Rheumatoid Arthritis Diagnostic Criteria

Written by Yang Ya Meng
Rheumatology
Updated on September 14, 2024
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The diagnostic criteria for rheumatoid arthritis include, first, the presence of swelling and pain in multiple joints, especially characterized and significant in the smaller joints. Second, serological tests show elevated levels of antibodies, commonly rheumatoid factor and anti-CCP antibodies. If both are elevated, it is most meaningful. Third, the duration of joint swelling and pain should be more than six weeks. Fourth, we must also check some inflammatory markers for joints, such as elevated erythrocyte sedimentation rate and C-reactive protein. If these markers are elevated, and the patient has swelling and pain in multiple joints, then we can consider a diagnosis of rheumatoid arthritis.

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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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Symptoms and treatment methods of rheumatoid arthritis

Rheumatic arthritis is mostly related to streptococcal infections. Additionally, respiratory viruses and mycoplasma infections can also cause joint pain. Once joint pain occurs, especially if it is asymmetrical, one should consider these infection-related factors, thus necessitating comprehensive tests including anti-streptolysin O, erythrocyte sedimentation rate, and respiratory virus tests. Whether to treat rheumatic arthritis depends on symptoms like fever and joint pain. Should there be fever and joint pain, proper medication is required, primarily the use of anti-inflammatory drugs, specifically non-steroidal ones. Treatment should be combined with long-term administration of penicillin to ensure a full course of therapy. If joint pain occurs, immobilization is essential, meaning bed rest is necessary until the joint pain eases. During this period, a light diet and adequate water intake are also recommended. (Please follow the guidance of a professional physician for medication use.)

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Rheumatoid arthritis massage techniques

For the acute phase of rheumatoid arthritis, which is when the joints are significantly swollen and painful, it is not advisable to perform any form of massage. Both massage and intense exercise could potentially worsen the joint swelling and pain. At this time, what is needed is strict bed rest. After the acute phase of the joints eases, then consider some methods of exercise. In managing the acute phase of rheumatoid arthritis, one can consider using some anti-inflammatory pain relievers. The most commonly used are non-steroidal pain relievers, such as diclofenac sodium, to control joint pain, rather than massaging the joints, as this could only make the condition worse. (Please follow medical advice regarding specific medications.)

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The difference between osteoarthritis and rheumatoid arthritis.

Osteoarthritis refers to the damage of joint cartilage due to degeneration in old age, which can cause symptoms such as joint pain, limited mobility, and deformity. Rheumatoid arthritis, on the other hand, involves the destruction of joint cartilage solely due to rheumatic diseases, particularly accompanied by abnormal proliferation of the synovium, causing pain and local heating, and resulting in limited joint mobility. Rheumatic diseases feature migrating joint pain, which worsens when exposed to cold. Additionally, diagnostic indicators such as positive rheumatoid factor will show increased levels, thus making it relatively easy to distinguish between osteoarthritis and rheumatoid arthritis.

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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.)