让我们来谈谈类风湿关节炎

Whether you’ve just been diagnosed or worry you could have rheumatoid arthritis, you’re probably nervous, confused, and maybe even a little scared. That’s normal, and everyone featured on HealthCentral with a chronic illness felt just like you do now. But we—and they—are here for you. On this page alone, you’ll discover the realities and challenges of the condition, but also the best treatments, helpful lifestyle changes, where to find your rheumatoid arthritis (RA) community, and all the crucial information to help you not merely manage—but thrive. We’re sure you’ve got a lot of questions...and we’re here to answer them.

What Is Rheumatoid Arthritis, Anyway?

The term "arthritis" feels familiar because: Who hasn't seen the stock image ofelderly-person-gripping-knee? But in fact, the word is often used incorrectly. First, "arthritis" is a catchall term; there isn’t just one variety. Rheumatoid arthritis (RA) is the second most-common type, affecting approximately 1.3 million people in the United States, 70% of whom are women, according to the Arthritis Foundation. Second, RA doesn’t affect only the retirement set, nor does it hit just knees and hands. RA is an autoimmune disorder that causes systemic inflammation, which primarily infiltrates the joints but also has effects beyond them. While it can occur at any time, RA typically develops between ages 40 and 60. That being said, RA can also affect children via a condition called juvenile idiopathic arthritis.

To really understand RA, it helps to have an image in your mind of how joints work. So, picture this: Joints contain several structures that allow you to move easily.

• When healthy, the ends of the bones in a joint are protected from rubbing together by an elastic slippery material calledcartilage(yep, the same stuff your ear is made of).
• 整个关节由胶囊包围，被称为synovial sac。
• 组织的薄层称为synovial membrane线的囊。
• 膜分泌润滑synovial fluid, which reduces friction, protecting the cartilage and joints during movement.

但这里的时候RA撞击会发生什么：免疫系统本质上擦枪走火，并设置在滑膜的景点，攻击，如果是外来入侵者。

In the early stages, the synovial membrane becomes inflamed and thickened, causing pain and limiting joint movement. Some people report feeling a warm or even burning sensation around the affected joints as well as a stiffness that makes movement slow. Over time, untreated inflammation can damage cartilage and bones. The space between bones can become smaller, causing joints to become unstable, misaligned, more painful, and sometimes even immobile.

Eventually, inflammatory tissue begins to build up, sometimes causing nodules to form around the area, most commonly along the back of the forearms, elbows, joints, and pressure points such as sacrum, occiput, and heel. These nodules will fluctuate with disease activity. However, if you imagine someone with arthritis in their hands, the very firm nodules at the furthest finger joints are actually those seen in Osteoarthritis and not rheumatoid arthritis. And while RA is known for causing joint pain and inflammation, it can spark other symptoms throughout your body, including dry eyes, chest pain, and osteoporosis.

值得注意的是：在你感到任何关节疼痛，它的共同经验一般情况下，非特异性症状RA;不幸的是，他们似乎去的那种一切–fever, fatigue, loss of appetite—so linking them with RA doesn’t often happen. And that tightness you feel in your joints may only be an issue in the morning (making it seem like not such a big deal). With rest, any synovial fluid you have is soaked up by the cartilage, much like a sponge absorbs water. As you move, the cartilage is "squeezed," and the fluid bathes the joint. First thing in the a.m., there’s just not going to be a lot of extra fluid to keep things loose. But the more you move, the more fluid is released.

What Causes Rheumatoid Arthritis in the First Place?

科学家们认为，这种沉淀RA过度活跃的免疫反应是由遗传和环境因素之间复杂的相互作用引起的。称作Ital上复杂一部分，因为即使是在医学上顶尖高手都想通了类风湿性关节炎的确切原因。当他们继续在神秘的蚕食，一些具体的相关性已经确定或正在研究：

• 遗传学：Certain genes increase the开发风湿性关节炎的风险。For example, the genetic marker HLA-DR4 has been found in 60% to 70% percent of people of European ancestry with RA. But, what’s a “genetic marker”? It’s any variation in your DNA that may indicate an increased risk of developing a specific condition. However, simply having the gene does not mean that you have RA or that you will develop it. Because there are so many other factors that impact the development of rheumatoid arthritis and because the gene alone cannot confirm diagnosis or predict it in the future, docs do not perform genetic testing when diagnosing RA.

• 作为一个女人：由于妇女得这种病的三倍比男性更经常，一些专家认为荷尔蒙因素可能在导致类风湿性关节炎的作用。已经表明雌激素可以加快转速的B细胞（那些是白血细胞攻击的滑膜），从而加剧自体免疫疾病等RA。

• Viruses and infections:虽然我们知道，RA是由于免疫系统攻击人体的健康组织，医疗陪审团还在外面对cause for that response。Some researchers believe that healthy cells may get mixed up in the action when the body senses danger from a virus or infection; when the immune system kicks into gear and attacks the germs (aka an immune response), the body’s own tissue may get assaulted, too. That's when autoimmune diseases like RA pop up, and healthy joints fall under siege.

Do I Have the Symptoms of Rheumatoid Arthritis?

There’s a reason you’re often shown an illustration of a disembodied hand when discussing RA with your doctor! Rheumatoid arthritis most often hits the small joints of the hands and wrists first, where you may feel warmth, swelling, or tenderness. The joint pain of RA has been described in all sorts of ways—deep, dull, aching, throbbing, warm, hot, tender. However, most agree that the pain is typically worse in the early mornings. It can take at least 30 to 45 minutes for joints to loosen and feel better, and it generally worsens again after periods of inactivity.

That said, the signs of rheumatoid arthritis can also extend to your elbows, shoulders, knees, hips, ankles, feet, and neck. RA symptoms also tend to occur symmetrically; that is, joints on both sides of the body are usually affected at the same time. In some cases, other organ systems—including the eyes, heart, and lungs—may become inflamed too, leading to blurred vision, fluid build-up around the heart or lungs, along with chest pain and shortness of breath. (Right now, though, take a long, deep breath: RA is a serious illness, but complications can be controlled and even prevented. More on that below.)

很多人都体会到年（这是不可预测的那样）在天漫长的发作症状，这可能缓解句号隔开，当你的RA症状消退。事实上，随着女性RA谁是怀孕通常体验过怀孕的所有RA相关的症状完全沉寂，因为激素和免疫系统调节身体状态。这些症状通常会返回全部力量产后，因为身体恢复正常的荷尔蒙平衡和免疫系统的功能。

Early symptoms of RA may include:

• Fatigue and weakness
• Low-grade fever
• 身体不好的感觉一般
• 食欲和体重下降
• 接缝严密，通常在身体两侧，这可能是温暖的触感

With long-term, untreated rheumatoid arthritis, these additional symptoms may occur:

• Stiffness (especially after waking up)
• 但painless-skin肿块、类风湿nodules, on the hands, elbows, knees, or toes that can range in size from a pea to a mandarin orange
• Bent and misshapen joints
• Dry mouth
• Red, itchy eyes
• 胸痛和呼吸困难（在先进的情况下，炎症会影响心脏和肺）

When to Call Your Doctor or Rheumatologist

预约了医生，如果您遇到晨僵与任何RA的其他早期症状，包括发烧和体重减轻。如果你没有被诊断，初级保健医生才能把你风湿病运行类风湿性关节炎必要的测试。如果您有风湿性关节炎，并遇到一个重大的眩光或出现新的症状，请联系您的风湿病或初级保健医生寻求帮助。

怎么做医生诊断类风湿关节炎？

RA is diagnosed based on your medical history, a physical examination, and laboratory and imaging tests (e.g., X-rays).

Laboratory tests that may be used to help diagnose rheumatoid arthritis include:

• Anti-cyclic citrullinated peptide (anti-CCP) antibody:Antibodies are proteins made by your body to fight off foreign substances. Anti-CCP is an antibody present in most RA patients. This simple blood test looks for the presence and level of the antibody.
• Complete blood count (CBC):这种常见的测试用于测量血液中的红血细胞，白血细胞的水平，和血小板。低红细胞计数可以是在观察到的慢性炎症的指示。
• C-reactive protein (CRP):Your blood is drawn, then checked for the presence of the CRP protein, which is produced by your liver and can be found in your blood in response to inflammation.
• 红细胞沉降率（ESR）：After a sample of your blood is added to a tube, a technician measures the rate at which the red blood cells fall to the bottom of the tube. A fast sedimentation indicates inflammation, with blood cells clumping together and falling quicker.
• 类风湿因子：Also known as the latex agglutination test, this blood test is used to detect levels of this antibody, which are elevated in most patients who have RA.
• X射线：Images produced from X-rays show the amount of damage that RA inflammation has caused in your joints.
• MRI：磁共振成像用的磁场，射频，和计算机技术得到是如此敏感的图像质量，他们可以检测RA损害六个月以上的显示出来的X射线之前。
• 超声：有时被称为超声检查，这是一个非常敏感的试验暴露都出现这种情况在RA损伤以及炎症的存在的骨侵蚀。
• Synovial fluid analysis:在该试验中，当一个关节具有疼痛，炎症，或肿胀进行，流体从关节绘制帮助确定潜在的诊断。这可能是感染，痛风或关节炎，等等。对于文档得到这个权利，因为，很明显，痛风，例如，具有比RA完全不同的治疗方案是非常重要的。

什么是最好的治疗RA？

The goal of treatment is super simple: to keep you moving in all the ways you need to. That means reducing—and ideally stopping—the pain and inflammation that can eventually lead to joint damage. When RA is diagnosed early (check those symptoms!) and you’re aggressive with treatment, you're more likely to avoid complications later.

治疗 - 目标（T2T）是一种新望的治疗策略，其设定缓解或最小疾病活动为目标。工作原理：疾病活动经常监测，如果目标（缓解！）不满足，吃药和剂量进行调整，然后有，在你的约会。究竟如何？文档遵循预定的协议，其中可能包括药物，治疗，饮食结构的改变，RA-友好的练习，手术或治疗方案的组合。

RA的药物：你有选项

有更多的类风湿性关节炎的药物d treatment choices now available than ever before, which makes it easier to find the best treatment plan for you.

RA药物包括（上市，一般情况下，在你的RA是否是轻度，中度或重度排序）：

NSAIDS

非甾体抗炎药（NSAIDs），不动摇，不懈怠RA的进展，但是医生可能因炎症开一个大剂量治疗慢性疼痛。常用的NSAID包括那些你知道：

• Aspirin (Bufferin, Bayer)
• Celecoxib (Celebrex)
• Disalcid（双水杨酯）
• 布洛芬（布洛芬等品牌）
• Naproxen (Aleve and other brands)
• RELAFEN（萘丁美酮）
• COX-2 inhibitors, a subclass of NSAIDs that have a lower risk of internal bleeding or stomach ulcers—a common side effect of other NSAIDs that are used in large doses for a long time. If you做需要高剂量的其他NSAID的，它应该是一个短期修复。

DMARDs

These disease-modifying anti-rheumatic drugs (hence: DMARDs) help preserve joints by blocking inflammation. Due to the unpredictable risk of potential side effects from DMARDs—such as upset stomach, infection, hair loss, and liver damage—you must be closely monitored with regular (weekly to every few months) lab tests when taking these medications. DMARDs include:

• Trexall（甲氨蝶呤）
• 柳氮磺胺吡啶（柳氮磺吡啶）
• Arava (leflunomide)
• PLAQUENIL（羟氯喹）

Biologics

也被称为生物反应调节剂，这些药物被设计成控制免疫的某些部分系统实际上，他们是一类型的抗体。但是，而不是锁定到细菌或病毒，他们的目标，然后关机，蛋白质燃料炎症。（酷吧？）今天，有许多可用的不同的生物，所以医生根据他们把靶心对细胞进行分类。

• 肿瘤坏死因子抑制剂（TNF抑制剂）- 如Humira的（阿达木单抗），依那西普（依那西普），的Cimzia（赛妥珠单抗），SIMPONI（戈利木单抗），和是Remicade（英夫利昔单抗）-put在肿瘤坏死因子，即在人与RA中过量产生的天然存在的物质的制动器;它是第一炎症RA一个人变的主要原因。他们通过自我注射或静脉滴注取决于药物递送。
• B细胞抑制剂, like Rituxan (rituximab), are administered through an IV and kill B-lymphocytes that can spark inflammation.
• Interleukin-1 (IL) blockers一样KINERET（阿那白滞），是每日自注射;他们的目标白介素1，在主体中的炎症性化合物。
• Interleukin-6 inhibitors, such as self-injected Kevzara (sarilumab) and IV-administered or self-injected Actemra (tocilizumab), stop interleukin-6 proteins from attaching to cells and triggering inflammation.
• T-Cell inhibitors, like Orencia (abatacept), latch on to the surface of T-cells (aka inflammation-causing white blood cells). A doctor will give you this medicine via IV.

These medicines can slow the progression of RA and even bring about long periods of remission. Drawbacks? The delivery method—you must give yourself shots or visit an IV infusion center regularly—and because they tamp down your immune system, you may be more likely to catch colds and other infections.

类固醇

口服糖皮质激素，如DELTASONE（强的松），类风湿性关节炎症状提供快速救援，并在先进的情况下，可以防止RA相关的炎症损害您的眼睛和内脏。由于长时间使用时强的松有严重的副作用，它往往是保留对严重的突发或当其他治疗都无效。皮质类固醇注射到受影响的关节也可能会有所帮助。

Surgery

There are some RA cases—usually advanced and/or undertreated—where surgery may be a necessary consideration. Meaning: The pain is likely debilitating, and you no longer have normal joint function. There are two surgery types:

• 滑膜切除术。任何时候，肿胀已经变得如此糟糕，你有一个很难移动和运作，这种手术可以进行。它会从受影响的关节病变滑膜，以减少肿胀和疼痛，并有助于防止进一步的关节损害。
• 关节置换术。This surgery replaces the damaged joint with a mechanical one to restore joint function or fix a deformity. More than a million joint replacement surgeries are performed each year, mostly of the hip or knee, but the shoulders, elbows, and joints in the hands and feet may be replaced as well. Critical to discuss with your surgeon: the types of activities you want to continue after joint replacement. This will help your doc select the appropriate type of prosthesis and implantation technique, while giving you a deeper dive into the risks and limitations of surgery.

治疗可以帮助其他类型

If you have RA, yes, you have a chronic illness. But there are a number of things you can do—in addition to typical meds—to help you feel your best. For this, consider assembling a medical team of specialists from a variety of fields, including psychiatry, nutrition, and radiology.Other health-related professionals may also be part of your team to assist you with the following:

• Movement.Your doctor may prescribe an exercise program or advise you to see a physical or occupational therapist. While exercise that is too vigorous may worsen your symptoms,项目与温和的练习可以增加range of motion of your joints。因为水有助于支撑身体的一些练习更容易进行在游泳池或热水浴缸。跟你的医生哪些技术将是最适合你的。

• Sleep.Given how uncomfortable the condition is, more than half of people with RA have trouble晚上睡得。Plus, RA-related inflammation tends to deplete energy levels faster than for those without RA—so a solid eight hours of shut-eye is even more critical. Start tonight by using pillows as extra support where needed (for example, under a painful shoulder or between stacked knees).

• Compresses.Since heat works to reduce muscle tension and stimulate blood circulation, many people with RA say that applying something warm (a fresh-from-the-dryer hoodie will do!) makes joints feel better before exercise and other physical activity. Cold compresses, on the other hand, reduce inflammation, swelling, and soreness after an RA flare.

• Topical creams.Applying creams or lotions containing capsaicin (an extract from chili peppers!) may soothe minor joint pain. Ditto for those with camphor, menthol, or turpentine oil. Try: capsaicin-infusedCAPZASIN HP霜orJ.R.沃特金斯白色膏状搽剂, which has both camphor and turpentine oil.

• 夹板。你的风湿病可能会开夹板对于那些对你麻烦点区域。在严重发作，他们会通过固定关节帮助缓解疼痛。

• 饮食。While most evidence about the role of diet with RA is anecdotal, there are some studies that indicate certain foods may be helpful. In particular, the Mediterranean diet (aka the anti-inflammatory diet)—which emphasizes fish, olive oil, and vegetables—has been shown to have some impact on inflammation, likely due to the omega-3 fatty acids in certain fish. Several smaller studies also tout the helpfulness of a vegan or vegetarian diet on RA. Learn all aboutRA和饮食here.

是什么触发类风湿关节炎发作了？

Like a tornado, the triggers of rheumatoid arthritis are unpredictable. The best way to gain more control? Pinpointthe culprits behind your flares。Everyone’s are different, but typical offenders include:

• Stress
• Infections, including flu and cold, that activate your immune system
• Physical trauma, like surgery or broken bones
• Post-pregnancy
• Poor dental health
• Certain foods, including processed snacks, red meat, and excess refined sugars
• Too much exercise
• Dramatic, sudden changes in weather

RA是否有严重的并发症？

It can. Side effects from rheumatoid arthritis are manifestations of the condition itself and come in two varieties: those from untreated or undertreated RA, and those caused by joint damage.RA的常见并发症include:

• Heart disease。It affects more than half of all people with RA.
• Rheumatoid nodules, which occur in 30% to 40% of RA patients and are more bothersome than painful.
• 骨质疏松- 相关的骨折。这些是25％至30％，与RA的人比一般人群更常见。
• Infections (flu, staph, pneumonia). They’re twice as common in people with RA.
• 肺部疾病。It develops in nearly one-fourth of RA patients.
• 干眼症。这是最常见的眼部投诉人与RA。

大约有10％的人被诊断为RA（勤勉处理）在一年内经历完全缓解，约40％进入缓解within two years. That’s thanks to significant advances in treatment over the past two decades.

这就是为什么它是如此重要的不要忽视的症状，或推迟获得帮助。如果疾病进展和不治疗，当可能出现的最坏的副作用：运动的严重限制范围或者，接头的恶化，逐渐破坏。炎症过程减慢如纤维组织形式或骨头融合，和关节完全停止工作。

预防

虽然是从获得类风湿性关节炎保持没有已知的方法，也有很多的步骤，你可以采取的预防并发症，感觉更好的整体。

• 戒烟。34101名妇女的瑞典研究报告说，即使光吸烟与女性RA的风险增加和退出（或不启动的话）可以降低风险。
• 保持健康的体重，缓解关节压力。If you are overweight, you may want to consider a weight-loss plan, as excess pounds can put unnecessary stress on your joints. Consider working with a dietitian to help build a personalized diet or program that targets your specific goals (i.e. less sugar and more omega-3 fatty acids/fish) for managing your RA.
• Eat a healthy diet.虽然对于RA没有规定的饮食，目的是避免食物，引起炎症，如包装的零食，并且包括促进骨骼健康和免疫功能的食物。
• 启动或跟上的例行演习。Research shows that exercise can help alleviate RA symptoms and even improve day-to-day functioning. It can also make you more flexible, help you sleep better, and boost your endurance.

什么是生活像人的RA？

A day-to-day with rheumatoid arthritis often includes pain and fatigue, which can, admittedly, be overwhelming. You may also have to deal with people who don't really understand your condition and can't fully grasp what you're going through. If RA is relatively new to you, or you’re exhausted and in constant pain, we understand how impossible it can feel to gather the strength to search for good care and try new treatments. So start small: First educate yourself about RA, then work toward building confidence in who you are as a person living with RA.

情绪健康

People who have rheumatoid arthritis often feel that they must掩盖或掩饰他们的问题, which can be a real drain on your brain. The best solutions?

• 说出来。只需使用你打算通过什么与RA可以删除的孤独和帮助，负担你的人帮助你在你需要的方式和朋友家人聊天。
• 想办法来缓解压力。Try creating a self-care routine and exploring alternative treatments like meditation.
• Consider talking to a therapist.被诊断为RA往往会引发你哀悼你的健康和工作对接受您的情况悲伤的过程。你可能会感到沮丧，特别是如果你的病是超级活跃。通过优先发展你的心理健康，并与辅导员或治疗师（你的家人或文档风湿病可以指你一个）链接，你会为自己设定了RA管理的所有其他方面坚持到底。

性生活

百分之五十九那些具有RA的，每发表的一项研究中Rheumatology, felt the disease had a negative effect on their sex life. And no wonder: Depending on its severity, RA itself—along with some of the meds used to treat it—can decrease desire due to fatigue, stiffness, vaginal dryness, erectile dysfunction, and a decreased libido.

So, what’s the fix? Patience, communication, and understanding between you and your partner are obviously key. There are also certain sex positions that may feel more comfortable for you, typically based on your most ouchy joints:

• For wrist and/or elbow pain:根据需要对下你的胳膊肘的背面或侧面，以及地方枕头躺下。
• For neck pain:Don’t put pillows behind your neck or bend it forward when you’re on your back having sex. And be sure to talk to your doctor about how RA may affect your neck and how to protect it.
• 对于髋关节疼痛：If it hurts to move your hips around, have sex in a spoon position, with your partner behind you.
• 对于膝关节疼痛：你要保持你的膝盖伸直，所以尝试是在你的彼此面对的传教士体位或躺在底部。

怀孕

It’s complicated enough无RA-所以当然怀孕withthe condition comes with a billion extra questions.Will I have to come off my medication?（有些药品是不安全怀孕期间服用，有的则是很好。）我将通过RA上给我的孩子？(In short, not necessarily.) Learn as much as possible aboutthe issues to consider, and talk to your rheumatologist early on (ideally, before you start trying) regarding medication risks.

Where Can I Find Rheumatoid Arthritis Communities?

RA affects such a small percentage of the population that, without actively searching, running into another RA-er IRL is as likely as spotting a Charleston Chew at a movie-theater concession stand. Yet, finding your people—those who knowexactly你经历什么，是同样重要的是你的精神健康为找到一个治疗计划工程。形式的连接，探索资源，共享双方的痛苦和灵感，并结交新朋友，从这里开始。

Top RA Instagrammers

• 布里特·约翰逊，@hurtblogger

Follow because:She’s been through the mud—and pretty much stuck there—and does not sugarcoat the realities. She做es, however, find light and love in the tiniest places, constantly reminding you that if she can find the strength, so can you.

• Desiree Lee,@thebarbellbeautie

Follow because:She may be afraid of needles (hello, Humira shots), but she is not afraid of a barbell. Serving up your daily dose of workout inspiration—and actual workout routines—without ignoring the exercise issues that come with a chronic condition.

• 蕾妮·安德森，@the_rheumatoid_arthritis_mama

Follow because:She’s relatable on every level: She covers all aspects of how RA affects her life—and shares that emotional rollercoaster in her captions—including how she maintains a robust marriage in a hurting bod, keeps mommin’ through exhaustion, and fuels her health with arthritis-approved recipes.

• Eileen Davidson,@chroniceileen,chroniceileen.com

Follow because:她是一个大型主张谁背水战上使她发来提高认识什么是真的很喜欢有RA，和她做这件事没有（疼痛）的骨头。她是一个天生的讲故事的人，与上海社会科学院的一个侧面。

• 艾梅松本，@fitaimee_ra

Follow because:Just when you think you can’t rock mom life (or even have it at all), splurge on In-N-Out Burger, or muster the energy to exercise, Aimee is here to prove you wrong onall它的周期。

顶级RA相关的播客

• 慢性简报。通过versatile and hilarious writer Daniel Malito (who has had juvenile arthritis for more than 25 years, since he was 11 years old), the archives of this RA-related podcast are poignant and sometimes LOL-funny.
• 慢性性别。性教育家和活动家克里斯汀•舒尔茨主机this explicit—as in, NSFW unless you’re wearing headphones!—podcast, uncovering truths about how chronic illness and disability (including RA) affect relationships, sex, and sexuality.
• Sickness + Health。Artist and health advocate Cara Gael O’Regan has lived with Ehlers-Danlos Syndrome, another joint-related condition, for more than two decades; here, she does in-depth interviews on some of the toughest topics—insurance coverage, disability, mortality—as they intersect with chronic conditions and pain.
• Arthritis and Work by the Arthritis Society。While it’s not an ongoing series, this is a gold mine of solid work-related resources specific to balancing a career when you have RA.

顶级RA支持团体和非营利组织

• 关节炎基金会。This org and its award-winning magazine,今天关节炎,帮助你创建一个个性化的计划,一个完整的life. From quizzes (“What’s Your Arthritis Diet?”) and expert Q&A’s to customizable programs and tools (“Track and React,” a symptom-tracking app), the Arthritis Foundation encourages you to look at your RA diagnosis holistically.
• 关节炎国立研究基金会。在超过四十年来，这组提供赠款和关节炎研究的原因和预防，并为新的治疗方法，慢性关节条件组织筹款。无论您是重到科学与否，这就是你要寻找研究人员的最新和最伟大的RA结果。
• Rheumatoid Arthritis Support Network。Its goal? Provide up-to-date information so that people with RA know their options for prescription drugs and alternative therapies, and fully understand their diagnosis. The site also has a treasure trove of resources, including a rheumatologist directory.
• My RA Team。这个庞大的社交网络几乎与别人谁拥有风湿性关节炎您连接。这是伟大的情感上的支持，实用的建议，并在管理条件真实世界的洞察。