Rheumatology

Author: Bano Imam Afange

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Rheumatology is the part of medicine that concerns itself with diseases affecting joints and/or connective tissue. Connective tissue plays a huge role in connecting tissues and organs in the body. We can find connective tissue in many locations: tendons, skin, bone, blood vessels, lymphatic organs and bone marrow are just a few examples.

It is important to note that the term “rheumatism” does not relate to a specific disorder, but is an umbrella term for many different conditions. Rheumatic diseases are caused by both infectious, inflammatory and degenerative causes. Because connective tissue is found all over the body, the different rheumatic diseases may have manifestations all over the body. This is why joint pain is not the only common symptom here, but also symptoms from the gut, skin, nervous system and so on. An example is for patients with Bechterew´s disease (also called Ankylosing Spondylitis), you can find the patients suffering from lower back pain, inflammatory bowel disease, inflammation of the anterior chamber of the eye and more.

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Since autoimmune disorders constitute a large group here, rheumatology has been crossing paths with immunology throughout the last years. This is why specific blood markers for some of the conditions can lead to a final diagnosis and control of treatment.

We can divide the diseases in rheumatology into a couple of categories as follows

  • Degenerative arthro(joint)pathies
  • Inflammatory arthro(joint)pathies
  • Systemic conditions and connective tissue diseases
  • Soft tissue rheumatism
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When testing for rheumatic diseases, the doctor may need samples of your blood, urine, synovial fluid, spinal fluid, skin or other connective tissue lesions. A lung function test may also be needed in some rheumatic conditions. Further, your doctor may also order ECG, EMG, X-ray, Ultrasound, MR, CT and even a DEXA scan.

Here is what your doctor might screen your blood for:

  • Complete blood count
  • Blood chemistry screen
  • Blood tests evaluating the Liver
  • C-ractive protein (CRP) and erythrocyte sedimentation ratio (ESR)
  • Reumatoid factor
  • Anti-cyclic Citrullinated protein (Anti-CCP)
  • ANA, ANCA, SSA, SSB, Anti-dsDNA antibodies, Anti-sm antibodies, phospholipid antibodies
  • Serum Angiotensin converting enzyme (S-ACE)
  • Parvovirus 19
  • HLA-B27
  • TSH

Treatment of rheumatic diseases spans many different areas, both conservative, pharmacological and surgical:

Conservative treatment:

  • Physiotherapy
  • Ergotherapy

Pharmaceutical treatment:

  • Analgetics
  • NSAIDs
  • Disease modifying AntiRheumatic drugs (DMARDs)
  • Glucocorticoids
  • Intra venous Immunoglobulin injections
  • Biological treatment (TNF-α inhibitors)

Since many of the rheumatic diseases are autoimmune, some people have also found changing their diet helping for their condition. Usually they would consume food which is anti-inflammatory quality. Such diets are mostly plant-based. Plant-based food contains antioxidants, which may explain the anti-inflammatory characteristics of this diet.

 

Bano Imam Afange

KEMSA Blog Medicine

Sources

 

Erik Kåss (2016, September 12). Revamtiske sykdommer. Retrieved from https://sml.snl.no/revmatiske_sykdommer

Rheumatism. (2017, September 16).  Retrieved from https://en.wikipedia.org/wiki/Rheumatism

Rheumatology. (2017, October 6). Retrieved from https://en.wikipedia.org/wiki/Rheumatology

Ankylosing Spondylitis. (2017, October 15). Retrieved from https://en.wikipedia.org/wiki/Ankylosing_spondylitis

Immunologic Blood Tests (n.d.) Retrieved from http://www.rheumatologyinformation.org/patient_articles/view/immunologic-blood-tests

Karen Kennedy (n.d.) Nutrition Guidelines for People With Rheumatoid Arthritis. Retrieved from http://www.arthritis.org/living-with-arthritis/arthritis-diet/anti-inflammatory/rheumatoid-arthritis-diet.php

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