Rheumatology

Rheumatology is concerned with diseases of the joints, bones and soft tissues.

What is rheumatology?

Rheumatology is concerned with diseases of the joints, bones and soft tissues. The only common denominator of these diseases is impairment of the functional capacity of the locomotor apparatus as a result of pain or stiffness. This involves in particular diseases of the skeleton (osteoporosis, osteomalacia), degenerative diseases of the joints (osteoarthritis, diseases of the back), inflammation (rheumatoid arthritis, ankylosing spondylitis, vasculitis), periarticular diseases (inflammation of the tendon sheath, periarthritis) and muscle diseases (sprains, myositis).

Chronic rheumatic diseases

Primary chronic rheumatic diseases represent the main field of activity in rheumatology. From a clinical point of view, these forms of the disease require the main attention of specialists in rheumatology. Arthritis, osteoarthritis, and osteoporosis are the most important examples. Taken together, these three diseases are responsible for more than 90% of pathological changes in the musculoskeletal system. These are inflammatory diseases that affect joints and surrounding areas and develop chronically and progressively. These diseases often lead to stiffening and cause deformities. Primary chronic rheumatic diseases can be divided into two main groups: the "rheumatoid group" and the "spondyloarthritis group". Rheumatoid diseases affect the joints of the limbs, while spondyloarthritis diseases usually affect the spine.

Autoimmune diseases

The most serious diseases that fall within the rheumatologist's field of treatment also include autoimmune diseases (the immune system produces antibodies against its own body). These diseases can then affect all organs: Heart, brain, skin, eyes, and white and red blood cells, such as in systemic lupus erythematosus (SLE) or rheumatoid arthritis.

Although many believe that rheumatic diseases mainly affect people in middle and old age (which is certainly the case with degenerative rheumatic diseases), autoimmune rheumatic diseases (of an inflammatory nature) occur most often in young adults and quite frequently in adolescents and even children. Systemic juvenile idiopathic arthritis (also known as "Still's disease") is one of the most severe inflammatory rheumatic diseases known. The disease can progress chronically and leads to severe physical impairment. It usually affects children under the age of 10. There is also the form of systemic lupus erythematosus, which often occurs in adolescents, or ankylosing spondylitis (ankylosing spondylitis), which mostly affects young men, as well as rheumatoid arthritis, the first symptoms of which often occur in young women after childbirth or during periods of stress.

Treatment

The widespread prevalence of rheumatic diseases and their thorough research have led to a significant upswing in rheumatology. The tools available to rheumatologists to diagnose or detect anatomical lesions and dysfunctions have evolved considerably and are becoming increasingly reliable. Elaborate laboratory tests can determine, for example, the immunogenetic structure (i.e. the genes that control the immune response) or the specific autoantibodies that are often "markers" (or distinguishing elements) for certain diseases. Advances in radiology also mark a real turning point in musculoskeletal research, thanks to modern imaging techniques.

By clearly diagnosing the many rheumatic diseases and detecting lesions early and accurately, more effective treatment is possible and in many cases progression of the disease can be prevented. The most severe diseases of the past, such as rheumatic fever or gout (which can lead to kidney failure and death), are now perfectly curable diseases. The prognosis for other diseases such as rheumatoid arthritis, lupus, or scleroderma has also improved significantly. Today, these diseases have a significantly higher survival rate, the physical impairments are less and the quality of life of those affected has increased significantly compared to the past.

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