Internal Medicine

How do you recognize rheumatism?

introduction

There are now numerous rheumatological diseases known all through certain symptom complexes distinguish. Nevertheless, it often takes years for those affected to receive the final diagnosis, as numerous other diseases that can cause similar symptoms must be ruled out beforehand.

Partly they are Symptoms the disease like that nondescript, for example fever, malaise, muscle pain that cannot immediately be concluded that there is a rheumatological disease or that investigations are aimed at. Nonetheless, one is detection as fast as possible is advantageousto one in the course inflammation-related cartilage and bone destruction and related Restriction of movement through therapy at an early stage to prevent or to slow down their progress.

Rheumatism pain

Joint pain are a common symptom of rheumatism. These mainly occur in the morning and can improve during the day. A needs-based treatment can help to avoid pain-related restrictions on movement, among other things. Many used for this purpose Painkiller also curb inflammation of the joints.

Identifying rheumatism based on pain alone is almost impossible. However, it is typical that the Pain on and around the affected and mostly also swollen joint occur as well as frequently symmetrical involvement of the joints on both sides of the body for several weeks. The complaints and the pain occur often relapsing on with sometimes week-long, symptom-free intervals. Furthermore, it comes in the context of Weather changes for many people affected to one Worsening of the pain symptoms.

Rheumatism on the knee

In rheumatic diseases there is a immunological, chronic inflammation of the synovial membranewhich in the course of a Destruction and wear and tear of the cartilage and ultimately to one arthrosis (Joint wear). In technical terms, the disease is called Rheumatoid arthritis denotes, which means as much as one Joint inflammation as a result of a rheumatic disease. If the knee joint is affected, this leads to Swelling and sometimes severe pain in this area. Both are among the distinguishing features of a rheumatic joint disease, but can also occur in other diseases of this joint.

Are suspicious of a rheumatic genesis persistent pain and swelling, Which 6 weeks or more stop. In advanced disease is the Joint wear in the X-ray or MRI recognizable. A quick imaging alternative is ultrasound, with the help of which the inflammation of the mucous membranes in the knee can be clearly shown. However, a possible destruction of bone or cartilage cannot be assessed with this.

In rheumatic diseases, the Synovial fluid (Synovia), in this case that of the knee joint characteristic composition on certain cells. There is a possibility this Examine liquid in the laboratory. For this, the affected knee is after local anesthesia dotted. It's a minor procedure with minimal risk. Also one Blood test can facilitate the detection of a rheumatic disease. Please also read the section "Blood tests for rheumatism" below.

Another typical feature of a rheumatic disease is that the affected joints, in this case around the knee stiffened in the morning are. It takes at least an hour before those affected can move their joints fully again. One above all sudden change in weather is often with one Worsening of symptoms connected, which is also indicative of a rheumatic disease.

Another distinguishing feature of rheumatic disease involving the knee joint is one Disease of other joints of the body, often the finger with similar symptoms, e.g. Pain, stiffness in the morning. An important distinguishing feature is that rheumatism affects not only one knee joint, but also the other. One speaks here of "Symmetrical involvement of the same joints in both halves of the body".

Rheumatism on the hands

A rheumatic disease of the hands manifests itself in a similar way to that of other affected joints Swelling and pain. Typical identification features and procedures for identification have already been described in more detail under the item "Rheumatism on the knee" and can also be transferred to the hands.

A Involvement of the finger joints is very characteristic for a rheumatic disease, typically not just a finger joint, but several and this symmetrically both halves of the body affected. As a result of inflammation form gnarled herd on the joints as Rheumatoid nodules and consist, among other things, of inflammatory cells. You are one of the diagnostic identifiers rheumatic diseases and are often found in other joints, especially the elbow joint.

A advanced disease often leads through the Bone destruction and the pain to one Powerlessness of hands, one limited fine motor skills and deformations of the fingers.

Rheumatism in children

Rheumatic diseases can already manifest in childhood. A temporary inflammation of the joints (arthritis) with swelling, pain and reddening of the joint can occur as a result of inflammation of the gastrointestinal or urinary tract with certain bacteria. This form is known as "reactive arthritis". An important distinguishing feature is the simultaneous occurrence of inflammation of the eyes, joints and urinary tract. However, it is not caused by the bacteria mentioned, but by the antibodies that the body has formed in response to the infection and that now also attack structures in the eyes, joints and urethra.

Read more on the subject at: reactive arthritis

Juvenile idiopathic arthritis is a chronic inflammation of the joint that manifests itself in a manner similar to that of adults, but by definition occurs before the age of 16. The cause is still unclear. A typical distinguishing feature is the relapsing course of the inflammation with intervening, symptom-free phases. As already mentioned, the identifying features and symptoms are similar to rheumatism in adulthood, such as swelling and pain in the joints and stiffness of the joints, especially in the morning. In contrast to the disease in adulthood, only one joint can be inflamed here. As a result of the pain, the children unconsciously adopt relieving postures, which can lead to shortened muscles and tendons, so-called contractures and permanent movement restrictions.

The examination of the blood for certain markers, the synovial fluid and the preparation of X-ray, CT, MRI and ultrasound images contribute significantly to the detection of the disease.The children's blood is also often examined for certain genetic markers, which, if present, also contribute to the detection and support the suspicion of idiopathic rheumatoid arthritis.

Read more on the subject at: juvenile idiopathic arthritis

Participation of the eyes

A rheumatic disease presents itself not just through joint problems, even if these problems are often the most restrictive in the beginning. Since it is a autoimmune mediated disease acts, the co-responsible antibodies can also "attack" other structures in different parts of the body and cause an inflammatory reaction. Components of the eye are very often affected.

Especially Inflammation of the anterior segment of the eye, which includes the iris, ciliary body and cornea, among others often with pain and Redness of the eye connected. A reddening longer than 48 hours persists or in the course several weeks again and again occurs should therefore be replaced by a Ophthalmologist to be clarified. This is important because there are many in the course of and with chronic inflammation Complications, such as increased intraocular pressure (green Star) or swelling of the yellow spot (place of sharpest vision) with blindness may occur.

It is almost impossible to recognize a rheumatic genesis as a cause through these symptoms alone, especially if rheumatism is not yet known. It exists no specific teststhat can be done on the eye to detect rheumatism. The attending doctor will carry out further tests to rule out, among other things, an infection with bacteria, viruses or fungi.

The inflammation in the front part of the eye, whatever the cause, can be with the help of a ophthalmic examination instrument, the slit lamp can be detected. As part of the investigation, the Iris and the yellow spot assessed in order to rule out possible complications. Also the Intraocular pressure is measured if an increase is suspected.

Frequently ignited also the Dermis of the eye as part of a rheumatic disease. This is called Scleritis and is characterized, among other things, by pain when pressure is applied to the eyes. Here, too, is dermatitis no specific identifier for rheumatism. It can also be used in the context of other diseases, such as the gout or if infections occur.

Blood test for rheumatism

In general, the blood test is a diagnostic component that makes an important contribution to the detection of a rheumatic disease. In the following, certain parameters are presented which, if changed, can indicate rheumatism. It is important that the parameters are always considered in combination and not each individually, as some are also increased or decreased in other diseases or infections, i.e. are not particularly suitable for the diagnosis of rheumatism.

ESR: ESR is the abbreviation for sedimentation rate. An increased ESR occurs, among other things, as a result of inflammatory processes. This is the case with rheumatic diseases, but also other autoimmune diseases, infections caused by bacteria / viruses or the use of certain medications. An increased ESR is therefore a non-specific parameter in the diagnosis of rheumatic joint inflammation.
C-reactive protein (CRP): C-reactive protein is one of the most important parameters for assessing acute inflammation in the body. In such cases, it is produced by the liver and is able to activate certain defense mechanisms in the body. In the case of autoimmune diseases, including rheumatoid arthritis, this is undesirable because the body attacks and destroys itself.
An increased CRP in the blood reflects the inflammatory process within the joints, but can also be increased in the context of other autoimmune diseases and, above all, in bacterial infections. Like the sedimentation rate (ESR), it is one of the non-specific blood parameters for the detection of rheumatism. The CRP value is primarily used to diagnose acute inflammation within the body without differentiating between an infectious (bacteria, viruses) or non-infectious (rheumatism, other autoimmune diseases) cause. A rough estimate of the severity of the disease is also possible using this parameter.
Rheumatoid factor: The rheumatoid factor is an antibody that is directed against the body's own antibodies in the context of an autoimmune disease. For this reason it is also referred to as "autoantibodies" (directed against the body's own components). This antibody can be detected in the blood of 70% of patients suffering from rheumatic joint inflammation. You are "rheumatoid factor positive". There is no correlation between the amount of rheumatoid factor in the blood and disease activity. A high rheumatoid factor does not mean that the disease has to be particularly bad at a given time.
If the rheumatoid factor is detected in the blood, paradoxically, this does not immediately prove that a rheumatic disease is present.
CCP antibodies: The presence of this antibody in the blood is a specific identifier for rheumatoid arthritis and correlates with the course of the disease. In contrast to the rheumatoid factor, the CCP antibody, which is also referred to as ACPA in laboratory diagnostics, is not also in the blood in other diseases, so it is used specifically for the detection and detection of rheumatism. A severity classification and conclusions about the course of the rheumatic joint disease are also possible with the help of this antibody. They can be detected 10 years before the onset of the first symptoms, such as swelling or pain in the blood.
Read more on the subject at: CCP value