What is the best medicine to take for rheumatoid arthritis?

Written by Li Jing
Rheumatology
Updated on September 06, 2024
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Rheumatoid arthritis is a clinical manifestation of rheumatic fever, which is a delayed sequelae that occurs after infection with streptococci. The most common symptoms include fever, arthritis, rheumatic heart disease, subcutaneous nodules, or marginal erythema. It mainly occurs in adolescents and is most commonly triggered by cold weather and damp environments. In cases showing joint symptoms, the first choice of medication is nonsteroidal anti-inflammatory drugs (NSAIDs). Additionally, it is crucial to actively treat the primary disease, which means eliminating the causative factor by eradicating the streptococcal infection. Eradication of the streptococcal infection involves the use of long-acting penicillin, and it is necessary to complete the treatment course of two weeks. Moreover, appropriate rest during the acute phase and avoiding exertion is needed. (Please use medication under the guidance of a professional physician and do not self-medicate.)

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Written by Yang Ya Meng
Rheumatology
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How is rheumatoid arthritis diagnosed?

The diagnosis of rheumatoid arthritis primarily relies on blood tests, radiological examinations, and the patient's own symptoms. Rheumatoid arthritis is often referred to as internal rheumatoid arthritis. For a definitive diagnosis: Firstly, the patient must exhibit symmetrical swelling and pain in the joints of both hands, including the small joints. Further screening through blood tests shows elevated erythrocyte sedimentation rate (ESR) and C-reactive protein, which are two inflammatory markers. Additionally, the presence of rheumatoid factors, anti-CCP antibodies, and AKA antibodies being positive also play a role. Simultaneously, if radiological imaging suggests joint space narrowing and bone damage, this further supports the diagnosis of rheumatoid arthritis.

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Written by Yang Ya Meng
Rheumatology
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Rheumatoid arthritis should be seen in the rheumatology department.

Patients with rheumatoid arthritis should visit the department of rheumatology and immunology, as it is an immune-related disease. The primary mechanism of the disease involves the production of abnormal antibodies in the body, which attack the joints themselves, leading to symptoms such as joint swelling and pain. Additionally, rheumatoid arthritis can also manifest symptoms outside of the joints. The most common of these is interstitial lung disease in some patients, primarily presenting as asthma. Furthermore, some patients may experience kidney involvement, mainly characterized by significant proteinuria.

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Written by Guan Yu Hua
Orthopedic Surgery
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Difference between arthritis and rheumatoid arthritis

Arthritis is typically osteoarthritis, a chronic inflammation characterized primarily by degenerative changes in joint cartilage, followed by bone proliferation, making it a chronic disease. Early pathological changes include alterations in joint cartilage, such as subchondral bone extrusion, followed by changes in the muscles surrounding the periosteum and joint capsule. Early radiographic examinations can provide a definitive diagnosis. Its symptoms primarily manifest as pain. For rheumatoid arthritis, it generally presents as morning stiffness and joint swelling and pain more severe than in the surrounding area, which can essentially confirm a diagnosis. It usually affects large joints such as the knee, shoulder, or wrist joints, typically presenting as migratory pain. A definitive diagnosis can usually be made by testing for rheumatoid factor, with an anti-O level exceeding 500 units. Additionally, there may be a slight increase in white blood cells, accelerated erythrocyte sedimentation rate, and elevated C-reactive protein. Examination of the synovial fluid shows increased white blood cells and neutrophils. In such cases, using anti-rheumatic drugs might suffice, but it’s also crucial to ensure rest and local heat application. These two types of arthritis fundamentally differ.

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Written by Li Jing
Rheumatology
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Treatment of Acute Flare-ups of Rheumatoid Arthritis

During the acute phase of rheumatoid arthritis, typical treatment includes absolute bed rest and avoiding intense physical activities, followed by a diet rich in fresh fruits and vegetables containing vitamins. Medication-wise, sodium diclofenac or meloxicam are used, which are non-steroidal drugs that relieve joint pain. If these drugs are not effective, steroids such as methylprednisolone are administered, initially at doses of 20 mg or 40 mg, until the pain eases, then gradually reducing the steroid dosage. During steroid treatment, it's also important to prevent side effects, namely, by supplementing with calcium and incorporating drugs that protect the stomach lining. (The above medications should be used under medical supervision.)

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Written by Wang Cheng Lin
Orthopedics
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The difference between osteoarthritis and rheumatoid arthritis.

Osteoarthritis and rheumatoid arthritis have distinct differences. Osteoarthritis commonly occurs in middle-aged and elderly women and is caused by the wear, degeneration, and rupture of joint cartilage, leading to swelling and pain due to friction during joint movement. On the other hand, rheumatoid arthritis is caused by bacterial infections leading to the proliferation of synovium in the joints, causing swelling and pain. Over time, this condition can damage the joint's cartilage and meniscus, severely affecting joint mobility. The treatments for these two diseases are different. Osteoarthritis can be alleviated through rest, oral medication, and physical therapy to ease local pain. If these methods are ineffective after more than six months, surgical treatment may be necessary, mainly total knee replacement. However, the treatment for rheumatoid arthritis primarily relies on medication to relieve local pain by removing rheumatism. (The use of medication should be under the guidance of a doctor.)