Rheumatic diseases include a wide range of diseases that occur with a predominant lesion of the joints and periarticular tissues. A special group among them are systemic diseases – collagenoses and vasculitis, characterized by autoimmune genesis, local or diffuse damage to connective tissue. Rheumatic diseases are studied by a specialized section of internal diseases – rheumatology. The course is often accompanied by multiple organ damage with the development of cardiac, renal, pulmonary, cerebral syndromes, the treatment of which involves not only rheumatologists, but also narrow specialists – cardiologists, nephrologists, pulmonologists, neurologists. These diseases have a progressive course, disrupt the functional activity of the patient and can lead to disability.

Rheumatic diseases such as gout and arthritis have been known since the time of the ancient Greek physician Hippocrates. In the II century AD, the Roman philosopher and surgeon Galen introduced the term “rheumatism”, which denoted a variety of diseases of the musculoskeletal system. It was only in the XVIII – XIX centuries that descriptions of individual rheumatic diseases began to appear. Currently, according to the American Rheumatology Society, there are over 200 types of rheumatic pathology.

Depending on the predominant lesion, the whole variety can be divided into three large groups: joint diseases, systemic vasculitis and diffuse connective tissue diseases. Joint diseases are mainly represented by arthritis (rheumatoid, psoriatic, gouty, reactive, infectious, etc.), as well as osteoarthritis, ankylosing spondylitis, of the periarticular soft tissues. The group of systemic vasculitis includes hemorrhagic vasculitis, nodular periarteritis, Wegener’s granulomatosis, Horton’s disease, Goodpasture syndrome, Takayasu’s disease, obliterating thrombangiitis. Diffuse connective tissue diseases, or systemic diseases, are represented by systemic lupus erythematosus, scleroderma, dermatomyositis, Sjogren’s disease, Sharpe syndrome, etc. Separately in the classification is rheumatism, in which there is a simultaneous rheumatic lesion of the joints, connective tissue and blood vessels.

Currently, the etiology is considered from the perspective of a multifactorial concept, according to which their development is explained by the interaction of genetic, environmental and endocrine factors. At the same time, the genetic factor acts as a predisposing factor, and the external and endocrine factors act as producing, triggering moments. The most frequent provoking factors are infections caused by Epstein-Barr viruses, cytomegaly, herpes simplex, picornaviruses, etc.; intoxication, stress, insolation, hypothermia, trauma, vaccination; pregnancy, abortions. The unifying links of pathogenesis for all rheumatic diseases are a violation of immune homeostasis and the development of a severe immuno-inflammatory process in connective tissue, microcirculatory bed and joints.

Rheumatic diseases occur among patients of various age groups, including among children and adolescents (for example, arthritis in children, rheumatism in children, juvenile rheumatoid arthritis, connective tissue dysplasia, etc.). Nevertheless, the peak incidence falls on the mature age – from 45 years and older. Some rheumatic diseases develop more often in persons of a certain gender: for example, systemic diseases, rheumatoid arthritis, rheumatic polymyalgia are more characteristic of women, but gout, psoriatic arthritis, ankylosing spondylitis usually affect men.

Clinical manifestations of rheumatic diseases are extremely diverse and changeable, however, it is possible to identify certain symptomatic markers, in the presence of which you should immediately consult a rheumatologist. The main ones include: prolonged causeless fever, arthralgia, swelling and changes in the configuration of joints, morning stiffness of movements, muscle pain, skin rash, lymphadenitis, a tendency to thrombosis or hemorrhage, multiple lesions of internal organs. Systemic diseases are often disguised as diseases of the skin, blood, musculoskeletal system, oncopathology, which require differentiation in the first place.

Significant progress has been made in the diagnosis and treatment of rheumatic diseases in recent years, due to the development of genetics, immunology, biochemistry, microbiology, pharmacology, etc. The basis for making a correct diagnosis is immunological studies that allow to identify antibodies corresponding to a certain nosology. Radiography, ultrasound, CT, MRI, scintigraphy, arthroscopy, and biopsy are also widely used for the diagnosis of rheumatic diseases.

Unfortunately, to date, a complete cure of rheumatic diseases is impossible. Nevertheless, modern medicine in most cases is able to help alleviate the course of the disease, prolong remission, avoid disabling outcomes and severe complications. Treatment of rheumatic diseases is a long, sometimes lifelong process and consists of drug therapy, non-drug methods, orthopedic treatment and rehabilitation. The basis of the therapy of most rheumatic diseases are basic anti-inflammatory drugs, glucocorticosteroids and biological drugs. An essential role in complex therapy is assigned to extracorporeal hemocorrection – plasmapheresis, hemosorption, cytapheresis, plasmosorption, etc. Such non-drug methods of treatment of rheumatic diseases as physiotherapy, balneotherapy, physical therapy, acupuncture, kinesiotherapy, can significantly improve the functional status of patients. Orthopedic treatment (orthotics, surgical correction of joint function, endoprosthetics) is indicated mainly in the late period of rheumopathology to improve the quality of life of patients.

Prevention of rheumatic diseases is of a non-specific nature. To prevent them, it is important to avoid provoking factors (stress, infections, other loads on the body), pay sufficient attention to physical activity and taking care of your health, exclude bad habits. The rapid development of medical technologies allows us to hope for a speedy resolution of unclear issues concerning the occurrence and course of rheumatic diseases.

On the pages of our medical reference book, rheumatic and systemic diseases are separated into an independent section. Here you can get acquainted with the main diseases of the rheumatic profile, the causes of their occurrence, symptoms, advanced diagnostic methods, modern views on treatment.

Buerger’s Disease

Buerger’s disease is a systemic chronic process with a predominant occlusive lesion of peripheral small and medium arteries and veins. The course of Buerger’s disease is undulating, the clinic is characterized by ischemic lesions of the lower extremities – fatigue and numbness in the legs, paresthesia, pain, convulsions, trophic disorders (foot ulcers, necrosis, gangrene). Diagnostics includes immunological,…

Microscopic Polyangiitis

Microscopic polyangiitis is a generalized necrotizing vasculitis that occurs with a predominant lesion of small vessels (capillaries, arterioles, venules) of the lungs, kidneys and skin. With microscopic polyangiitis, cough, shortness of breath, chest pain, pulmonary bleeding, rapidly progressive glomerulonephritis, renal failure, cutaneous petechial rashes, arthralgia may be noted. Laboratory confirmation of microscopic polyangiitis is the…

Medicinal Lupus

Medicinal lupus is a reversible lupus–like syndrome caused by taking medications. Clinical manifestations of medicinal lupus are similar to SLE and include fever, arthralgia, myalgia, polyarthritis, pleurisy, pneumonitis, hepatomegaly, glomerulonephritis. The diagnosis is based on characteristic laboratory criteria (determination of antinuclear factor, antinuclear antibodies, LE cells in the blood) and the relationship of symptoms with…

Leukocytoclastic Vasculitis

Leukocytoclastic vasculitis is a chronic disease characterized by inflammation of small vessels of the skin. By its nature, it often has a secondary nature, develops against the background of rheumatological diseases, viral infections, malignant neoplasms. In the primary form, the lesion is isolated, the internal organs remain intact. Clinically, the disease is manifested by various…

Cryoglobulinemia

Cryoglobulinemia is a syndrome caused by the presence of precipitate proteins (cryoglobulins) in the blood serum, capable of precipitation at temperatures below 37 ° C. Manifestations of cryoglobulinemia may include hemorrhagic rash, Raynaud’s syndrome, arthralgia, peripheral polyneuropathy, hepatosplenomegaly, glomerulonephritis and renal failure. Diagnostic tests of cryoglobulinemia are blood tests for serum cryoglobulin, RF, anti-HCV, etc.;…

Collagenosis

Collagenosis are a group of diseases united by the same type of functional and morphological changes on the part of connective tissue (mainly collagen–containing fibers). A characteristic manifestation of collagenosis is a progressive course, involvement in the pathological process of various internal organs, blood vessels, skin, musculoskeletal systems. Diagnosis is based on multiple organ lesions,…

Infectious Arthritis

Infectious arthritis is an inflammatory joint disease of bacterial, viral, parasitic or fungal etiology. Disease can affect various joints and, in addition to local manifestations (swelling, hyperemia, soreness, restriction of movement in the joint), is accompanied by pronounced general symptoms (fever, chills, intoxication syndrome). The diagnosis of infectious arthritis is based on the data of…

Intermittent Hydrarthrosis

Intermittent hydrarthrosis is a chronic, constantly recurring disease, manifested by acute attacks of hyperproduction of synovial fluid with an increase in joint volume, discomfort and stiffness in it. It is characterized by the defeat of large joints, most often the knee. Diagnosis includes examination of blood and synovial fluid, ultrasound and radiography of the joint,…

Discoid Lupus Erythematosus

Discoid lupus erythematosus is a chronic inflammatory autoimmune skin disease that develops against the background of photosensitization (hypersensitivity to light). Clinical manifestations include erythema, scarring of the skin, follicular hyperkeratosis, hair loss, nail damage. The diagnosis is made on the basis of symptoms, anamnestic data, the presence of lupus cells in the blood, immunological tests…

Deforming Osteoarthritis

Deforming osteoarthritis is a progressive dystrophic change in bone joints with primary damage to cartilage tissues and subsequent degeneration of the entire complex of the bone and joint apparatus. Disease is characterized by arthralgia, functional insufficiency of the joints and pronounced changes in their shape. Pharmacotherapy of deforming osteoarthritis is aimed at slowing the progression…