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Misdiagnosis with life hanging by a thread
Li Na, a 28-year-old young white-collar worker who has just entered the workforce, has recently suffered from joint pain. At first, she only experienced occasional pain in her wrists, but gradually, the pain spread to her fingers, elbows, and knees...... Li Na was in so much pain that she couldn't sleep all night, and her work was seriously affected.
Seeing their daughter in such pain, Li Na's parents rushed to take her to the doctor. The doctor asked about the medical history, gave Li Na an examination, and quickly made a diagnosis: "It seems to be rheumatism, take some anti-inflammatory painkillers, pay attention to keeping warm, and observe for a while."
Li Na breathed a sigh of relief after hearing this, thinking that rheumatism should not be a serious illness, and she should be fine if she took medicine. After taking the medicine for a week, not only did the pain not be relieved, but symptoms such as low-grade fever and fatigue appeared. Li Na felt that something was wrong and decided to go to a major hospital to find a rheumatology and immunology specialist for follow-up.
Professor Wang, chief physician of the Department of Rheumatology and Immunology, carefully inquired about Li Na's symptoms and examined her joints in detail.
When he heard that Li Na's pain was caused by morning stiffness and lasted for more than 1 hour, Professor Wang frowned, and he suspected that Li Na was not suffering from ordinary rheumatism, but rheumatoid arthritis!
In order to further clarify the diagnosis, Professor Wang prescribed a series of tests for Li Na: blood routine, rheumatoid factor, anti-cyclic citrulline antibody, and joint color ultrasound......
A few days later, the results of the examination came back, which confirmed Professor Wang's judgment: Li Na's rheumatoid factor and anti-cyclic citrulline antibodies were both strongly positive, and the joint ultrasound showed synovitis in multiple joints, which are characteristic manifestations of rheumatoid arthritis.
Seeing the test results, Li Na felt confused: aren't rheumatoid arthritis and rheumatism both "rheumatism", why is there such a big difference?
"Although both rheumatoid and rheumatoid have manifestations of joint pain, they are completely different diseases. Rheumatism is caused by the invasion of wind, cold and dampness, mostly induced by cold, rain, etc., with joint pain as the main manifestation, and the prognosis is generally good through cold and dampness treatment;
Rheumatoid arthritis is a chronic, progressive autoimmune disease with an unclear etiology, in addition to symmetrical polyarticular inflammation, it can also affect the heart, lungs and other systemic organs, and if not intervened in time, it can lead to joint deformity, disability, and even life-threatening. Therefore, clinically, we must distinguish between the two clearly, otherwise the condition will be delayed!"
After listening to Professor Wang's explanation, Li Na suddenly realized that she had almost missed her illness before. Professor Wang comforted her and said: "Fortunately, it was detected in time, and your condition is still in the early stage, as long as you actively cooperate with the treatment, there is still a good hope that you will control your condition and avoid disability."
I will now formulate a standardized treatment plan for you, mainly including oral immunosuppressants such as methotrexate and leflunomide, and glucocorticoids if necessary, in addition to regular follow-up and monitoring of adverse drug reactions. You have to build up your faith and try to achieve relief in the shortest possible time!"
Under Professor Wang's meticulous treatment, Li Na's condition gradually improved, her pain was significantly relieved, and various inflammatory indicators tended to be normal.
A few months later, Li Na had returned to a near-normal life. She sincerely thanked Professor Wang, and felt that the difference between rheumatoid arthritis and rheumatism is really not ordinary, and the consequences of misdiagnosis are really unimaginable!
Li Na's story has attracted a lot of attention from the medical community. It is reported that the symptoms and signs of rheumatoid arthritis are complex and diverse, and the early manifestations can be similar to rheumatoid arthritis, which can easily lead to misdiagnosis and missed diagnosis.
Studies have shown that patients with rheumatoid arthritis have an average delay of up to 1 year, and those who delay diagnosis for more than half a year have a significantly higher incidence of joint deformity and dysfunction.
It can be seen that when symmetrical polyarticular inflammation occurs in young patients, it is necessary to be alert to the possibility of rheumatoid arthritis, and improve serology and imaging examinations as soon as possible to avoid delaying the pathogenesis and causing big mistakes.
In addition, the diagnosis and treatment of rheumatoid arthritis should also follow the principle of individualization and standardization. The formulation of treatment plan needs to consider factors such as the patient's age, course of disease, disease activity, etc., as well as weigh the efficacy and adverse reactions, regularly evaluate the efficacy, and adjust the drug in a timely manner.
The emergence of new treatments, such as biologics, has brought new hope for disease control. At the same time, self-management should not be neglected, such as exercising, protecting joints, and learning pain management, which are all important aspects of disease control.
Li Na's misfortune is a warning to all doctors and patients: rheumatoid arthritis is not as simple as "rheumatism"! We need to raise awareness of rheumatoid, strengthen the differentiation from rheumatism, and use accurate diagnosis and standardized treatment to stop the disease from worsening and spreading.
We must learn to live in harmony with the disease, use a positive and optimistic attitude, scientific and effective management, and create a colorful sky of "rheumatoid" life in the haze of pain and disability!
As a doctor, I sincerely hope that all medical workers can follow Dr. Li Na's professionalism and wisdom as an example, always maintain the spirit of vigilance and exploration in the diagnosis and treatment of diseases, and bring good news to patients with individualized and precise medical treatment.
At the same time, the majority of patients and friends should also be vigilant, learn self-management, and use good doctor-patient interaction to build a great wall of steel for disease prevention and treatment! Let us work together to use wisdom and courage to compose more hymns to life on the road to fight rheumatoid!
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(The story in the article is purely fictional, if there is any similarity is purely coincidental, if the body is not well, seek medical help in time)