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      Medical Degree Program in China - Rheumatology

       1. Introduction

      Rheumatism is a disease that attracts joints, bones, muscles, blood vessels and the soft tissue or connective, most of them are autoimmune diseases. The incidence is more subtle and slow, long course, and most of them have a genetic predisposition. Diagnosis and treatment have a certain degree of difficulty. Different autoantibodies can be checked out in the blood, which may be associated with different HLA subtypes; for non steroidal anti-inflammatory drugs (NSAID), corticosteroids and immunosuppressive agents have good short-term or long-term remission of reaction.
       
      2. Disease Introduction
       
      All the diseases that cause bone joint, muscle pain can be attributed to rheumatic disease in a broad sense. Up to now, in rheumatology classification, there are more than 100 kinds of diseases, including a variety of reasons caused by the infection, immune, metabolic, endocrine, genetic and degenerative, tumor, local, poisoning and so on. In a narrow sense, rheumatic disease should be limited to dozens of diseases in internal medicine and immune related areas. Some of these diseases are interdisciplinary, such as gout, osteoarthritis, infectious arthritis.
       
      3. Disease Classification
       
      (1). Arthritis - based diseases: such as rheumatoid arthritis (RA), Adams ti's disease for juvenile and adult type, rigidity of ankylosing spondylitis, psoriatic arthritis.
      (2). Associated with infection: such as rheumatic fever, Lyme disease, Wright syndrome, reactive arthritis.
      (3). Diffuse connective tissue disease, systemic lupus erythematosus (SLE) and primary Sjogren syndrome (PSS), systemic sclerosis (SSC), polymyositis (PM), dermatomyositis (DM), mixed connective tissue disease (MCTD), vasculitis.
       
      4. Causes of Disease
       
       (1) Immune response
       (2) Genetic background
       (3) Infection
       (4) Endocrine factors
       (5) The environmental and physical factors
       (6). Others
       
      5. Clinical Manifestations
       
      (1) Most of the rheumatic diseases have joint lesions and symptoms.
      (2) Heterogeneity
      (3) Rheumatism is a disease that is mostly a violation of the system.
      (4) A variety of antibodies and immune complexes (CIC) appeared in the serum.
      (5) The Reynolds phenomenon often occurs in this kind of disease.
       
      6. Disease Diagnosis
       
      Disease history
      Because many rheumatic diseases prevalence should be detailed history collection, except the personal history, including family history; comprehensive examination, special attention should be paid to joint symptoms, skin and mucous membrane lesions, Raynaud's phenomenon, vasculitis lesions. According to the medical history, different diseases can be initially diagnosed.
      Laboratory Examination of Rheumatic Diseases
      (1) Routine examination
      (2) Serological examination
      (3) Joint fluid examination
      Imaging Examination
      (1) X- line flat sheet
      (2) Computed tomography (CT) 
      (3) Magnetic resonance imaging (MRI) 
      (4) Radiography
      (5) Arthroscopy
      (6) Biopsy
      (7) Isotope bone scans
      (8) Ultrasonic examination
       
      7. Disease Treatment
       
      Medication
      (1) Non steroidal anti-inflammatory drugs (NSAIDs)
      (2) Adrenal cortical hormone
      (3) Improving the condition of anti rheumatic drugs (DMARDs), also known as slow acting anti rheumatic drugs
      (4) Others
      Other measures
      Surgical treatment
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