Differential diagnosis of rheumatoid arthritis

Written by Li Jing
Rheumatology
Updated on May 08, 2025
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Rheumatoid arthritis is mostly related to streptococcal infections and needs to be differentiated from internal rheumatoid arthritis, ankylosing spondylitis, and other joint pains caused by autoimmune diseases. The main characteristic of rheumatoid arthritis is symmetrical pain in the joints of both hands, usually affecting multiple joints and accompanied by morning stiffness, and even systemic symptoms such as mild fever. The main features of ankylosing spondylitis are stiffness in the neck or pain in the lower back, with pain worsening after rest and alleviating after activity. Diagnosis requires a combination of CT of the sacroiliac joints and tests such as HLA-B27. Joint pain caused by other autoimmune diseases, such as systemic lupus erythematosus, often presents clinically with facial rashes, accompanied by hair loss, recurrent oral ulcers, and even Raynaud's phenomenon and mild fever. Diagnosis requires comprehensive tests including complete blood count, erythrocyte sedimentation rate, autoimmune antibodies, abnormal immunoglobulins, etc., based on the corresponding clinical manifestations and tests, to provide differential diagnosis.

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Written by Yang Ya Meng
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Foods to Avoid with Rheumatoid Arthritis

Patients with rheumatoid arthritis should adhere to a light diet and avoid spicy foods, overly nourishing and greasy foods. Specifically, the following foods should be avoided: vegetables such as celery, coriander, shiitake mushrooms, leeks, and seaweed. In terms of meat, one should reduce consumption of warming foods like lamb, beef, and dog meat. Also, it is advisable to limit intake of high-protein seafood such as shrimp, crab, and sea cucumber. Regarding fish, preference should be given to freshwater fish, while the consumption of sea fish should be minimized. These are the foods that should be avoided by those suffering from rheumatoid arthritis.

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Written by Lv Yao
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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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Written by Liu Li Ning
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The difference between rheumatoid arthritis and osteoarthritis

Rheumatic arthritis is an inflammatory connective tissue disease caused by infection with Group A beta-hemolytic streptococcus. It is primarily characterized by migratory pain in the major joints of the limbs and may also present with fever, rash, erythema annulare, subcutaneous nodules, chorea, and carditis. Osteoarthritis mainly affects the major joints such as the hands, knees, shoulders, and lumbar spine, often without migratory symptoms. This condition is a degenerative change, primarily seen in middle-aged and elderly individuals. The treatment of this disease mainly includes calcium supplementation, keeping the joints warm, taking non-steroidal anti-inflammatory drugs, and medications that improve the condition, mainly glucosamine sulfate and diacerein.

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Written by Liu Li Ning
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Do you need to take X-rays for rheumatoid arthritis?

Rheumatoid arthritis requires imaging, especially of the affected joints. It is typically necessary to do this routinely. The main purpose is to check for any bone damage, primarily to differentiate it from rheumatoid arthritis. Because rheumatoid arthritis generally does not leave joint deformities, while rheumatoid arthritis, if not treated properly, can lead to bone destruction and in severe cases, joint fusion. In addition to imaging, rheumatoid arthritis also requires complete blood count, erythrocyte sedimentation rate, C-reactive protein, anti-streptolysin O, and echocardiography among other tests to comprehensively assess the condition and determine the treatment plan.

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Written by Liu Li Ning
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Can people with rheumatoid arthritis drink red bean and coix seed beverage?

Patients with rheumatoid arthritis can drink red bean and coix seed beverage, which does not significantly affect the condition and is rich in proteins, potentially aiding in recovery. Rheumatoid arthritis is a common rheumatic disease, related to infections by streptococci. With the widespread use of penicillin in recent years, the incidence of rheumatoid arthritis has been decreasing. Currently, it is mainly seen in patients with recurrent streptococcal infections, such as those who frequently suffer from tonsillitis, which increases their likelihood of developing rheumatoid arthritis. Patients with rheumatoid arthritis should maintain a light diet and can appropriately consume more high-quality protein foods, such as lean meat, milk, and eggs, while avoiding or reducing spicy and stimulating foods.