​What are the five classic signs of common rheumatism?

*It is only for medical professionals to read.
Reference pictures and texts summarize the typical signs of common rheumatism patients.
Be cautious
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 It is important to know that rheumatism not only invades the joints, muscles, bones, and blood vessels of the human body, but also invades related soft tissues or connective tissues.
Therefore, clinically, it is broadly believed that all diseases that cause bone, joint and muscle pain can be classified as rheumatism.

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The last issue sorted out the typical signs of the six common rheumatism (what are the classic signs of the six common rheumatism? This article summarizes), the response is overwhelming, today I continue to sort out the signs and characteristics of other typical rheumatism, for your reference and learn! Sjogren’s syndrome (SS) Sjogren’s syndrome (SS) is a chronic inflammatory autoimmune disease that mainly involves the exocrine glands, also known as autoimmune exocrine disease
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The incidence of primary Sjogren’s syndrome (pSS) in the Chinese population is 0.
3% to 0.
7%, and the prevalence in the elderly is 3% to 4%
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The main clinical manifestations are keratoconjunctivitis sicca and xerostomia.
In severe cases, it can also affect important organs and systems such as the kidneys, lungs, and nervous system
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■ Patients with keratoconjunctivitis sicca due to the decrease of mucin secreted by the lacrimal glands often have symptoms such as dry eyes, foreign body sensation, and lack of tears.
In severe cases, there is no tears when crying, and some patients also have repeated purulent infections of the eyelid margins.
, Conjunctivitis, keratitis and other symptoms
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Figure 1: Keratoconjunctivitis sicca (picture from the Internet) ■ Xerostomia Patients with xerostomia manifestations also have the following characteristics: (1) Patients with severe dry mouth are sticky due to the dryness of oral mucosa, teeth and tongue.
It is necessary to drink water frequently when speaking, and it must be accompanied by water or liquid food when eating; (2) Rampant dental caries is also one of the characteristics of this disease
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Nearly half of the patients will have multiple difficult-to-control caries, the teeth will gradually blacken, then small pieces will fall off, and finally only the residual root will remain; (3) adult mumps
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About 50% of patients will have intermittent, alternating parotid gland swelling and pain, which can involve one or both sides
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The symptoms of most patients resolve spontaneously in about 10 days, but persistent swelling may also occur
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A small number of patients also have submandibular gland enlargement, while sublingual gland enlargement is less; (4) The tongue of the patient shows tongue pain, the tongue surface is dry and cracked, and the tongue papilla is atrophied and smooth; (5) Oral mucosa has ulcers Or secondary infection
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Figure 2: Dry mouth (picture from the Internet) Figure 3: Rampant dental caries (picture from the Internet) ■ Other symptoms In addition to the above two local manifestations, the superficial parts of SS patients such as the nose, hard palate, trachea and its branches, digestion The exocrine glands of the tract mucosa and vaginal mucosa may be involved, resulting in less secretion and corresponding symptoms
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It is worth noting that not all patients with dry mouth and eyes have Sjogren’s syndrome.
Patients need to undergo a clinical differential diagnosis.
The degenerative function of the lacrimal glands and salivary glands in the elderly and the influence of environmental factors should also be excluded.
Some attention should also be paid.
The diagnosis of the disease can be made only after adverse reactions of drugs or radiotherapy
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In addition, SS patients with internal organ damage, such as pulmonary interstitial disease, thrombocytopenia, renal tubular acidosis, and other pSS patients, often do not go to the doctor with dry mouth and eyes as the main complaint
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Reactive arthritis (ReA) ReA is an acute non-septic arthritis secondary to infection in other parts of the body.
In addition to joint manifestations, reactive arthritis is often accompanied by one or more joint manifestations
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In recent years, it has been discovered that most microorganisms such as bacteria, viruses, chlamydia, mycoplasma, spirochetes, etc.
can cause reactive arthritis after infecting the human body.
Therefore, the broad scope of reactive arthritis is broad and it is one of the common clinical arthritis
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■ Pre-infection symptoms Before the onset of arthritis, patients may develop low-grade fever, diarrhea, conjunctivitis, and symptoms of urinary system infections such as frequent urination, urgency, and dysuria
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■ Musculoskeletal system symptoms The first symptoms of ReA patients are often acute arthritis, which usually presents acute onset within 1 to 6 weeks after urinary tract or intestinal infection, and presents sausage-like fingers (toes) with periarthritis
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Arthritis generally lasts 1 to 3 months, and individual cases can last for more than half a year
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The affected joints often have heat, swelling, and pain.
The knee joints often have obvious swelling and a large amount of fluid.
The back discomfort often involves the buttocks and thighs, making the symptoms worse when the patient is resting in bed and inactive
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Figure 4: Hand arthritis (picture from the Internet) Figure 5: Sausage-like finger (toe) (picture from the Internet) ■ In addition to symptoms other than joints, in addition to joint-related symptoms, inflammation of the genitourinary tract, skin and mucous membrane symptoms, cardiac aorta Lesions are also common symptoms of ReA patients
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In addition, about 50% of sexually transmitted ReA patients can also see proteinuria, microscopic hematuria or aseptic pyuria, and a small number of patients can see glomerulonephritis and IgA nephropathy
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In addition, severe systemic necrotizing vasculitis, thrombotic superficial phlebitis, purpura, amyloidosis, cranial nerve and peripheral neuropathy are also rare complications in patients with chronic diseases
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RS3PE syndrome RS3PE syndrome, the full name of mild seronegative symmetric synovitis with pitting edema syndrome, is a special type of rheumatic disease with arthritis as the main manifestation
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The disease is more common in elderly men, the ratio of male to female is about 2:1, the age of onset is generally more than 55 years old, with an average of 69 years old, and it can sometimes be seen in young adults [2]
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■ Symptoms of arthritis such patients usually have sudden onset, symptoms include symmetrical peripheral joint pain, swelling and stiffness, which are common in wrist joints, metacarpophalangeal joints of both hands and proximal interphalangeal joints
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In addition, the bilateral elbows, shoulders, knees, ankles and foot joints of some patients may also be affected due to acute inflammation of the joint synovium
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At the same time, the patient's tendon sheath synovitis can also lead to increased local capillary permeability, and subcutaneous edema of the back of the hand and foot, which affects the movement of the hand and foot joints, and may cause carpal tunnel syndrome
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Figure 6: Hand arthritis (picture from the network) ■ systemic symptoms in addition to the joint symptoms, patient discomfort may also be accompanied by systemic manifestations such as fatigue, fever, malaise, muscle pain
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Behcet's disease (BD) Behcet's disease, also known as Behcet's syndrome, is clinically characterized by recurrent oral ulcers, genital ulcers, and ophthalmia.
At the same time, various organs such as digestive system, cardiovascular system, and nervous system can occur.
Involvement is a chronic variant systemic vasculitis
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The patient's condition showed an alternating change of "onset-remission".
Except for a few deaths due to poor control of visceral damage, most patients had a good prognosis
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Figure 7: Recurrent oral ulcers (pictures from the Internet) Figure 8: Ophthalmitis (pictures from the Internet) Vasculitis Vasculitis, as the name implies, is inflammation of blood vessels.
It is a group of autoimmune diseases caused by the disorder of human immune function.
Damage to own blood vessels
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It can be reflected in different diseases according to the size of the main involved blood vessels: 1.
Systemic vasculitis involving large blood vessels: including aortic arteritis and giant cell arteritis; 2.
Systemic vasculitis involving medium-sized blood vessels: including Polyarteritis nodosa, thromboangiitis obliterans, Kawasaki disease; Figure 9: Kawasaki disease 3.
Systemic vasculitis involving small blood vessels: including antineutrophil cytoplasmic antibody (ANCA) related vasculitis, immunity Complex small vasculitis; 4.
Systemic vasculitis involving variable blood vessel size: including BD, Cogen syndrome; 5.
Single organ vasculitis: including skin leukocyte destructive vasculitis, cutaneous arteritis, primary central nervous system Nervous system vasculitis, isolated aortitis; 6.
Vasculitis related to systemic diseases: including lupus erythematosus-related vasculitis, rheumatoid arthritis-related vasculitis and sarcoidosis-related vasculitis; 7.
Related to possible causes Vasculitis: including hepatitis C virus-related cryoglobulinemia vasculitis, hepatitis B virus-related vasculitis, syphilis-related aortitis, serum sickness-related immune complex vasculitis, drug-related immune complex vasculitis, drug-related ANCA-related Vasculitis and tumor-associated vasculitis
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References: [1] Zhao Yan, Jia Ning, Wei Li, Wang Zhiguo, etc.
Clinical verification of the 2002 international classification (diagnostic) criteria for primary Sjogren’s syndrome.
"CNKI; WanFang", 2003 [2] Zhang Yizhi.
Discussion of typical and difficult cases [C]//2011 National Academic Conference on Dermatology and Venereology of Integrated Traditional Chinese and Western Medicine.
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[3] Peng Jinmin, Zhang Zhuoli, Dong Yi.
173 cases of Behcet's disease Analysis of clinical characteristics[J].
Chinese Journal of General Practitioners,2006,005(003):154-157.
[4]Diri E,Buscemi DM,Nugent K M.
Churg-Strauss Syndrome:Diagnostic Difficulties and Pathogenesis[J].
American Journal of the Medical Sciences, 2003, 325(2):101.