Difference between Rheumatic Fever and Rheumatoid Arthritis

Written by Yang Ya Meng
Rheumatology
Updated on September 01, 2024
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The key difference between rheumatic fever and rheumatoid arthritis primarily lies in the fact that patients with rheumatic fever, besides exhibiting symptoms such as joint pain, also develop cardiac and dermatological manifestations. Patients with rheumatic fever may experience mitral stenosis and symptoms like erythema on the skin. Moreover, the examination of antibodies in rheumatic fever patients mainly shows an elevation in anti-streptolysin O antibody. In contrast, patients with rheumatoid arthritis typically display elevated rheumatoid factor, anti-CCP antibodies, and anti-AKA antibodies, and they seldom have skin or cardiac manifestations. Therefore, to differentiate rheumatic fever from rheumatoid arthritis, one can test for anti-streptolysin O and rheumatoid factor, and further conduct an echocardiogram to determine any cardiac involvement.

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Written by Liu Li Ning
Rheumatology
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Can rheumatic fever be contagious?

Rheumatic fever generally is not contagious. Because the onset of rheumatism is somewhat related to infection by Group A beta-hemolytic streptococcus, and it is not a contagious disease, it does not spread. Common clinical manifestations of rheumatic fever include fever, erythema marginatum, subcutaneous nodules, joint pain, chorea, and carditis. During the acute phase of rheumatism, it is recommended to rest in bed and avoid overexertion. In terms of medical treatment, because it is related to streptococcal infection, penicillin antibiotics are generally recommended. If there is concurrent carditis, corticosteroids should be used in combination to improve the condition.

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Written by Yang Ya Meng
Rheumatology
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Is rheumatism hot compress useful?

Hot compresses for rheumatic diseases can alleviate joint pain by increasing the local skin temperature, and have a certain effect in relieving joint swelling and pain. However, they cannot fundamentally solve the problem. Rheumatic diseases still require chronic oral medication treatment. The commonly used medications for treating rheumatic diseases fall into three main categories. The first category consists of drugs that control pain symptoms, which we call anti-inflammatory analgesics, commonly including medications like celecoxib. Additionally, to control the progression of rheumatism, it is also necessary to use some immunosuppressants, with the most common being methotrexate and leflunomide. If the above methods are not effective, we may consider treatment with biologics. (Medication should be administered under the guidance of a doctor.)

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Written by Liu Li Ning
Rheumatology
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Can you drink alcohol with rheumatic fever?

Rheumatic fever should not involve alcohol consumption. Because drinking could potentially trigger a flare-up of rheumatic fever and worsen the symptoms. Rheumatic fever is an inflammatory disease caused by Group A beta-hemolytic streptococcal infection. Common clinical manifestations include fever, subcutaneous nodules, erythema marginatum, joint pain or arthritis, chorea, carditis, and so forth. During the acute phase, the main symptoms are fever and joint pain, which can be treated with penicillin antibiotics to combat infection. Joint pain can be relieved with non-steroidal anti-inflammatory drugs, such as etoricoxib. In cases where carditis occurs during the acute phase, combined treatment with corticosteroids is also required. Regarding diet, it is advisable to eat lightly, and both smoking and drinking alcohol should be avoided.

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Written by Yang Ya Meng
Rheumatology
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What tests are needed for rheumatic fever?

The examinations for rheumatic fever include laboratory tests and electrocardiograms, as well as imaging studies. Laboratory tests include indicators of streptococcal infection, commonly using throat swab bacterial cultures, which have a positivity rate of about 20% to 25%. They also include anti-streptolysin O tests, generally considered positive if the titer is above 1:400. Secondly, the tests include those for acute inflammatory response, common markers of which are elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Electrocardiograms help in detecting various arrhythmias, such as sinus tachycardia and prolonged PR interval. Echocardiography can be used to detect any abnormalities in the mitral valve of the heart.

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Written by Yang Ya Meng
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The difference between rheumatic fever and rheumatoid arthritis

The main difference between rheumatic fever and rheumatoid arthritis is that in addition to symptoms of arthritis, rheumatic fever also presents with elevated anti-streptolysin O levels and valvular heart disease, with some patients displaying subcutaneous erythema and chorea-like symptoms. Rheumatoid arthritis, on the other hand, primarily manifests as joint pain, and rarely involves heart valve issues. Additionally, rheumatoid arthritis is characterized by elevated rheumatoid factor, anti-CCP antibodies, and anti-AkA antibodies as its main clinical features. Patients with rheumatoid arthritis also exhibit increased inflammatory markers. The key differences between rheumatic fever and rheumatoid arthritis lie in the different antibodies involved and the general association of rheumatic fever with cardiac involvement.