Rheumatism

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Rheumatism
Other namesRheumatic disease
Specialty Rheumatology

Rheumatism or rheumatic disorder is an umbrella term for conditions causing chronic, often intermittent pain affecting the joints and/or connective tissue. The study of, and therapeutic interventions in, such disorders is called rheumatology. [1] The term "rheumatism", however, does not designate any specific disorder, but covers at least 200 different conditions. [2]

Chronic pain is pain that lasts a long time. In medicine, the distinction between acute and chronic pain is sometimes determined by an arbitrary interval of time since onset; the two most commonly used markers being 3 months and 6 months since onset, though some theorists and researchers have placed the transition from acute to chronic pain at 12 months. Others apply acute to pain that lasts less than 30 days, chronic to pain of more than six months duration, and subacute to pain that lasts from one to six months. A popular alternative definition of chronic pain, involving no arbitrarily fixed duration, is "pain that extends beyond the expected period of healing". Epidemiological studies have found that 10.1% to 55.2% of people in various countries have chronic pain.

Joint location at which two or more bones make contact

A joint or articulation is the connection made between bones in the body which link the skeletal system into a functional whole. They are constructed to allow for different degrees and types of movement. Some joints, such as the knee, elbow, and shoulder, are self-lubricating, almost frictionless, and are able to withstand compression and maintain heavy loads while still executing smooth and precise movements. Other joints such as sutures between the bones of the skull permit very little movement in order to protect the brain and the sense organs. The connection between a tooth and the jawbone is also called a joint, and is described as a fibrous joint known as a gomphosis. Joints are classified both structurally and functionally.

Connective tissue type of biological tissue

Connective tissue (CT) is one of the four basic types of animal tissue, along with epithelial tissue, muscle tissue, and nervous tissue. It develops from the mesoderm. Connective tissue is found in between other tissues everywhere in the body, including the nervous system. In the central nervous system, the three outer membranes that envelop the brain and spinal cord are composed of connective tissue. They support and protect the body. All connective tissue consists of three main components: fibers, ground substance and cells. Not all authorities include blood or lymph as connective tissue because they lack the fiber component. All are immersed in the body water.

Contents

Sources dealing with rheumatism tend to focus on arthritis,[ citation needed ] but "rheumatism" may also refer to other conditions causing chronic pain, grouped as "non-articular rheumatism", also known as "regional pain syndrome" or "soft tissue rheumatism". [3] The term "Rheumatic Diseases" is used in MeSH to refer to connective tissue disorders. [4]

Arthritis form of joint disorder that involves inflammation of one or more joints

Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In some types other organs are also affected. Onset can be gradual or sudden.

Medical Subject Headings (MeSH) is a comprehensive controlled vocabulary for the purpose of indexing journal articles and books in the life sciences. It serves as a thesaurus that facilitates searching. Created and updated by the United States National Library of Medicine (NLM), it is used by the MEDLINE/PubMed article database and by NLM's catalog of book holdings. MeSH is also used by ClinicalTrials.gov registry to classify which diseases are studied by trials registered in ClinicalTrials.

Types

Many rheumatic disorders of chronic, intermittent joint pain have historically been caused by infectious diseases. Their etiology was unknown until the 20th century and not treatable, like Lyme disease (in the Northern and Northeastern US), coccidiomycosis or Valley fever (in the Western US), and Chikungunya in India and a myriad of causes for postinfectious arthritis also known as reactive arthritis like, for example, the once very common rheumatic fever after Group A Streptococcus infection up to the rare Whipple's disease.

Lyme disease infectious disease caused by Borrelia bacteria, spread by ticks

Lyme disease, also known as Lyme borreliosis, is an infectious disease caused by a bacterium named Borrelia spread by ticks. The most common sign of infection is an expanding area of redness on the skin, known as erythema migrans, that appears at the site of the tick bite about a week after it occurred. The rash is typically neither itchy nor painful. Approximately 70–80% of infected people develop a rash. Other early symptoms may include fever, headache and tiredness. If untreated, symptoms may include loss of the ability to move one or both sides of the face, joint pains, severe headaches with neck stiffness, or heart palpitations, among others. Months to years later, repeated episodes of joint pain and swelling may occur. Occasionally, people develop shooting pains or tingling in their arms and legs. Despite appropriate treatment, about 10 to 20% of people develop joint pains, memory problems, and tiredness for at least six months.

Chikungunya Infection caused by the chikungunya virus

Chikungunya is an infection caused by the chikungunya virus (CHIKV). Symptoms include fever and joint pain. These typically occur two to twelve days after exposure. Other symptoms may include headache, muscle pain, joint swelling, and a rash. Symptoms usually improve within a week; however, occasionally the joint pain may last for months. The risk of death is around 1 in 1,000. The very young, old, and those with other health problems are at risk of more severe disease.

Reactive arthritis arthritis that is an autoimmune disease which develops due to an infection located elsewhere in the body

Reactive arthritis, formerly known as Reiter's syndrome, is a form of inflammatory arthritis that develops in response to an infection in another part of the body (cross-reactivity). Coming into contact with bacteria and developing an infection can trigger the disease. By the time the patient presents with symptoms, often the "trigger" infection has been cured or is in remission in chronic cases, thus making determination of the initial cause difficult.

Major rheumatic disorders currently recognized [ according to whom? ] include

Back pain type of pain felt in the back

Back pain is pain felt in the back. The back is divided into middle back pain (thoracic), lower back pain (lumbar) or coccydynia based on the segment affected. Neck pain (cervical), which is considered an independent entity, can involve similar processes. The lumbar area is the most common area for pain, as it supports most of the weight in the upper body. Episodes of back pain may be acute, sub-acute, or chronic depending on the duration. The pain may be characterized as a dull ache, shooting or piercing pain, or a burning sensation. Discomfort can radiate into the arms and hands as well as the legs or feet, and may include numbness, or weakness in the legs and arms.

Bursitis human disease

Bursitis is the inflammation of one or more bursae of synovial fluid in the body. They are lined with a synovial membrane that secretes a lubricating synovial fluid. There are more than 150 bursae in the human body. The bursae rest at the points where internal functionaries, such as muscles and tendons, slide across bone. Healthy bursae create a smooth, almost frictionless functional gliding surface making normal movement painless. When bursitis occurs, however, movement relying on the inflamed bursa becomes difficult and painful. Moreover, movement of tendons and muscles over the inflamed bursa aggravates its inflammation, perpetuating the problem. Muscle can also be stiffened.

Capsulitis

In anatomy, capsulitis is inflammation of a capsule.

Although these disorders probably have little in common in terms of their epidemiology, they do share three characteristics: they cause chronic, often intermittent pain, they are difficult to treat and are collectively very common.

Epidemiology is the study and analysis of the distribution and determinants of health and disease conditions in defined populations.

Pain type of unpleasant feeling

Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain's widely used definition defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage"; however, due to it being a complex, subjective phenomenon, defining pain has been a challenge. In medical diagnosis, pain is regarded as a symptom of an underlying condition.

Rheumatic diseases caused by autoimmunity include:

Treatment

A vast number of traditional herbal remedies have been recommended for "rheumatism". [8] Modern medicine, both conventional and alternative, recognises that the different rheumatic disorders have different causes (and several of them have multiple causes) and require different kinds of treatment.

Nevertheless, initial therapy of the major rheumatological diseases is with analgesics, such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs), members of which are ibuprofen and naproxen. Often, stronger analgesics are required.

The ancient Greeks recorded that bee venom had some beneficial effects on some types of rheumatism. Bee and ant stings were known as a folk remedy in the late 19th century, and at least one physician developed a treatment consisting of repeated formic acid injections. [9] Certain Amazonian tribes, including the Zo'é, use fire ant stings as a remedy for aches and pains. [10]

Cod liver oil has also been used as a remedy.

Neem Tree Oil according to East Indian cultures has also been used as a remedy. [11]

History

The term rheumatism stems from the Late Latin rheumatismus, ultimately from Greek ῥευματίζομαι "to suffer from a flux", with rheum meaning bodily fluids, i.e. any discharge of blood or bodily fluid.

Before the 17th century, the joint pain which was thought to be caused by viscous humours seeping into the joints was always referred to as gout, a word adopted in Middle English from Old French gote "a drop; the gout, rheumatism", not to be confused with the present day specific term referring to excess of uric acid.[ citation needed ]

The English term rheumatism in the current sense has been in use since the late 17th century, as it was believed that chronic joint pain was caused by excessive flow of rheum which means bodily fluids into a joint. [12]

See also

Related Research Articles

Rheumatoid arthritis An arthritis that is an autoimmune disease which attacks healthy cells and tissue located in joint.

Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are involved, with the same joints typically involved on both sides of the body. The disease may also affect other parts of the body. This may result in a low red blood cell count, inflammation around the lungs, and inflammation around the heart. Fever and low energy may also be present. Often, symptoms come on gradually over weeks to months.

Gout Medical condition that results in recurrent pain and swelling of joints

Gout is a form of inflammatory arthritis characterized by recurrent attacks of a red, tender, hot, and swollen joint. Pain typically comes on rapidly, reaching maximal intensity in less than twelve hours. The joint at the base of the big toe is affected in about half of cases. It may also result in tophi, kidney stones, or urate nephropathy.

Rheumatology is a branch of medicine devoted to the diagnosis and therapy of rheumatic diseases. Physicians who have undergone formal training in rheumatology are called rheumatologists. Rheumatologists deal mainly with immune-mediated disorders of the musculoskeletal system, soft tissues, autoimmune diseases, vasculitides, and heritable connective tissue disorders.

Arthralgia literally means joint pain. Specifically, arthralgia is a symptom of injury, infection, illness, or an allergic reaction to medication.

Septic arthritis arthritis that involves infection by a pathogen located in joint

Septic arthritis, also known as joint infection or infectious arthritis, is the invasion of a joint by an infectious agent resulting in joint inflammation. Symptoms typically include redness, heat, and pain in a single joint associated with a decreased ability to move the joint. Onset is usually rapid. Other symptoms may include fever, weakness, and headache. Occasionally, more than one joint may be involved.

Juvenile idiopathic arthritis rheumatoid arthritis that involves an autoimmune disease onset in children under 16 which attacks the healthy cells and tissue of located in joint

Juvenile idiopathic arthritis (JIA), also known as juvenile rheumatoid arthritis (JRA), is the most common form of arthritis in children and adolescents. Juvenile, in this context, refers to an onset before age 16, while idiopathic refers to a condition with no defined cause, and arthritis is the inflammation of the synovium of a joint.

Synovial fluid fluid found in the cavities of synovial joints

Synovial fluid, also called synovia,[help 1] is a viscous, non-Newtonian fluid found in the cavities of synovial joints. With its egg white–like consistency, the principal role of synovial fluid is to reduce friction between the articular cartilage of synovial joints during movement. Synovial fluid is a small component of the transcellular fluid component of extracellular fluid.

Bone pain is pain coming from a bone. It occurs as a result of a wide range of diseases and/or physical conditions and may severely impair the quality of life.

Calcium pyrophosphate dihydrate crystal deposition disease arthritis that has material basis in the accumulation of salt crystals located in joint

Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, also known as pseudogout and pyrophosphate arthropathy is a rheumatologic disease which is thought to be secondary to abnormal accumulation of calcium pyrophosphate dihydrate crystals within joint soft tissues. The knee joint is most commonly affected.

Relapsing polychondritis Human disease

Relapsing polychondritis is a multi-systemic condition characterized by repeated episodes of inflammation and deterioration of cartilage. The often painful disease can cause joint deformity and be life-threatening if the respiratory tract, heart valves, or blood vessels are affected. The exact mechanism is poorly understood, but it is thought to be related to an immune-mediated attack on particular proteins that are abundant in cartilage.

Felty's syndrome, also called Felty syndrome, (FS) is rare autoimmune disease characterized by the triad of rheumatoid arthritis, enlargement of the spleen and too few neutrophils in the blood. The condition is more common in those aged 50–70 years, specifically more prevalent in females than males, and more so in Caucasians than those of African descent. It is a deforming disease that causes many complications for the individual.

Mixed connective tissue disease, commonly abbreviated as MCTD, is an autoimmune disease characterized by the presence of high blood levels of a specific autoantibody, now called anti-U1 ribonucleoprotein (RNP). The idea behind the "mixed" disease is that this specific autoantibody is also present in other autoimmune diseases such as systemic lupus erythematosus, polymyositis, scleroderma, etc. It was characterized in 1972, and the term was introduced by Leroy in 1980.

Palindromic rheumatism (PR) consists of sudden and rapidly developing attacks of arthritis. There is acute pain, redness, swelling, and disability of one or multiple joints. The interval between recurrent palindromic attacks and the length of an attack is extremely variable from few hours to days. Attacks may become more frequent with time but there is no joint damage after attacks. It is thought to be an autoimmune disease, possibly an abortive form of rheumatoid arthritis.

Alfred Baring Garrod British doctor

Sir Alfred Baring Garrod was an English physician.

Michael D. Lockshin, M.D., is an American professor and medical researcher. He is a researcher of autoimmune diseases, with focus on antiphospholipid syndrome and lupus. He is currently Professor of Medicine and Obstetrics-Gynecology at the Weill-Cornell University Medical College in New York City. In addition, he is Director, Barbara Volcker Center for Women and Rheumatic Disease and Co-Director, Mary Kirkland Center for Lupus Research both at the Hospital for Special Surgery

Jaccoud arthropathy (JA), Jaccoud deformity or Jaccoud's arthopathy is a chronic non-erosive reversible joint disorder that may occur after repeated bouts of arthritis. It is caused by inflammation of the joint capsule and subsequent fibrotic retraction, causing ulnar deviation of the fingers, through metacarpophalangeal joint (MCP) subluxation, primarily of the ring and little-finger. Joints in the feet, knees and shoulders may also get affected. It is commonly associated with systemic lupus erythematosus (SLE), and occurs in roughly 5% of all cases.

Intermittent hydrarthrosis

Intermittent hydrarthrosis (IH), also known as periodic synoviosis, periodic benign synovitis, or periodic hydrarthritis, is a chronic condition of unknown cause characterized by recurring, temporary episodes of fluid accumulation (effusion) in the knee. While the knee is mainly involved, occasionally other joints such as the elbow or ankle can additionally be affected. Fluid accumulation in the joint can be extensive causing discomfort and impairing movement, although affected joints are not usually very painful. While the condition is chronic, it does not appear to progress to more destructive damage of the joint. It seems to affect slightly more women than men.

References

  1. " rheumatism " at Dorland's Medical Dictionary
  2. N. Altorok, S. Nada, V. Nagaraja, B. Kahaleh (2016). Medical Epigenetics, Chapter 17 - Epigenetics in Bone and Joint Disorders. Boston: Academic Press. pp. 295–314. ISBN   978-0-12-803239-8.CS1 maint: Multiple names: authors list (link)
  3. "eMedicine - Nonarticular Rheumatism/Regional Pain Syndrome : Article by Daniel Muller".
  4. Rheumatic+Diseases at the US National Library of Medicine Medical Subject Headings (MeSH)
  5. Salvador G, Gomez A, Vinas O, et al. (August 2003). "Prevalence and clinical significance of anti-cyclic citrullinated peptide and antikeratin antibodies in palindromic rheumatism. An abortive form of rheumatoid arthritis?". Rheumatology (Oxford). 42 (8): 972–5. doi:10.1093/rheumatology/keg268. PMID   12730510.
  6. Puéchal, X; Terrier, B; Mouthon, L; Costedoat-Chalumeau, N; Guillevin, L; Le Jeunne, C (March 2014). "Relapsing polychondritis". Joint, Bone, Spine : Revue du Rhumatisme. 81 (2): 118–24. doi:10.1016/j.jbspin.2014.01.001. PMID   24556284.
  7. Janeways: "immunology"
  8. Vogl, S; Picker, P; Mihaly-Bison, J; Fakhrudin, N; Atanasov, AG; Heiss, EH; Wawrosch, C; Reznicek, G; Dirsch, VM; Saukel, J; Kopp, B (2013). "Ethnopharmacological in vitro studies on Austria's folk medicine--an unexplored lore in vitro anti-inflammatory activities of 71 Austrian traditional herbal drugs". Journal of Ethnopharmacology . 149 (3): 750–71. doi:10.1016/j.jep.2013.06.007. PMC   3791396 . PMID   23770053.
  9. "British Bee Journal & Bee-keepers Adviser". 13 August 2018 via Google Books.
  10. Isolated: The Zo'é tribe (documentary)
  11. Isha Foundation
  12. Barnhart, Robert K., ed., Barnhart Dictionary of Etymology, H.W. Wilson Co., 1988. Quote "The meaning of a disease of the joints is first recorded in 1688, because rheumatism was thought to be caused by an excessive flow of rheum into a joint thereby stretching ligaments"

Further reading

Classification
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