About
Compare
Most of these pages exist because two things get confused for each other, and often confused in ways that cost people time. Each one says what separates them, and each one says plainly where the evidence runs out. That second half is the reason a good number of them exist at all.
What these pages are for
Almost every question a patient brings to a rheumatology visit is a comparison between two things. It isn't what lupus is, it's whether this is lupus or rheumatoid arthritis. It isn't what an inflammatory marker measures, it's why one of them is up and the other one isn't, which is a different question altogether.
A page written to explain one thing answers the second-best question, so these pages go the other way round. Each one starts from the pair that people confuse, then works out what splits the two apart. Where a single feature settles it, the page says so rather than hedging.
The comparisons fall into three groups of roughly equal size. Some set two conditions side by side, some set two tests side by side, and some set two treatments side by side, with the last group including two ways of eating and two ways of moving. All of them give you the numbers wherever numbers exist.
Where the evidence runs out, these pages say so
Several of these comparisons have no clean answer, and that's a finding rather than a failure on our part. Nobody has run a trial putting methotrexate against a set lifestyle program in rheumatoid arthritis, so the page comparing them says that plainly and then reports what each side has been tested against instead. Outside celiac disease, no trial in our source set tested gluten on its own either.
Saying so is more useful than the alternative. If you know the comparison hasn't been done, you can weigh advice accordingly, and if you've been given a confident answer instead, that answer was often built out of two unrelated studies. That swap is common enough in writing about autoimmune disease that several of these pages exist mainly to point at it.
The other thing worth knowing is how small some of the real effects are. Fish oil does lower arthritis pain, though its effect barely clears zero at one end of the range. Mediterranean eating comes with an odds ratio of 0.88 for developing rheumatoid arthritis, which is a long way from the transformation it often gets sold as, and those figures are on the pages in full with their limits attached.
How to use them at an appointment
The most valuable thing on any of these pages is usually a question rather than an answer. Take a normal C-reactive protein, which doesn't rule out rheumatoid arthritis, and knowing that turns into a question worth asking out loud. Or take morning stiffness, where over an hour points one way and under half an hour points the other, and knowing that turns into something worth reporting carefully.
Take the details rather than the conclusion when you go. A clinician can do a great deal with how long your stiffness lasts, which joints swell, and whether both sides are alike. A clinician can do a good deal less with a printed page, and these pages are built to help you supply the first kind of thing rather than the second.
None of them replaces an assessment, and none is written as though it could. What they can do is smaller than that, which is to close the distance between what you've been told and what the studies say. That's a fair thing to want before a fifteen minute visit.
Every comparison on this site.
Lupus vs rheumatoid arthritis
Two diseases that both attack joints. Only one of them routinely goes after the kidneys, the blood, and the brain.
Osteoarthritis vs rheumatoid arthritis
Wear and tear against an immune attack. Why the joint picture separates them. And why getting it right early counts far more in one.
Fibromyalgia vs rheumatoid arthritis
Both cause pain, stiffness, and exhaustion. Only one appears on an exam and on blood tests. And the treatments have almost nothing in common.
Sjogren's vs ordinary dry eye
Dry eyes are usually just dry eyes. Some features turn an eye complaint into a rheumatology question. Here they are.
Raynaud's vs poor circulation
One is a blood vessel spasm that comes and goes. The other is an artery that has grown tighter and stays that way. The color change tells them apart.
Anti-CCP vs rheumatoid factor
Why a positive anti-CCP carries more weight. And why a negative one still leaves about a third of cases unexplained.
CRP vs ESR
Two swelling markers. They disagree with each other often enough to be worth learning one at a time.
Methotrexate vs lifestyle
Can diet and exercise replace the drug? What the lifestyle trials measured. And the head-to-head trial nobody has run.
Mediterranean vs the autoimmune protocol
One has research behind it in inflammatory arthritis. The other has none this site could check. And cutting foods out has a cost.
Gluten-free vs Mediterranean
No trial here tested gluten on its own outside celiac disease. And the one trial that cut foods out removed four at once.
Strength training vs cardio
Which to do first in a swelling disease. What weight work changes that cardio doesn't. And what neither one reliably moves.
Questions patients ask.
Why compare things at all rather than just explain them?
Because the question people come with nearly always compares two things against each other. Nobody wants to know what an inflammatory marker is in the abstract, they want to know why their sedimentation rate is up while their C-reactive protein is normal. Setting two things side by side answers the question that was asked, while explaining one of them answers the easier question instead.
How do you decide which comparison to write?
By what gets confused in clinic and in search results, which is a shorter list than you'd think. Where two conditions cause similar symptoms and need opposite treatment, those go near the top, because getting it wrong costs a person months of their life. A pair of tests can cost a person just as much, usually when a normal result gets read as reassurance.
Do these pages tell me which one I have?
They tell you what separates the two and what a doctor is weighing, which is genuinely useful and isn't a diagnosis. Every one of them is written to help you ask a better question at your next visit rather than to answer it in your kitchen. Where a feature settles the matter the page says so, and where it doesn't, it says that too.
Why do some of these pages say the evidence isn't there?
Because on several of these questions the evidence genuinely isn't there, and saying so beats filling the space. Take methotrexate against a lifestyle program in rheumatoid arthritis, where nobody has run that trial, or gluten on its own outside celiac disease, where no trial has tested it either. A page that admits the comparison is missing tells you something, while a confident answer would have hidden it.
Are these written by a doctor?
Every page here says whether Dr. Luebker has read that exact wording, and a page still waiting on her says so in plain words at the foot of it. It claims no medical review until she gives it. The sources sit at the bottom of every page with their identifiers attached, so you can go and read the study yourself rather than taking anybody's summary.
A comparison I want isn't here. What now?
The condition pages cover each diagnosis in more depth than a comparison can, and the lab reference section covers each blood test with its performance figures. Between those two you can usually build the comparison yourself. If there's a pairing you keep looking for and not finding, it's worth telling us, because that's how this list gets longer.
All of them
- Mediterranean diet vs AIP
- Methotrexate vs lifestyle for RA
- Biologics vs DMARDs
- Anti-CCP vs rheumatoid factor
- CRP vs ESR
- Fibromyalgia vs rheumatoid arthritis
- Lupus vs rheumatoid arthritis
- Osteoarthritis vs rheumatoid arthritis
- Raynaud's vs poor circulation
- Gluten-free vs Mediterranean
- Strength training vs cardio
- Sjogren's vs ordinary dry eye