Saying:
Recently, many people have inexplicable joint pain, what is the problem? Is it gout, or rheumatoid arthritis?
Chunyujun invited Dr. Zhang Guangfeng, deputy chief physician of the Department of Rheumatology and Immunology of Guangdong Provincial People's Hospital, to share with you how to distinguish gout from rheumatoid arthritis:
Not only for ordinary patients, these two diseases are easy to "stupidly and indistinguishable"; In clinical work, arthritis presents similarly, but the etiology is indeed very complex. Only with the right diagnosis can you get a good treatment.
Gouty arthritis
The main cause of gouty arthritis is elevated uric acid, often before the onset of the disease there are clear triggers such as drinking, eating, strenuous exercise or cold, more common in men, generally premenopausal women are rarely attacked gout.
And it is characterized by a single joint acute attack of redness, swelling, heat and pain, the most common site of attack is the big toe, night attacks are more common, generally within 24 hours of the pain peak, severe and unbearable. Laboratory tests have significantly elevated uric acid, and ultrasound or dual-energy CT can detect urate crystals deposited in the joints. If the above characteristics are met, the diagnosis of gouty arthritis is considered first.
Rheumatoid arthritis
Rheumatoid arthritis is more common in middle-aged and elderly women, and joint swelling and pain are often characterized by symmetrical, small joints, and multiple joints involving at the same time, accompanied by morning stiffness (inflexible joint movement in the morning).
In particular, the proximal interphalangeal joint (middle segment), metacarpophalangeal joint (the joint between the palm and fingers), and wrist joints of the fingers are the most common, and multiple joints of the whole body, such as elbows, shoulders, knees, and ankles, can be affected.
Laboratory tests are mainly elevated rheumatoid factor, early rheumatoid indicators (especially anti-cyclic citrullinated antibodies), B-ultrasound or MRI can show synovitis, and bone erosion and bone destruction can occur in the middle and late stages, resulting in joint deformity. If the above women are met, symmetry, polyarticular involvement, elevated rheumatoid factor, positive early rheumatoid markers, and synovitis on imaging, rheumatoid arthritis is considered first.
There are hundreds of diseases in rheumatism, most of which can lead to arthritis, and careful differential diagnosis is very important.
Author: Zhang Guangfeng, Deputy Chief Physician, Department of Rheumatology and Immunology, Guangdong Provincial People's Hospital
Editor: Chunyujun
Source: Figureworm Creative