Dougados M
Université René-Descartes Institut de rhumatologie, Hôpital Cochin, Paris.
Rev Prat. 1997 Nov 15;47(18):1998-2004.
The diagnosis of rheumatoid arthritis is mainly based on the clinical findings showing in typical cases a bilateral symmetrical polysynovitis predominantly on the small hand and feet joints, without any other extra-rheumatological feature. Even this clinical presentation is very suggestive of the diagnosis, other diagnoses of diseases life and or function threatening (septic arthritis, viral arthritis, arthritis related to hemopathy, systemic vasculitis ...) have to be systematically evocated. The interest of an early diagnosis of rheumatoid arthritis is to facilitate the treatment and the monitoring of the patients since such treatment seems to be more efficient when initiated at an early stage of the disease.
类风湿关节炎的诊断主要基于临床表现,典型病例表现为双侧对称性多关节炎,主要累及手足小关节,且无任何其他非风湿性特征。即使这种临床表现强烈提示诊断,但仍必须系统地排除其他对生命和/或功能有威胁的疾病诊断(如化脓性关节炎、病毒性关节炎、血液系统疾病相关关节炎、系统性血管炎等)。早期诊断类风湿关节炎的意义在于便于对患者进行治疗和监测,因为在疾病早期开始治疗似乎更有效。