The difference between rheumatic fever and rheumatoid arthritis

Written by Yang Ya Meng

Rheumatology

Updated on September 03, 2024

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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.

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Written by Yang Ya Meng

Rheumatology

57sec

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Rheumatic fever clinical symptoms

The clinical manifestations of rheumatic fever primarily include: Some patients may experience low fever and rashes, and about half of the patients may exhibit symptoms such as morning stiffness. The joint pain associated with rheumatic fever often occurs more frequently in the large joints of the lower limbs and is asymmetrical, but it can also affect small joints and central axis joints. It commonly presents as non-migratory arthritis. Secondly, patients with rheumatic fever may experience cardiac involvement, with the most common being heart valve disease, particularly mitral valve stenosis. Additionally, patients with rheumatic fever may also suffer from kidney involvement, often presenting with symptoms such as hematuria and proteinuria, which are typical clinical symptoms of rheumatism.

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Written by Liu Li Ning

Rheumatology

44sec

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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

57sec

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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 Yang Ya Meng

Rheumatology

53sec

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Is the rheumatoid factor high in rheumatic fever?

Patients with rheumatic fever often do not have elevated rheumatoid factor levels, as rheumatic fever primarily follows a streptococcal infection. There is typically an increase in anti-streptolysin O antibodies, while rheumatoid factors are often negative. In addition to elevated anti-streptolysin O, patients with rheumatic fever may also experience valvular heart disease, most commonly mitral stenosis. Some patients may present with skin erythema and symptoms similar to chorea, which leads us to consider the possibility of rheumatic fever. The treatment of rheumatic fever primarily involves regular antibiotic therapy and continued administration of intramuscular benzathine penicillin for a period of time. (The use of medications should be under the guidance of a professional doctor.)

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Written by Liu Li Ning

Rheumatology

49sec

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Is a hot towel compress useful for rheumatism?

Rheumatic fever is not effectively treated by applying a towel. It is a systemic inflammatory disease caused by an infection of group A beta-hemolytic streptococcus. Clinically, common manifestations include fever, erythema marginatum, subcutaneous nodules, joint pain or arthritis, chorea, and carditis. The heart involvement primarily affects the valves, with the mitral and tricuspid valves being the most commonly affected, leaving many patients with valvular vegetations. The incidence of rheumatic fever has become relatively rare, mainly due to the widespread use of penicillin in recent years. During the acute phase of rheumatic fever, if joint pain occurs, non-steroidal anti-inflammatory drugs such as etoricoxib or meloxicam can be used for treatment.