Kalitsakis Ioannis - Rheumatologist,Rheumatic diseases

Rheumatic Diseases: Myths and Reality

Among the general public, there are several misconceptions about rheumatic diseases. This often has significant implications and impacts on the timely and effective treatment of these conditions, but also on the right attitude of the family, the social environment and the working environment towards people with a rheumatic disease.

What are rheumatic diseases?

Rheumatic diseases are non-traumatic and non-surgical diseases of the musculoskeletal system and connective tissue diseases. It is the diseases of joints, tendons, ligaments, serum pockets, muscles, bones and spine. However, some rheumatic diseases, such as So-called autoimmune rheumatic diseases, are not limited to the musculoskeletal system, but they also affect various other organs or systems of the human body, such as Kidneys, skin, eyes, lungs, heart, arteries, veins, liver, brain, etc.

Are rheumatic diseases a problem for the elderly?

There is a widespread perception that "arthritic" affects older people and is therefore a predominant problem of the elderly. Indeed, some of these diseases, and even the most common ones, such as osteoarthritis and osteoporosis, challenge older people. In reality, however, no age is immune. The most serious rheumatic diseases, such as autoimmune rheumatic diseases (Rheumatoid arthritis - Systemic Erythema Lynx - Axial Spondyloarthritis - Systemic Scleroderma) not only affect younger and middle-aged people more often, but they are even presented to children.

What are rheumatic diseases?

Rheumatic diseases are many, about 200, and can be classified as:

1. Inflammatory rheumatic diseases

They are the prime subject of the rheumatologist, have autoimmune etiology and according to the target organ, include:

Joint Damage (Arthritis)	Rheumatoid arthritis, Psoriatic arthritis, Axial spondyloarthritis, Juvenile idiopathic arthritis
Muscle - skin infection	Polymyositis, Dermatomyositis
Salivary and exocrine gland damage	Sjogren's syndrome
Skin and internal organ damage	Systemic lupus erythematosus, Systemic scleroderma
Vaginal Attacks (arteries and veins)	Temporal arteritis, Wegener's granulomatous antiphospholipid syndrome, Adamantiadis- Behcet, Arthritis Takayasu Kawasaki Disease
Self-inflammatory diseases	Mediterranean fever Still's disease
Crystallized arthritis	Urinary arthritis Pseudorubic arthritis

2. Degenerative type arthropathies

Osteoarthritis is the most common condition in this class and usually involves knees, hips, fingers and spine. Here, joint damage is not due to inflammation, but to the gradual destruction of articular cartilage (the "crisp" that covers the joints and allows for smooth movement), resulting in gradual joint deformity, osteophyte formation, pressure of adjacent Soft particles, etc. All this is accompanied by intense pain, deformities and joint dysfunction.

3. Diseases of extraarticular rheumatism

These conditions are related to periarticular soft molecules, such as muscles, tendons, with which the muscles adhere to the bones, the tendon sheaths, i.e. the tubular sheaths surrounding the tendons, and the serum sacs, I.e., small cysts containing a minimum amount of fluid and having as their main task the reduction of mechanical friction during muscle contraction and movement of the joints. Here, usually, pathological conditions are associated with over-stressing syndromes of the above tissues.

4. Metabolic bone diseases

This group includes osteoporosis, the most common of all, osteomalacia, Paget's disease and others. It should be noted that osteoporosis is the so-called "silent scourge" of our time, since, contrary to what is believed, it does not show symptoms until it is too late, when the first fracture, usually in the bones of the spine, Which, of course, besides intense pain, causes many other serious problems.

What are the symptoms of rheumatic diseases?

The main characteristic symptoms of these conditions are:

* Pain that may involve joints, tendons, serums, muscles, bones, waist or neck.

* Dizziness, ie difficulty in movement, especially after resting. The severity of the stiffness is also very useful in distinguishing between certain rheumatic conditions as morning stiffness is a common feature of all inflammatory rheumatic diseases and lasts longer than half an hour while the stiff stiffness after immobility , Which lasts only a few minutes, is a feature of osteoarthritis.

* Reduce movements in the joints, in the middle or in the neck.

Swelling and swelling of the joint

Inflammatory autoimmune rheumatic diseases that are usually multi-systemic (ie other non-musculoskeletal systems are also affected) may also occur:

* General symptoms, such as fever, strength and malaise.

* Extraarticular symptoms such as rashes, mouth sores, redness or eye pain (uveitis), dry eyes (feeling of strange or dust in the eyes), severe hair loss, headache, cough, shortness of breath, sores in the arms or legs etc .

How to diagnose rheumatism?

Often it is difficult, especially when joint involvement affects exacerbations and recessions or migraine (from one joint to the other) or when general and extraarticular symptoms predominate (see above). Although blood tests and imaging methods can help us a lot (and here it is worth noting the contribution of ultrasound in the imaging of joints and periarticular structures), nothing can substitute for the patient's clinical examination and a detailed history of The treating physician.

Is there a cure for rheumatic diseases?

Yes, today, thanks to advances in Rheumatology, there are great therapeutic options for treating rheumatic diseases. Rheumatology, the medical branch dealing with the study, research, diagnosis, prevention and treatment of rheumatic diseases, has made remarkable advances in the treatment of rheumatic diseases in recent years. And this has been made possible by our knowledge of the pathogenetic mechanisms of these diseases and the progress of biotechnology.

How Can We Treat Rheumatic Diseases?

The basic and necessary conditions for the treatment of rheumatic diseases are:

Timely diagnosis
Early and proper therapeutic intervention
The excellent cooperation between a patient and a doctor
The collaboration with other specialties and institutions

(Physiotherapists, occupational therapists, physiotherapists, psychologists, pediatricians, rheumatism associations, etc.)

The main goals of the treatment include:

Relieve pain and other symptoms
Improving the functionality of the joints
Preventing or inhibiting joint damage
Improving the quality of life of patients
Disease recession

The recession, which is equivalent to a cure, since the condition has stopped, does not cause pain or motor function disorders, and does not threaten the integrity of the joints or other organs affected before the onset of treatment can be maintained indefinitely, With the condition of continuous and long-term application of the treatment program under the supervision of the treating rheumatologist.

What are rheumatic diseases?

Myths and reality

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