Understanding Rheumatology Causes, diagnosis, and treatment
What are rheumatic diseases (Rheumatology)
Rheumatic diseases affect the joints of tendons, ligaments, bones and muscles. Among them are many types of arthritis, a term used for conditions that affect your joints.
Sometimes they are called musculoskeletal diseases. Common symptoms such as joint pain, loss of mobility in the joint, inflammation, redness and warmth in the joint or affected area include
What causes rheumatic disease
Most of these conditions occur when your immune system goes awry and attacks your tissues.
Doctors are not sure about the reasons for this (rheumatic disease). Sometimes the reason is in your genes. Other times it is the result of factors around you, such as cigarette smoke, pollution, or something that causes infection.
And it also seems that rheumatic diseases affect women more often than men.
Common rheumatic diseases
Years ago, such conditions fell under the broad title of rheumatism. There are now more than 200 diseases:
- Osteoporosis
- Rheumatoid arthritis
- Lupus
- Adhesive Spondylitis
- Sjogren syndrome
- Psoriatic arthritis
- Gout
- Scleroderma
- Infectious arthritis
- Anonymous Arthritis
- Rheumatic muscle pain
Osteoporosis
Unlike most rheumatic diseases, osteoporosis is not associated with problems in your immune system.
But it results from cartilage damage, usually affecting the knees, hips, lower back, neck, fingers and feet.
Symptoms:
- Pain in the joints
- Swelling
- Hardening
Muscle weakness can make joints unstable. Depending on the body parts it affects, osteoporosis can lead to difficulty walking, grabbing objects, dressing, combing your hair or sitting.
Diagnosis: Your doctor will ask about your medical history and symptoms. You’ll also undergo a physical exam.
Usually by the time a person with osteoporosis seeks treatment, there are visible changes in the joint’s X-ray.
X-rays may show a narrowing of the joint area or the presence of bone spurs. In some cases, your doctor may request an MRI to provide a picture of the inside of the joint.
Rheumatoid arthritis
Rheumatoid arthritis occurs when the immune system attacks your tissue and causes joint pain, swelling and stiffness. It’s not part of normal aging.
Symptoms:
- Pain and swelling in multiple joints (usually the same joints on both sides of the body, such as both wrists or both ankles)
- Problems with other organs such as eyes and lungs
- stiffness of joints, especially in the morning
- Fatigue
- Blocks known as rheumatoid nodules
Diagnosis: You will get an examination and tell your doctor about your health history. The doctor may take X-rays and samples of joint fluid. They will conduct blood tests that look for different signs of inflammation. These include:
- Antinuclear antibodies
- Anti cyclic citrulinated peptide
- Complete blood count
- C-reactive protein
- Erythrocyte sedimentation rate
- Rheumatoid factor
Lupus
Lupus (also called systemic lupus erythematosus) is an autoimmune disease. It can affect many organs of the body.
Symptoms:
- Joint pain
- Fatigue
- Joint stiffness
- Skin rashes , including a “butterfly” rash across the cheeks
- Sun allergy
- Hair loss
- Blue or white fingers or toes when exposed to cold (called Raynaud’s phenomenon)
- Problems with other organs such as the kidneys
- Blood disorders , such as anemia and low levels of white blood cells or platelets
- Chest pain such as inflammation of the lining of the heart or lungs
- Seizures or strokes
Diagnosis: your doctor will ask about your medical history, do a physical examination, and order laboratory tests of blood and urine samples.
Blood tests include an antinuclear antibody test (ANA) as most people with lupus have a positive blood test (ANA)
Adhesive Spondylitis
Adhesive spondylitis usually begins gradually as a lower back pain. It usually involves joints where the spine is attached to the pelvis, known as incipient impotent joints. Adhesive spondylitis is more common in young people, especially from teenage years to the age of 30.
Symptoms:
- Progressive pain in the lower back and buttocks
- Low back pain that gets worse until it reaches the top of the spine
- Pain between the shoulder blades and neck
- Pain and stiffness in the back, especially when waking up
Pain in the middle of the back, then the upper back and neck (after 5-10 years)
If the condition worsens, your spine may become stiffer. It may become difficult to bend over for daily activities.
Diagnosis: your doctor will give you a physical examination and ask about your medical history. You may get an X-ray of your back, looking at the sacroiliac joints. A blood test for a protein called HLA-B27 may help confirm the diagnosis.
Sjogren’s syndrome
Sjogren’s syndrome causes parts of your body to become dry, such as the eyes or mouth. Some people also suffer from rheumatoid arthritis and lupus.
The cause is unknown, but it occurs when the immune system attacks those parts of the body. It is more common in women than in men.
Symptoms:
- Dry eyes
- Eye irritation
- Dry mouth (the glands in your mouth don’t produce enough saliva)
- Tooth decay or gum disease
- Joint pain and stiffness
- Diseases of internal organs
Diagnosis: your doctor will do a physical examination and ask about your medical history.
You can also take other tests. To confirm the diagnosis, the doctor may perform a biopsy, taking tissue from your inner lip for verification in the laboratory.
Psoriatic arthritis
A form of autoimmune arthritis is sometimes associated with psoriasis skin symptoms.
Symptoms:
- Painful swollen joints
- Hardness – loss or range of movement
- Swelling of fingers and toes
- Pain in tendons or ligaments
- Rash
- Changes in fingernails and toenails
- Fatigue
- Eye inflammation
Most people may experience skin symptoms before they develop joint symptoms. Sometimes it affects joints first. Some people are asymptomatic on the skin.
Diagnosis: Genes play a role in this disease, so your doctor will ask about your medical history and that of your relatives.
Your joints are checked to see if they are swollen and inflamed, and they may pull fluids from one to make sure that gout or infectious arthritis is not the cause of your problems.
They will also examine the skin for signs of psoriasis. Imaging tests can show whether you have damage to joints. Blood tests for psoriatic arthritis looking for signs of inflammation include:
- C-reactive protein
- Erythrocyte sedimentation rate
- Rheumatoid factor
Gout
It is an accumulation of uric acid crystals in the joint. Most of the time, it’s your big toe or another part of your foot.
Symptoms:
- Severe pain in the joints
- Discomfort: even after the acute pain is gone, your joint will still hurt.
- Inflammation and redness: the joint will be red, swollen and tender.
- Problem with movement: your joint will be stiff.
Diagnosis: gout can look like a lot of other diseases. Your doctor will ask you to do the following tests:
- Analysis of synovial fluid to check for the presence of uric acid crystals in the joint
- Uric acid if there are high levels in the blood
- Basic Metabolic Panel
- Complete blood count
- Inflammation tests such as rheumatoid factor and antibodies
Scleroderma
This means that the skin becomes hard, Local scleroderma is the most common type that affects children. About 90% of children are diagnosed between the ages of 2-14.
As well as the same number of adults. They are usually diagnosed in their forties. This type can strengthen the skin and everything under it, including fat, connective tissue, muscles and bones.
Systemic sclerosis can affect many parts of the body, from the skin and blood vessels to organs, muscles and joints.
Symptoms:
- A problem with the digestive system
- Dry mouth, eyes, skin or vagina
- Heart, kidney or lung problems
- Stiff, swollen or warm joints
- Muscle weakness
- Thick skin on your fingers
- Raynaud’s phenomenon-reduced blood flow to the fingers and toes which can cause them to turn blue
- Telangiectasia, dilated small blood vessels that you can see through your skin
Diagnosis: the doctor will ask about your medical history and current symptoms.
They will probably do blood tests to look for antibodies (proteins) associated with scleroderma. These include:
- (ANA)
- (ACA)
- (Scl-70)
Infectious arthritis
It is arthritis caused by an infection in the joint and its symptoms appear quickly and usually only one joint is affected but it can affect other joints.
Symptoms:
Swelling and severe pain in the joints
Diagnosis: your doctor will do a complete physical examination and ask about your medical history.
They may take a sample of fluid from the joint to find out the cause of the infection.
They may also do an X-ray of the joint or do other imaging tests, such as an MRI or ultrasound, to see if there is any damage.
Anonymous Arthritis
The most common form of arthritis in children in which the child’s immune system mistakenly attacks its own tissues, causing inflammation of the joints and other organs and systems
Symptoms:
- Joint pain
- Swelling of the joints
- Fever
- Skin rash
Diagnosis: the doctor will ask about your child’s health history to find out how long it has been since the symptoms appeared.
Then they check the child’s joints for swelling, redness, range of motion. They will probably do blood tests that look for various signs of inflammation.
Such examinations include the following:
- Anti-cyclic acid peptides (Anti-CCP)
- Anti-nuclear antibodies (ANA)
- Complete blood count
- Erythrocyte sedimentation rate (ESR)
- HLA-B27
- Rheumatoid factor (RF)
They will finish imaging tests to check for joint damage, such as X-rays, magnetic resonance imaging, or computed tomography.
Rheumatic muscle pain
It is an inflammatory condition that mostly affects the elderly and can come on slowly or suddenly.
Symptoms:
- Stiffness in the morning and after sitting or lying down
- Fever
- Poor appetite
- Weight loss
- Pain and stiffness in at least two parts of the body such as buttocks, hips, neck, thighs, arms and shoulders
Diagnosis: the doctor will ask about the medical history and do a physical examination. Then they do blood tests to look for various signs of inflammation.
The goal is to rule out other autoimmune conditions such as lupus and rheumatoid arthritis. The tests include:
- Anti-acid peptides (Anti-CCP)
- Antibodies (ANA)
- Complete blood count
- C-reactive protein
- Erythrocyte sedimentation rate (ESR)
- Rheumatoid factor
- rheumatic disease
