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“慢性风湿性关节炎诊断名称的商榷”一文中所提到的问题,我在工作中也有同感。以我院门诊为例,有很大一部分是因为腰腿疼而就诊,各原单位军医多诊断为风湿性关节炎。但经询问病史,大多因住地或工作环境寒冷潮湿所致;病期数月到数年不定;疼痛主为两膝关节及腰部,病情变化与天气冷热有明显关系;经多种治疗很长时期无效,或仅能使疼痛一时减轻;除关节痛外一般无其他自觉及他觉症状,各种化验及特殊检查(如照片等)均阴性。很明显根据上述症状诊断为风湿性关节炎或病灶性风湿样关节炎都不恰当。但在我所了解的医疗单位,这样的诊断还是较为普遍。因此有必要对风湿性关节炎的诊断提出商榷。
“Consultation on the diagnosis of chronic rheumatoid arthritis ” The article mentioned in the question, I feel the same at work. In our hospital clinic, for example, a large part because of waist and leg pain and treatment, the original unit more than the military diagnosis of rheumatoid arthritis. However, when asked about the medical history, most of them were caused by the cold and dampness of their living or working environment. The duration of the disease was variable from several months to several years. The main pain was the two knees and the waist. The change of the disease was obviously related to the hot and cold weather. Period ineffective, or only temporarily relieve pain; except for joint pain and other symptoms generally do not consciously and he felt a variety of laboratory tests and special tests (such as photos, etc.) were negative. Obviously, the diagnosis of rheumatoid arthritis or focal rheumatoid arthritis based on the above symptoms is not appropriate. But in my understanding of the medical unit, such a diagnosis is still more common. Therefore, it is necessary to discuss the diagnosis of rheumatoid arthritis.