Brief Introduction to Rheumatoid Arthritis, May 6, 2003

Brief Introduction to Rheumatoid Arthritis, May 6, 2003

This disease is common and frequently occurring. In addition to joint pain, swelling, and deformity, erythrocyte sedimentation rate, C-reactive protein, and rheumatoid factor serve as important diagnostic indicators. The disease most often affects middle-aged and elderly individuals, though young people and children can also be affected. Middle-aged patients typically present with acute fever and joint swelling and pain, with all three tests—erythrocyte sedimentation rate, C-reactive protein, and rheumatoid factor—showing positive results. Elderly patients, however, often develop chronic symptoms, with less obvious joint swelling and chronic-type pain; test results may not always be positive, leading to what is commonly referred to as atypical rheumatoid arthritis.

1. Differential diagnosis of rheumatoid arthritis

(1) Osteoarthritis: Degenerative changes in the joints due to aging, with all three objective tests negative, blood work (-), accompanied by osteoporosis and degenerative changes within the joints.

(2) Ankylosing spondylitis: The lumbar spine and sacroiliac joints are frequently affected, with all three tests positive; 95% of patients test positive for HLA-B27, making it easy to confirm the diagnosis.

(3) Rheumatic arthritis: Common in adolescents, migratory in nature, with upper respiratory infections and pharyngitis in the early stages, rheumatic fever in the mid-stage, and valvular heart disease in the late stage.

(4) Gouty arthritis: Pain in the toes, high uric acid levels, and kidney damage.

(5) Psoriatic arthritis: Accompanied by psoriasis.

(6) Reiter's syndrome: Also known as urethral-eye-synovial syndrome, a clinical condition characterized by arthritis combined with sterile urethritis and conjunctivitis.

(7) Lupus arthritis: A complication of systemic lupus.

(8) Hepatitis B-related arthritis: Accompanied by hepatitis B.

2. Treatment of rheumatoid arthritis

(1) Western medicine: ① Hormones; ② Methotrexate; ③ Tripterygium glycosides.

(2) Traditional Chinese medicine: Guizhi Shaoyao Zhimu Tang, Shaoyao Gancao Santenggua, Wumi Niugutou, Jin Niu Baihuo, Jimingsan, Wujisan, Wuyao Shunqisan (Wuyao Shunqima Chenjiang, Jiegeng Gancao Jiangzao Chang, Baizhi Chuanxiong and Xixin, headache, joints, and gastrointestinal issues), Siwu Tang (Four Substances, Wuyao, Xiangfu).