Is the C-reactive protein high in rheumatoid arthritis?

Written by Liu Li Ning
Rheumatology
Updated on May 20, 2025
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Rheumatoid arthritis, during the acute flare-up phase, can show an increase in C-reactive protein (CRP). After the condition has eased, there can be a significant decrease in CRP, which can initially be used to judge the recovery of the condition.

The onset of rheumatoid arthritis is somewhat associated with infection by Group A beta-hemolytic streptococci. Clinically, it primarily presents as migratory pain in the large joints of the limbs and generally does not cause joint deformities; this is an important marker for differentiating it from rheumatoid arthritis.

In the acute phase of rheumatoid arthritis, treatment is mainly symptomatic, predominantly using nonsteroidal anti-inflammatory drugs (NSAIDs) such as etoricoxib or diclofenac sodium sustained-release capsules to alleviate symptoms.

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Written by Wang Cheng Lin
Orthopedics
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Is the ankle pain due to gout or rheumatoid arthritis?

In clinical practice, the first reason for ankle pain is rheumatic or rheumatoid arthritis, which mainly involves the synovium of the joint in the early stages, causing synovial hyperplasia and effusion leading to pain. The second cause is gout, which is due to dietary habits, such as frequent consumption of greasy or seafood-based foods, and a preference for beer, leading to increased uric acid levels and gout. The third cause is osteoarthritis in middle-aged and elderly people, which leads to degeneration of joint cartilage and pain. The fourth cause is sprains, which can lead to damage to cartilage and ligaments within the joint, causing pain. To determine whether ankle pain is caused by gout or rheumatic arthritis, one can simply visit a hospital for a checkup, such as a uric acid test to see if there is a significant increase in gout uric acid levels. If the uric acid level is significantly elevated, it is likely caused by gout. Additionally, one can check for a rheumatism panel to see if the anti-O test is positive; if it is, it may suggest that rheumatic factors are causing the pain.

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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 Lv Yao
Orthopedics
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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 Yang Ya Meng
Rheumatology
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Rheumatoid Arthritis Diagnostic Criteria

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

The treatment methods for rheumatoid arthritis mainly fall into three categories: The first category is anti-inflammatory analgesics, which include non-steroidal analgesic drugs such as slow-release diclofenac sodium. For patients with especially high inflammatory indicators, low-dose corticosteroids may also be considered. The second category of drugs includes slow-acting drugs commonly used in the treatment of rheumatoid arthritis, such as methotrexate and leflunomide, which are immunosuppressants. If the patient does not respond well to non-steroidal analgesic drugs or immunosuppressants, biological agents can be considered as a treatment option. Common biological agents include tumor necrosis factor antagonists. (Specific medications should be taken under the guidance of a physician.)