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 Liu Li Ning
Rheumatology
44sec home-news-image

Rheumatoid arthritis hurts more at night or during the day?

The pain of rheumatoid arthritis is irregular. It can hurt at night or during the day, and it varies from person to person. The onset of rheumatoid arthritis is somewhat related to streptococcal infection. Clinically, it mainly presents as migratory swelling and pain in the large joints of the limbs, generally without leaving joint deformities. The onset of rheumatoid arthritis is related to streptococcal infection, so it requires treatment with penicillin antibiotics. During the acute phase, it is also recommended to use non-steroidal anti-inflammatory drugs to alleviate symptoms. Commonly used drugs include sustained-release capsules of diclofenac sodium, meloxicam, or etoricoxib.

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Written by Li Jing
Rheumatology
1min 14sec home-news-image

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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Written by Yang Ya Meng
Rheumatology
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Will rheumatoid arthritis RF be high?

Patients with rheumatic arthritis generally do not have elevated rheumatoid factor levels, but there may also be a slight, minor increase. Typically, high titers of positive rheumatoid factors are not present. If a patient with rheumatic arthritis has a significant increase in rheumatoid factor, that is, more than three times the normal value, we need to reconsider the diagnosis of rheumatic arthritis. At this point, further tests are required to refine the diagnosis, including ASO (anti-streptolysin O), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), anti-CCP antibody, and anti-AK antibody, to better determine whether the condition is rheumatic arthritis or rheumatoid arthritis.

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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.)

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Written by Yang Ya Meng
Rheumatology
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Can people with rheumatoid arthritis drink alcohol?

Patients with rheumatoid arthritis can drink a small amount of alcohol, but long-term heavy drinking is not recommended. This is mainly because patients with rheumatoid arthritis need to take non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief due to joint pain. The most significant side effect of these painkillers is their impact on the gastrointestinal tract. As alcohol is known to be harsh on the stomach, patients who take NSAIDs while drinking alcohol are at a higher risk of developing complications such as gastrointestinal bleeding. Therefore, it is advised that patients with rheumatoid arthritis should not engage in long-term heavy drinking. (Medication should be used under the guidance of a doctor.)