What items can be checked out in rheumatoid examination

Rheumatoid arthritis is a common autoimmune disease in clinical practice. In addition to being diagnosed through some symptoms, it also requires examination and detection. Many people do not know what tests should be performed for rheumatoid disease. In clinical practice, there are many tests for rheumatoid disease.

1. Autoantibodies

The autoantibodies used clinically in the field of rheumatic diseases are divided into the following four categories: antinuclear antibodies, rheumatoid factor, antineutrophil cytoplasmic antibodies, and antiphospholipid antibodies. It has many uses in the diagnosis of diffuse connective tissue diseases.

1. Antinuclear antibody spectrum.

2. Rheumatoid factor: In addition to appearing in rheumatoid arthritis, it is also seen in other connective tissue diseases, such as systemic lupus erythematosus, Sjögren's syndrome, mixed connective tissue disease, systemic sclerosis, etc.

3. Anti-neutrophil cytoplasmic antibodies (ANCA) use normal human neutrophils as substrates and are divided into C-ANCA (cytoplasmic type) and P-ANCA (perinuclear type) according to the pattern of fluorescence observed. Their other respective antigens are serine proteases and bone oxidases in the cytoplasm. This antibody is extremely helpful for the diagnosis of vasculitis, and different ANCA antigens indicate different vasculitis. For example, C-ANCA mainly appears in Wegener's granulomatosis and Churg-Strauss syndrome, while P-ANCA is seen in microscopic polyarteritis nodosa, crescentic nephritis, rheumatoid arthritis, systemic lupus erythematosus, etc.

4. Antiphospholipid antibodies: There are two determination methods used clinically: antiphospholipid antibodies and lupus anticoagulant. This antibody appears in various autoimmune diseases such as systemic lupus erythematosus. Antiphospholipid syndrome refers to clinical manifestations of arterial or venous thrombosis, thrombocytopenia, habitual miscarriage accompanied by antiphospholipid antibodies and/or lupus anticoagulants. In addition to being secondary to systemic lupus erythematosus, it can also be primary.

2. Synovial fluid examination

It reflects the inflammation of the synovium of the joint to a certain extent. In particular, finding urate crystals in synovial fluid or positive synovial bacterial culture can help to confirm the diagnosis of gout or suppurative arthritis, respectively.

3. Joint imaging examination

X-ray examinations are helpful in the diagnosis and differential diagnosis of joint lesions, and can also be used to follow up and understand the evolution of joint lesions. It is currently the most commonly used imaging diagnostic method, and others include joint CT, MRI, and isoflurane examinations.

Pathology

Pathological changes seen in biopsy, such as lupus bands for systemic lupus erythematosus, rheumatoid nodules for rheumatoid arthritis, cheilitis for Sjögren's syndrome, and synovial lesions for arthritis caused by different causes, are all of great significance.