Rheumatism

Rheumatism is a general term that describes a broad group of diseases affecting the joints, muscles and connective tissue. These diseases often cause symptoms such as pain, swelling, stiffness and limited movement. Many rheumatic diseases are autoimmune, developing when the immune system attacks the body’s own tissues.

What is Rheumatism?

Rheumatism is a musculoskeletal disorder that affects one or more structures like tendons, muscles, ligaments, bones and joints causing pain and restricted movement. It can occur at almost any age and may lead to various disorders in the immune system. The most dangerous type of rheumatism is considered to be rheumatoid arthritis.

Rheumatism usually presents with pain, swelling and restricted movement and can be triggered by factors like genetics, age, gender, environmental factors and obesity. It often causes more pain in overweight individuals and manifests as swelling, warmth and pain in the joints. If not treated, it can lead to serious conditions and complications.

What Causes Rheumatism?

Rheumatism is a broad term that encompasses a variety of different diseases and the causes of these diseases are often complex. Generally, the causes of rheumatic diseases are a combination of genetic, environmental and immune system-related factors. Here are the main causes of rheumatism.

1. Genetic Factors

Family History:
- Having a family member with a rheumatic disease can increase an individual’s risk of developing these conditions. Genetic predisposition plays a significant role in the development of certain rheumatic diseases.

2. Immune System

Autoimmune Reactions:
- Most rheumatic diseases are autoimmune disorders, meaning the immune system mistakenly attacks the body’s own healthy tissues. Diseases like rheumatoid artritis, lupus and ankylosing spondylitis have autoimmune characteristics.

3. Environmental Factors

Infections:
- Some rheumatic diseases can be triggered after viral or bacterial infections. For example, rheumatic fever can develop following a streptococcal infection.
Smoking and Alcohol:
- Smoking, particularly increases the risk of rheumatism arthritis. Excessive alcohol consumption can also have negative effects on overall health.
Trauma or Injury:
- Trauma or injury to joints or connective tissues can play a role in the onset of certain rheumatic diseases.

4. Hormones

Hormonal Changes:
- Especially in women, changes in hormone levels can influence the development of rheumatic diseases. For instance, lupus is more common in women then men and hormonal fluctuations can affect the course of the disease.

5. Metabolic and Other Factors

Uric Acid Levels
- Gout is a condition that results from the accumulation of high levels of uric acid in the body, leading to painful crystal deposits in the joints.
Diet and Lifestyle:
- Unhealthy eating habits, obesity and physical inactivity can contribute to the development of certain rheumatic diseases like osteoarthritis.

What Are the Types of Rheumatism?

1. Rheumatoid Arthritis (RA)

Definition: A chronic autoimmune disease.
Symptoms: Joint pain, swelling and stiffness especially noticeable in the mornings. It typically affects joints symmetrically.
Treatment: NSAIDs, corticosteroids, DMARDs, biological agents and physical therapy.

2. Osteoarthritis (OA)

Definition: A degenerative joint disease resulting from the wear an tear of joint cartilage.
Symptoms: Pain, joint stiffness, limited movement and joint creaking.
Treatment: NSAIDs, pain relievers, physical therapy, weight management and surgical intervention.

3. Ankylosing Spondylitis

Definition: A chronic autoimmune disease affecting the spine and sacroiliac joints.
Symptoms: Lower back pain, spine stiffness, especially in the mornings. In advanced stages, the spine may fuse.
Treatment: NSAIDs, biological agents, exercise and physical therapy.

4. Systemic Lupus Erythematosus (SLE)

Definition: An autoimmune disease that can affect various organs and tissues in the body.
Symptoms: Joint pain, skin rashes, fever, fatigue, kidney problems and hair loss.
Treatment: NSAIDs, corticosteroids.

5. Gout

Definition: A painful inflammatory joint disease caused by the accumulation of uric acid crystals in the joints.
Symptoms: Sudden onset of severe joint pain, swelling, redness typically affecting the big toe.
Treatment: NSAIDs, colchicine, corticosteroids, medications to lower uric acid levels and dietary changes.

6. Fibromyalgia

Definition: A chronic condition characterized by musculoskeletal pain, fatigue and specific tender points.
Symptoms: Widespread body pain, fatigue, sleep disturbances cognitive difficulties.
Treatment: Pain relievers, antidepressants, anticonvulsants, exercise and sleep management therapies.

7. Psoriatic Arthritis

Definiton: An autoimmune type of arthritis associated with psoriasis.
Symptoms: Joint pain, swelling, skin psoriasis lesions, nail changes.
Treatment: NSAIDs, DMARDs, biological agents, corticosteroids.

8. Juvenile Idiopatik Arthritis (JIA)

Definiton: A chronic autoimmune type of arthritis that affects children.
Symptoms: Joint pain, swelling, limited movement, fever, skin rashes.
Treatment: NSAIDs, DMARDs, biological agents, physical therapy.

9. Reactive Arthritis

Definiton: Joint inflammation typically triggered by an infection.
Symptoms: Joint pain, swelling, urinary tract or eye infections, skin rashes.
Treatment: NSAIDs, antibiotics, corticosteroids, physical therapy.

10. Sjögren‘s Syndrome

Definition: An autoimmune disease that affects the glands that produce moisture.
Symptoms: Dry mouth, dry eyes, joint pain, swelling, fatigue.
Treatment: Artificial tears, moisturizing agents, immunosuppressive drugs.

How is Rheumatism Diagnosed?

1. Medical History

Symptoms:
- The patient is asked to describe their symptoms in detail, including pain, swelling, stiffness and limited range of motion.
Family History:
- The presence of any family history of rheumatic diseases is investigated
Past Medical Conditions:
- Previous infections, traumas or other health issues are considered.

2. Physical Examination

Joints
- The joints are examined for swelling, tenderness, warmth, redness and range of motion.
Muscle and Connective Tissues:
- Muscle weakness, tender points and other related symptoms are evaluated.
General Health:
- A general health assessment is conducted, including skin, eyes, mouth and other organ systems.

3. Laboratory Tests

Blood Tests:
- Erythrocyte Sedimentation Rate (ESR): Measures the level of inflammation the body.
- C-Reactive Protein (CRP): Indicates the level of inflammation.
- Rheumatoid Factor (RF): May be positive in lupus and other autoimmune diseases.
- Antinuclear Antibody (ANA): May be positive in lupus and other autoimmune diseases.
- HLA-B27: May be positive in ankylosing spondylitis and some other rheumatic diseases.
- Uric Acid: Used in the diagnosis of gout.
Urine Tests:
- Performed to assess kidney function and to check for kidney involvement in diseases like lupus.

4. Imagining Tests

X-Ray:
- Used to evaluate joint damage and deformities.
Magnetic Resonance Imagining (MRI):
- Provides detailed images of soft tissues, ligaments and joint capsules.
Ultrasound:
- Used to assess fluid accumulation and inflammation in the joints.
Computed Tomography (CT):
- Evaluates complex joint structure and bone changes.

5. Additional Tests and Evaluations

Joint Aspiration
- Joint fluid may be aspirated for examination, helping to detect infection or crystal deposits.
Biopsy:
- In rare cases, a biopsy of the skin or other tissues may be performed to support the diagnosis of rheumatic diseases.

6. Specialist Consultation

Rheumatologist:
- Consulting a doctor specialized in rheumatic diseases is an essential step in the diagnosis and treatment process.
Multidisciplinary Approach:
- If needed, other specialist (orthopedic surgeon, nephrologist, dermatologist, etc.) may be involved in the diagnosis and treatment process.

How is Rheumatism Treated

The treatment and management of rheumatic diseases generally require a multidisciplinary approach. Given the chronic nature of these conditions, early diagnosis and appropriate treatment can enhance the quality of life for patients and slow the progression of the disease. Treatment plans should be tailored to the individual needs of patients and regular follow-ups are essential.

Conclusion

The diagnosis of rheumatic disease requires accurate and comprehensive evaluation. Diagnosis is achieved through the correct identification of symptoms a physical examination and the combination of laboratory tests and imagining techniques. Early diagnosis and appropriate treatment can significantly impact the course of the disease and the quality of life. Collaborating with a rheumatologist is the most effective approach for the diagnosis and treatment of rheumatism.