Primary symptoms of migratory rheumatism

It is currently difficult to find a treatment method that can cure rheumatic disease in a short period of time. Many patients have gone through a long period of treatment without any relief, which greatly affects their daily lives. Especially when an attack occurs, patients will feel pain in their joints and other symptoms will occur, making it impossible for them to work and study normally.

Clinical manifestations

1. Most rheumatic diseases have joint lesions and symptoms, which can be as high as 70-80%. About 50% only have pain, while severe cases have comprehensive inflammatory manifestations such as redness, swelling, heat, pain and impaired function; most of the time, multiple joints are affected. The size of the joints affected varies depending on the type of disease.

2. Heterogeneity, that is, the same disease has different subtypes. Due to different genetic backgrounds, causes and mechanisms, the types, symptoms, severity and treatment responses of clinical manifestations are also different.

3. Rheumatic diseases are mostly multi-system diseases. The pathologies of many diseases overlap and the symptoms are similar. MCTD is a typical example of this.

4. Various antibodies and immune complexes (CIC) appear in the serum and can be deposited in tissues (skin, synovium) or organs (kidney, liver) to cause disease.

5. Raynaud's phenomenon often occurs in this type of disease, such as SLE and MCTD. [1]

Disease diagnosis

Medical history

Because rheumatic diseases are diverse, a detailed medical history should be collected, including family history in addition to personal history; a comprehensive physical examination should be performed, with special attention to joint symptoms, skin and mucous membrane lesions, Raynaud's phenomenon, and vasculitis lesions. Different diseases can be preliminarily diagnosed based on the medical history.

Laboratory tests

(1) Routine examination: Rheumatism is a disease that affects multiple systems and organs throughout the body, so the patient should undergo a comprehensive examination, including blood, urine, stool, erythrocyte sedimentation rate, CRP, and comprehensive biochemical examination (liver function, kidney function, muscle enzyme spectrum, etc.).

(2) Serological examination: ① General: RF, C3, C4, CH50, CIC, IgG, IgA, IgM, IgE. ②Specificity: a. The antinuclear antibody spectrum is of great significance for the diagnosis and differential diagnosis of rheumatic diseases. Generally, ANA is done first. If the titer is > 1:40, other items should be further checked. b. HLA: Although HLA is closely related to rheumatic diseases, we still don’t know much about it. Commonly used and more specific ones such as HLA B-27 have a positivity rate of up to 81.8% for AS and 40% for Reiter’s syndrome, but only 10% for psoriasis. The positivity rate of DR4/DR1 for RA is 49-79%, and for JRA is 7%, but the Dw4 of JRA is 26%, and the Dw14 is 47%. The positivity rate of DR3 in SLE is only 2.7%, and in pSS is 5.6%. Only 3.3% of Behcet's disease are HLA B5 positive. c. Others: such as anti-keratin antibodies (AKA), anti-histone antibodies (Anti-histone antibody), anti-phospholipid antibodies, anti-perinuclear factor (ANCA), etc., which have diagnostic reference value for some diseases.

(3) Joint fluid examination: Fresh joint fluid is very important and should be subjected to routine culture, serological and immunological examinations.