(1) Typical rheumatoid arthritis, also known as typical rheumatoid arthritis or polyarthritis. Its clinical manifestations are:
① morning stiffness; ② joint swelling, pain and recurrent attacks; ② Multiple joints are involved, and single arthritis is rare; ④ Symmetrical joints were involved, and symptoms between different joints shifted, with an interval of more than 65438 0 months; ⑤ Joint inflammation restricts each other; ⑥ The course of disease can last for months or even decades; ⑦ Periarticular tissue lesions and complications.
(2) atypical rheumatoid arthritis, also known as atypical rheumatoid arthritis. Can be divided into the following categories:
① Rheumatoid fever: clinically, it can be divided into rheumatoid arthritis with long-term high fever and rheumatoid arthritis with long-term low fever. Rheumatoid fever, mainly high fever, is caused by cold, trauma and other factors, which is irregular and intermittent. When fever occurs, the body temperature is mostly above 38℃-40℃, and some are as high as 42℃. The temperature difference may fluctuate greatly in a day, and fever is accompanied by chills, rashes, joint pain and other symptoms. Fever usually lasts for 2-8 hours, and suddenly drops, accompanied by sweating, fatigue, loss of appetite, emaciation, anemia and other symptoms. Rheumatoid symptoms of low fever are extremely atypical and are often misdiagnosed as tuberculosis or latent rheumatism. The patient's body temperature is mostly between 37.3℃ and 38℃, and rarely exceeds 38℃. There are many systemic symptoms, such as obvious fatigue, fatigue, burnout, sweating, morning stiffness, joint swelling, pain and so on.
② Monoarthritis: The disease usually starts from a single joint of hip, knee and ankle, and the lesion is always confined to 1 joint, and then recurs, with remission and aggravation alternating slowly. Often accompanied by other joint pain, but not swelling, the course can last 1 year to several years.
③ Less arthritis: This kind of arthritis is mostly fixed on 2-3 joints, and it occurs in wrist, ankle, knee, metatarsal and medullary joints. Joint symptoms are mild, development is slow, and there is a long remission period.
④ Recurrent rheumatism: also known as paroxysmal rheumatism. It is characterized by periodic attacks, which last for hours, days or even 2-3 weeks, and subside spontaneously, with severe joint pain, which is mostly induced by fatigue, drinking and insomnia.
⑤ Arthritis sicca: The main clinical manifestations are joint stiffness and contracture. Joint swelling is not obvious, severe or painless, but joint destruction and proliferation develop rapidly, and joint damage and deformation can occur within several months to 1-2 years, and develop into disability.
⑥ Visceral type: It mostly occurs in children and adolescents. Its characteristic is that when visceral symptoms are prominent, the inflammatory manifestations of joint pain are generally moderate, sometimes mild, or relegated to a secondary position. It can be manifested as heart damage, rheumatoid vasculitis, lung and kidney damage, joint lymphadenopathy, joint hepatosplenic syndrome, neuropsychiatric and endocrine system damage, eye, digestive system and blood system damage.
(3) Rheumatoid arthritis in children. Its clinical manifestations are as follows:
① Long-term high fever is the main manifestation; ② Rheumatoid arthritis; ③ Monoarthritis; 4 small arthritis. See above for their respective characteristics.
(4) Overlapping rheumatoid arthritis. Its clinical manifestations are as follows:
① Rheumatoid overlapping rheumatism: severe systemic symptoms, accompanied by obvious heart damage and heart failure; ② Rheumatoid overlapping systemic lupus erythematosus; ③ Rheumatoid overlapping Reiter syndrome. The above information is provided by the Department of Rheumatology and Immunology, General Hospital of Beijing Military Region for reference only.