viruses, mycoplasma), heredity, endocrine metabolism and nutrition. Cold and humidity are the main causes of the disease. Traditional Chinese medicine believes that under the condition of weak immune function, the metabolism of qi, blood and water and dampness is disordered and attacked by external evils (wind, cold and dampness), which leads to the unsmooth operation of qi, blood and water and dampness, obstruction of meridians, stagnation of heat for a long time, heat toxicity, invasion of joints, destruction of tissues, and formation of damp-heat osteoarthralgia.
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Is joint pain rheumatoid arthritis?
Arthralgia is not necessarily arthritis, because there are many reasons for joint pain, such as joint ligament injury caused by trauma, wrist synovitis, fossa swelling, synovial plica syndrome of knee joint and so on. Cryoglobulinemia, foreign body synovitis, bursitis of greater trochanter of femur, piriformis syndrome, calcaneal inflammation, etc. Therefore, joint pain is not necessarily arthritis, such as repeated attacks or persistent pain in a joint. You must go to the hospital for a detailed examination by the doctor and make a correct diagnosis so as to treat it in time.
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What tests should I do if I have arthritis?
If you suspect that you have rheumatoid arthritis, you should go to the hospital to do the following tests in time: Commonly used: 1. Blood test (1) ESR, the normal value is 0- 15mm/h for male and 0-20 mm/h for female (2) anti-streptolysin "O" test (0) 500u, children.
If necessary, you can do it if possible: (1) C-reactive protein, normal value.
If necessary, you can also do: X-rays and joint puncture and liquid test. The above examination can only be used as a reference in clinical work. It can't be used as the main basis for diagnosis, and the examination results are combined with clinical manifestations, so many patients have obvious clinical symptoms, but laboratory tests can't reflect them.
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Necessary conditions for diagnosis of rheumatoid arthritis (diagnostic criteria)
The diagnosis of rheumatoid arthritis is mainly based on clinical manifestations (conscious symptoms). Generally, one or two small joints at the distal end begin to be painful and swollen, and gradually develop into multiple joints, which are partially symmetrical, wandering and intermittent. More than half of patients may have morning stiffness (stiff hands when getting up in the morning) and disappear after exercise.
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It's not terrible to have rheumatoid arthritis.
Rheumatoid arthritis is an inflammatory, progressive and destructive autoimmune disease, which is extremely harmful to human body. If individual patients are not treated in time, joint stiffness, deformation and muscle atrophy will soon occur, resulting in lifelong disability. Some people used to call it "immortal cancer", which sounds terrible. In fact, rheumatoid arthritis is a relatively difficult disease at present, but it is not an incurable disease, and not every patient has it. With the continuous progress of human society and the continuous development of science and technology, many medical problems are being solved one by one. Organ transplantation, kidney replacement, liver replacement and heart replacement, which people never dreamed of before, are all successful cases. How many rheumatoid diseases are there? In recent years, people have also invested a lot of manpower and material resources in the research of rheumatoid diseases. Excavating the treasure house of traditional Chinese medicine, new drugs for treating rheumatism and rheumatoid diseases are constantly produced. According to the clinical observation of a large number of patients in recent years, many patients can completely recover and maintain their normal physiological functions as long as they insist on regular treatment, establish confidence and good mentality in overcoming diseases, treat diseases correctly, insist on functional exercise and cooperate closely with their families.
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What factors may be related to rheumatoid arthritis?
A: Rheumatoid arthritis has complicated causes and belongs to the category of "arthralgia syndrome" in traditional Chinese medicine. Obstruction means blocking, and the evil of wind, cold, dampness and heat invades the human body, resulting in poor circulation of qi and blood and impassability of meridians; Or phlegm and blood stasis, blocking in the meridians, deep into the joints and tendons, can occur. In addition, the occurrence of arthralgia syndrome is closely related to the rise and fall of physical fitness, climatic conditions and living environment. We studied the relationship between the differences of endocrine, metabolism, nutrition, geography, occupation, psychology and social environment and the onset of rheumatoid arthritis. Bacterial and viral infections and genetic causes may also be related to the pathogenesis. At present, rheumatoid arthritis is considered as an autoimmune disease.
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Is rheumatoid arthritis familial?
A: Rheumatoid arthritis is not a genetic disease, but it may be related to genetic factors. Through family investigation, we found that the positive rate of rheumatoid factor in close relatives of patients with rheumatoid arthritis is 2-3 times higher than that of the general population. In the family of patients with rheumatoid arthritis, the incidence of rheumatoid arthritis is 2- 1d times higher than that of the general population.
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What are the modes of onset of rheumatoid arthritis?
A: There are many ways of onset of rheumatoid arthritis, but there are two main types: occult and acute.
1. Occult onset: about 60%-70%, it is difficult for patients to tell the specific onset date. Initial symptoms may include general malaise or local joint symptoms. Some patients first have fatigue, low fever, loss of appetite and skeletal muscle pain. After a few weeks or months, joint pain and swelling often appear from one or several beautiful joints, which are symmetrically distributed.
2. Acute onset: About 8%- 15% patients have an acute onset, which progresses rapidly, with pain, swelling and limited movement of multiple joints in a short time. Often accompanied by fever, lymphadenopathy or subcutaneous nodules and other extraarticular manifestations.
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What are the joints most commonly involved in rheumatoid arthritis?
A: Rheumatoid arthritis mainly involves the joints of limbs, especially the small joints of hands and feet (especially the proximal interphalangeal joints and metacarpophalangeal joints or metatarsophalangeal joints), wrists, elbows, knees, irritability and shoulder joints. In addition, there may be temporomandibular arthritis, which is characterized by pain when chewing, local swelling in severe cases, and difficulty in opening the mouth; There can also be cervical spondylosis, manifested as neck pain, which can affect the clavicle and shoulders, such as cervical subluxation, which can cause spinal cord compression and even endanger life.
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What is morning stiffness? How to calculate the morning stiffness time?
A: After waking up in the morning, patients with rheumatoid arthritis feel stiff in the affected joints or nearby muscles, unable to turn over and get out of bed, unable to fasten their clothes with clenched fists, and have difficulty walking. Only after slow physical activity can this sense of stiffness be obviously alleviated. The calculation of morning stiffness should start from the time when the patient wakes up in the morning to the time when the patient's stiffness is obviously reduced, which is called morning stiffness time.
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What is rheumatoid subcutaneous nodule?
A: Subcutaneous nodules are hard, round or oval, and painless. The diameter of 0.2- 10 cm is too small, and it is mostly located in areas with more friction, such as elbow extension, achilles tendon, scalp, ischial tubercle or around joints. Rare parts are ears and bridge of the nose. Subcutaneous nodules rarely cause symptoms, and occasionally rupture or complicated with infection. Typical subcutaneous nodules grow slowly and persist or disappear when the disease is relieved. The appearance of subcutaneous nodules is closely related to the high drop of serum rheumatoid factor, serious joint damage and rheumatoid active lesions.
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What is rheumatoid factor? What is the significance of rheumatoid factor to rheumatoid arthritis?
A: Rheumatoid factor is an antibody in the serum of a few normal people and many patients with phlegm disease. Laboratory staff can detect this antibody through certain detection methods. If it is positive, the serum should be diluted and determined to determine the level of serum rheumatoid factor. It is usually expressed by the titer of 1: cypress or 1: 60.
Serum rheumatoid factor is one of the conditions for the diagnosis of rheumatoid arthritis, which has reference significance for the diagnosis of rheumatoid arthritis.
The increase of serum rheumatoid factor titer is often related to patients with rheumatoid arthritis who are in the active stage of the disease, have a long course of disease or have extraarticular manifestations. When the disease is controlled or relieved, rheumatoid factor may turn negative. Therefore, rheumatoid factor is regarded as an index to judge disease activity and drug treatment effect in clinic.
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What is early rheumatoid arthritis?
A: In early rheumatoid arthritis, the synovium is in an inflammatory stage histologically, mainly manifested as inflammatory cell infiltration; Clinically, patients have morning stiffness, joint pain, swelling, hydrops or limited activity, but no joint deformity; From the X-ray film, there is no abnormality in any structure of the affected joint. If every doctor or patient can grasp the early stage of rheumatoid arthritis, that is, only about 2 years, and actively use drugs to change the course of disease, it will greatly avoid reducing the bad outcome of advanced rheumatoid arthritis.
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What is advanced rheumatoid arthritis?
A: The late stage of rheumatoid arthritis series is due to synovial thickening, pannus formation, erosion and destruction of cartilage and subchondral bone, which eventually leads to joint deformity and stiffness. Clinically, patients not only have joint pain and swelling, but more importantly, they have irreversible severe joint deformity, rigidity or complete loss of function. X-ray examination of joints showed that the joint structure was seriously damaged or bony fusion. At this stage, patients often cannot take care of themselves, walk inconveniently or stay in bed all day.
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What are the characteristics of joint lesions of rheumatoid arthritis?
Answer: 1. Pain or swelling of multiple joints (5 or more joints) is more common.
2. Small joints of hands and feet, such as metacarpophalangeal joints (metatarsophalangeal joints), proximal interphalangeal joints, wrists, elbows, knees and ankles, are common.
3 symmetrical lesions, that is, both joints of limbs are involved.
4. Accompanied by stiffness, that is, there is stiffness in the joints in the morning, which often lasts for more than 30 minutes.
5. Persistent joint pain and swelling in the early stage, joint deformity, stiffness and functional loss in the later stage.
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Can patients with rheumatoid arthritis be paralyzed?
A: Patients with rheumatoid arthritis often have a fear that the development of the disease will lead to paralysis, so the ideological burden is heavy. In fact, it will not cause paralysis, because it generally does not invade the central nervous system. Paralysis is not really paralysis, but it is mistaken for paralysis because the joints are seriously damaged, resulting in deformity or dysfunction, which makes the patient inconvenient to move or even bedridden. Therefore, it is necessary to distinguish limb paralysis or paralysis caused by nervous system diseases from disability caused by rheumatoid arthritis. If patients with rheumatoid arthritis actively cooperate with drug therapy and exercise joint function under the condition that joint function has not been completely lost and deformity and rigidity are not serious, joint dysfunction will be alleviated and they will not stay in bed for a long time.
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What factors will aggravate the symptoms of patients with rheumatoid arthritis?
A: Humid environment, cold climate, rainy weather, excessive fatigue, mental stimulation and irregular life will aggravate symptoms.
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What is juvenile rheumatoid arthritis?
A: Juvenile rheumatoid arthritis is a common and frequent rheumatic disease in children, which is limited to children before t6. According to the clinical manifestations of juvenile rheumatoid arthritis in the first six months, it can be divided into three types: systemic type, multi-joint type and few-joint type. Systemic juvenile rheumatoid arthritis is mainly characterized by high fever, rash and arthritis; Multi-joint type refers to involving more than 5 joints; Less joint type refers to less than 4 joints.
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What is ankylosing spondylitis?
A: Ankylosing spondylitis is a systemic disease characterized by chronic progressive inflammation of axial joints. Almost all lesions involve sacroiliac joint and spinal facet joints, and calcification of intervertebral disc annulus fibrosus and its adjacent related ligaments often occurs. Severe diseases in the late stage may cause spinal ankylosis.
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What are the dietary requirements of patients with rheumatoid arthritis?
Rheumatoid arthritis is a chronic wasting disease, some patients are accompanied by fever or anemia, and some patients can induce gastrointestinal discomfort or ulcer due to drug treatment. Therefore. The diet of patients with rheumatoid arthritis needs to be supplemented with enough protein, sugar and vitamins, and the food should be easy to digest, avoiding irritating and cold hard food.
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How do patients with rheumatoid arthritis exercise joint function?
A: After the acute inflammation of rheumatoid arthritis is controlled. That is to start joint function exercise. Because patients with rheumatoid arthritis have more involved joints and the recovery speed of each joint is different, it is impossible to adhere to consistency in joint movement. Joint exercise can increase muscle strength and prevent joint contracture, stiffness and muscle atrophy. Exercise should be gradual and persistent. Methods It can be determined flexibly according to the illness, such as bed exercise, resistance exercise, sitting exercise, standing on crutches, walking and so on. The amount of activities should be from small to large, the time of activities should be from short to long, the number of activities should be from less to more, the way of activities should be changed from passive to active, and the amount and intensity of activities should be gradually increased to a tolerable level.
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