The pathogenesis of rheumatoid arthritis

Written by Yang Ya Meng
Rheumatology
Updated on July 03, 2025
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Rheumatic arthritis, also known as rheumatic fever, primarily develops due to infection by Group A beta-hemolytic streptococci in the throat area, which triggers recurrent episodes of systemic connective tissue inflammation. It mainly affects the joints, heart, skin, and subcutaneous tissues, and occasionally the central nervous system can be involved, as well as significant internal organs such as the lungs and kidneys. Clinically, it often presents primarily with arthritis and carditis, and may be accompanied by fever, rash, subcutaneous nodules, and chorea. This disease has a certain degree of self-limitation, and acute episodes often predominantly feature joint pain.

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Written by Yang Ya Meng
Rheumatology
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What should be avoided with rheumatoid arthritis?

Patients with rheumatoid arthritis should avoid the following three categories of food: The first category includes foods that can easily trigger photosensitivity, such as celery, coriander, shiitake mushrooms, seaweed, and leeks; these should be avoided. The second category includes overly warming and tonifying foods, such as dog meat, lamb, and longan; it is best to consume these sparingly. The third category includes high-protein seafood, such as shrimp and crab; these should be consumed in limited quantities because they may exacerbate rheumatoid arthritis symptoms and potentially trigger allergic reactions.

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Written by Liu Li Ning
Rheumatology
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Can rheumatoid arthritis be cured through exercise?

Rheumatoid arthritis can be somewhat alleviated by exercise in terms of disease recovery. Rheumatoid arthritis primarily manifests as migratory swelling and pain in the major joints throughout the body. The onset of the disease is somewhat associated with streptococcal infections. In recent years, due to the widespread use of penicillin, rheumatoid arthritis has become very rare in clinical settings. Since the onset of rheumatoid arthritis is related to infections, long-acting penicillin is generally used for treatment if there is no accompanying carditis. Joint pain can be treated with non-steroidal anti-inflammatory drugs such as etoricoxib or sustained-release capsules of diclofenac sodium; if carditis is present, corticosteroids can be used. Patients with rheumatoid arthritis can engage in gentle aerobic exercises like swimming, yoga, jogging, Tai Chi, etc.

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Written by Liu Li Ning
Rheumatology
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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 Yang Ya Meng
Rheumatology
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Rheumatoid arthritis affected areas

Clinically, rheumatoid arthritis is referred to as rheumatic fever. It primarily affects the large peripheral joints, such as the shoulder, elbow, knee, and ankle joints, with these being the main areas of affliction. The pain often migrates and has a certain self-limiting nature, generally improving on its own in about two weeks. Additionally, rheumatoid arthritis can also affect the heart, with some patients experiencing palpitations and shortness of breath after activity, as well as discomfort in the precordial area. Rheumatoid arthritis may also present with symptoms like ring-shaped erythema on the skin. These are the common sites of affliction for rheumatoid arthritis.

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Written by Liu Li Ning
Rheumatology
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Rheumatoid arthritis is caused by what?

Rheumatic arthritis is a type of infectious arthritis caused by streptococcal infection and is one of the clinical manifestations of rheumatism. It primarily presents as migratory pain in large joints, most commonly affecting the large joints of the lower limbs, such as the knees, ankles, wrists, etc. Since rheumatic arthritis is related to streptococcal infection, treatment mainly involves the use of penicillin drugs, commonly long-acting penicillin, which requires strict adherence to the treatment course to completely cure the streptococcal infection. During the acute phase, joint pain often occurs, hence the common use of non-steroidal anti-inflammatory drugs, such as diclofenac sodium and etoricoxib, to alleviate symptoms of pain. During acute episodes, bed rest is necessary, with attention to joint immobilization. During the remission period, getting out of bed and exercising is encouraged to restore joint function and flexibility. (Please use medications under the guidance of a professional physician; do not self-medicate.)