How Do I Tell the Difference Between Lupus and Arthritis?

Systemic lupus erythematosus arthritis is a manifestation of systemic lupus erythematosus (SLE) disease, and systemic lupus erythematosus is an autoimmune disease with clinical manifestations of multiple systemic damage. Main manifestations are fever, rash, hair loss, joint pain or arthritis, nephritis, serositis, hemolytic anemia, leukopenia, thrombocytopenia, and central nervous system damage. Those with visceral (kidney, central nervous) damage have a poor prognosis. More common in women of childbearing age between 20 and 40 years old. In recent years, the incidence of systemic lupus erythematosus has increased in China. Early diagnosis and comprehensive treatment can significantly improve its prognosis.

Basic Information

Visiting department

Division of Rheumatology

Multiple groups

20 to 40 year old women of childbearing age

Common symptoms

Fever, rash, hair loss, joint pain or arthritis, nephritis, etc.

Contagious

no

Causes of systemic lupus erythematosus arthritis

The etiology of this disease is not clear, and it may be related to genetic, environmental (sunlight or ultraviolet rays, drugs, microbial pathogens, etc.), immunity, estrogen and other factors to cause immune disorders.

Clinical manifestations of systemic lupus erythematosus arthritis

Mild joint pain with morning stiffness is the most common initial manifestation of systemic lupus erythematosus, and most patients eventually develop arthritis with obvious symptoms and joint effusions in some cases. The most commonly affected joints are the proximal interphalangeal, wrist, and knee joints. The joint involvement of systemic lupus erythematosus is mostly symmetrical and insidious, and gradually worsens. Half of the joints are accompanied by morning stiffness, which can show mobility and dysfunction.

Systemic lupus erythematosus arthritis examination

In patients with systemic lupus erythematosus and arthritis, articular cartilage or bone damage is rare, except for swelling of soft tissues and signs of diffuse osteoporosis around the joints. A few patients can develop invasive joint disease similar to rheumatoid arthritis. When combined with joint effusion, the amount of effusion is usually small, its appearance is clear, protein content and cell count are low, generally white blood cell count is less than 3 × 10 ⁹ / L, mainly lymphocytes, total complement level in effusion Reduced, unlike rheumatoid arthritis.

Diagnosis of systemic lupus erythematosus arthritis

Diagnosis can be made based on the cause, clinical manifestations, and laboratory tests.

The disease can also be diagnosed by antinuclear antibody tests: most of the anti-nuclear antibodies in the active phase of SLE are positive. If the antinuclear antibodies are negative, the possibility of the disease is ruled out. Antinuclear antibody tests are sensitive and can replace lupus cell tests to diagnose the presence of SLE. X-ray examination of the joints was mostly boneless.

Differential diagnosis of systemic lupus erythematosus arthritis

Systemic lupus erythematosus arthritis needs to be distinguished from rheumatoid arthritis. Early polyarthritis and polyarthritis of systemic lupus erythematosus are easily misdiagnosed as rheumatoid arthritis. The latter joint disease was persistent and severe, with long morning stiffness, more common deformities, rare systemic damage, and X-rays showing invasive arthritis.

Complications of systemic lupus erythematosus arthritis

Necrosis of the femoral head, talus head, and humerus skull occurs in this disease, and the incidence of osteonecrosis increases in patients receiving steroid treatment.

Systemic lupus erythematosus arthritis treatment

The treatment of systemic lupus erythematosus arthritis should emphasize the principle of individualization, and strive to achieve the best therapeutic effect with minimal side effects.

General treatment

Get psychotherapy and stay optimistic. Bed rest during the acute phase, appropriate work and activities after stable conditions; early detection and prevention of infection; avoid the use of lupus-inducing drugs (such as contraceptives); avoid sun exposure and ultraviolet radiation; pay attention to pregnancy can induce systemic lupus erythematosus activity.

2. Non-steroidal anti-inflammatory drugs

These drugs have anti-inflammatory, analgesic and antipyretic effects. Adverse reactions were gastrointestinal discomfort, rash, elevated transaminase, or kidney damage. Should be observed for adverse reactions, should not be too long. Lupus nephropathy should be used with caution in order to avoid aggravating kidney damage.

3. Antimalarials

Including chloroquine and hydroxychloroquine. With anti-inflammatory, immunosuppressive, anti-photoallergic and stabilizing nuclear proteins. Such drugs are excreted slowly and are prone to deposit on the cornea and retina, causing disease, so regular eye examinations are required during treatment.

4. Glucocorticoids

With anti-inflammatory, anti-proliferative and immunosuppressive effects. Can be used for patients with systemic lupus erythematosus joint disease who should not choose non-steroidal anti-inflammatory drugs.

5. Drugs that change the condition

It has the effect of delaying, preventing or repairing joint diseases, but has no immediate anti-inflammatory and analgesic effects.