Arthritis and Rheumatism

Arthritis and Rheumatism Overview

An estimated 43 million people in the United States have arthritis or other rheumatic conditions. By the year 2020, this number is expected to reach 60 million. Rheumatic diseases are the leading cause of disability among adults age 65 and older.

Rheumatic diseases are characterized by inflammation (signs are redness and/or heat, swelling, and pain) and loss of function of one or more connecting or supporting structures of the body. They especially affect joints, tendons, ligaments, bones, and muscles. Common symptoms are pain, swelling, and stiffness. Some rheumatic diseases can also involve internal organs. There are more than 100 rheumatic diseases.

What the Term "Arthritis" Actually Means

Many people use the word "arthritis" to refer to all rheumatic diseases. One possible reason is that many of the rheumatic diseases are associated with joint pain, even if the primary disease is not an arthritis. However, the word arthritis literally means joint inflammation. The many different kinds of arthritis comprise just a portion of the rheumatic diseases. Some rheumatic diseases are described as connective tissue diseases because they affect the supporting framework of the body and its internal organs. Others are known as autoimmune diseases because they occur when the immune system, which normally protects the body from infection and disease, harms the body's own healthy tissues. Whereas clinically, arthritis and rheumatic disease are not necessarily the same entity, throughout this fact sheet the terms "arthritis" and "rheumatic diseases" are sometimes used interchangeably.

Risk Factors

Scientists are studying risk factors that increase the likelihood of developing a rheumatic disease. Some of these factors have been identified.

In osteoarthritis, inherited cartilage weakness or excessive stress on the joint from repeated injury may play a role.
In lupus, rheumatoid arthritis, and scleroderma, the combination of genetic factors that determine susceptibility and environmental triggers are believed to be important.
Family history also plays a role in some diseases such as gout and ankylosing spondylitis.
Gender is another factor in some rheumatic diseases. Lupus, rheumatoid arthritis, scleroderma, and fibromyalgia are more common among women. This indicates that hormones or other male-female differences may play a role in the development of these conditions.

Rheumatic diseases affect people of all races and ages. Some rheumatic conditions are more common among certain populations. For example:

Rheumatoid arthritis occurs two to three times more often in women than in men.
Scleroderma is more common in women than in men.
Nine out of 10 people who have lupus are women.
Nine out of 10 people who have fibromyalgia are women.
Gout is more common in men than in women.
Lupus is three times more common in African American women than in Caucasian women.
Ankylosing spondylitis is more common in men than in women.

Symptoms

Common Symptoms of Arthritis

Swelling in one or more joints
Stiffness around the joints that lasts for at least 1 hour in the early morning
Constant or recurring pain or tenderness in a joint
Difficulty using or moving a joint normally
Warmth and redness in a joint

Diagnosis

Diagnosing rheumatic diseases can be difficult because some symptoms and signs are common to many different diseases. A general practitioner or family doctor may be able to evaluate a patient or refer him or her to a rheumatologist (a doctor who specializes in treating arthritis and other rheumatic diseases).

The doctor will review the patient's medical history, conduct a physical examination, and obtain laboratory tests and x rays or other imaging tests. The doctor may need to see the patient more than once to make an accurate diagnosis.

Treatment

Treatments for rheumatic diseases vary depending on the disease, the severity of disease manifestations, and the patient. Therapies include rest and relaxation, exercise, proper diet, medication, and instruction about the proper use of joints and ways to conserve energy. Other treatments include the use of pain relief methods and assistive devices, such as splints or braces. In severe cases, surgery may be necessary. Treatment plans usually combine several types of treatment. The doctor and the patient work together to develop a treatment plan that helps the patient maintain or improve his or her lifestyle.

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases - Questions and Answers About Arthritis and Rheumatic Diseases

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Last Reviewed: Jun 11, 2009

Raymond Hong, MD, MBA, FACR
Assistant Professor
Division of Rheumatology
University Hospitals
School of Medicine
Case Western Reserve University

Arthritis and Rheumatism