There are more than 100 types of rheumatic diseases — disorders characterized by inflammation of various connective or supporting structures of the body, including the joints, muscles, and bones. Rheumatic diseases, including all forms of arthritis and spondyloarthropathies (inflammatory spinal conditions), are usually painful, chronic, and progressive, which means they get worse over time. They can also lead to potentially severe complications. For example, rheumatoid arthritis, a condition in which the immune system attacks tissue that lines the joints, can increase your risk of certain cancers and lead to nerve dysfunction, among other things. Early diagnosis and treatment can help slow the progression of the disease.
Rheumatic Disease Diagnosis
No single test can diagnose rheumatic diseases. Diagnosis of arthritis and other rheumatic diseases begins with a discussion of your medical history. Your doctor will talk with you about your symptoms, including:
How much pain you’re inWhere, exactly, you feel pain or other symptoms, such as stiffness and swellingWhen your symptoms began and whether they’re constant or change throughout the dayDrugs, body positions, and other things that may relieve your symptomsFactors that worsen the pain
Next, she will ask about your current and past health — illnesses, exercise habits, travel habits, and your family’s medical history, especially with regards to rheumatic diseases and autoimmune disorders. She will then conduct a detailed physical examination, checking for visible signs of swelling, stiffness, or redness in your joints. The exam will also test your range of motion and reflexes and look for things like swollen glands and eye inflammation. If you doctor suspects you have some kind of rheumatic disease, she will order one or more laboratory tests to help rule out other potential causes and come to a reliable diagnosis. Specifically, she may order blood tests, which can help detect markers of inflammation, antibodies associated with certain diseases, abnormal blood counts, and abnormal organ function, among other things. Tests on your urine and joint fluid may also be necessary. Imaging tests of your joints and bones can help detect inflammation, fluid buildup, cartilage loss, soft tissue tears, and bone or joint erosion and damage. Your doctor may ask to have you undergo X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, or ultrasounds.
Rheumatic Disease Medication
Various types of medication are prescribed to treat rheumatic diseases. Some drugs only treat symptoms like pain and inflammation, while others can alter the course of the disease. Depending on the condition, medication may include:
Oral analgesics (painkillers), such as over-the-counter acetaminophen, and prescription narcotics (opioids), like oxycodone and hydrocodone, which don’t affect the underlying cause of the diseaseTopical analgesicsNonsteroidal anti-inflammatory drugs (NSAIDs), including over-the-counter ibuprofen and naproxen sodium, and prescription-grade drugs called COX-2 inhibitors, which can help reduce pain and inflammationCorticosteroids, which have strong anti-inflammatory properties but significant side effects when used for a long timeDisease-modifying anti-rheumatic drugs (DMARDs), which can help slow the progression of rheumatic diseases by affecting the body’s immune reactions and inflammatory processesBiologics, a subclass of DMARDs that work by targeting specific steps in the body’s inflammatory processesJanus kinase inhibitors, a new DMARD subclass that works by targeting Janus kinase (JAK) pathways, which are involved in the body’s immune system response
Other Rheumatic Disease Treatments
Besides medication, various other types of treatments may be prescribed for rheumatic disease, including:
Specific exercise regimes to increase muscle strength and joint flexibilityPhysical therapyOccupational therapyHot and cold therapySplints, braces, and assistive devices to support weak jointsRelaxation therapySurgery (particular for arthritis)
