John Myers
Joints hurt, muscles tear, and morning stiffness characterizes everyday life: millions of Germans suffer from rheumatoid arthritis. Medications, exercise, and the right diet alleviate the symptoms.
Doctors today summarize around 400 different diseases under the generic term “rheumatic diseases” – these include gout, lupus erythematosus, vascular diseases (vasculitis), and many more. Rheumatic diseases affect people of all ages, even children can suffer from rheumatism.
Rheumatism mostly occurs in the musculoskeletal system, but not only affects “hard” structures such as bones, joints, or cartilage, but also “soft parts” such as muscles, ligaments, or tendons. Even organs, pleura, or nerves can be affected.
Rheumatism also damages the blood vessels. Affected people can have heart attacks and strokes much earlier. If left untreated, the disease affects life expectancy.
Rheumatic diseases can be divided into four main groups:
- inflammatory rheumatic diseases
- Wear-related (degenerative) joint and spinal diseases
- soft tissue rheumatism
- Metabolic diseases with rheumatic complaints (pararheumatic diseases)
Rheumatoid arthritis is one of the most common rheumatic diseases
The most common is rheumatoid arthritis (formerly known as chronic polyarthritis, cP), a progressive joint inflammation in which the inner lining of joints, tendon sheaths, or bursae is attacked. An estimated 800,000 people in Germany suffer from it, including almost three times as many women as men. The disease usually begins in the second half of life. In Germany, however, around 15,000 children are also affected. Rheumatism has not yet been cured, but it can be treated easily: If the disease is detected early enough, the inflammation can be stopped or slowed down.
Symptoms: Pain and morning stiffness in the joints
Rheumatoid arthritis sometimes manifests itself initially in a non-specific manner with exhaustion, and rarely also fever. The first concrete signs are warm, swollen, or reddened joints. Typically, the joints are affected symmetrically, for example, both thumbs. The disease often begins in the metatarsophalangeal joints of the fingers and toes, which hurt at night and feel stiff for over an hour in the morning.
The disease can be slow and mild. In some – often older – patients, however, the joints deform very quickly, stiffen and cause severe pain. The patients can then no longer cope with their everyday life without help.
Rheumatism or arthrosis?
The diagnosis is not always easy to make. It is relatively easy for young patients because they usually do not show any signs of wear and tear on their joints. In older patients suffering from osteoarthritis, it becomes increasingly difficult to tell the difference. And both diseases can be present at the same time.
Diagnosis with a blood test, ultrasound, and MRI
If several joints are inflamed for more than six weeks, there is a suspicion of rheumatoid arthritis. The doctor will take blood: increased blood sedimentation and increased CRP (C-reactive protein) generally indicate inflammation. If the so-called rheumatoid factor and certain antibodies can also be detected, then the diagnosis of rheumatoid arthritis is considered certain. However, there is also a “seronegative” form of this disease, in which rheumatoid factor and antibodies are absent. The inflamed, thickened synovial membrane can be seen on ultrasound.
Imaging procedures such as X-rays or magnetic resonance imaging (MRI) can show whether there is already damage to bones or cartilage.
