Inflammatory rheumatism is an expression that includes many diseases. These diseases usually affect the joints and adjacent connective tissue, and rarely the vessels and internal organs. The two most common diseases are rheumatoid arthritis (inflammatory joint rheumatism) and ankylosing spondylitis (inflammatory spine rheumatism). Apart from these, there are diseases such as psoriatic arthritis and spondylitis (psoriasis rheumatism), Sjogren's syndrome, other spondylitis, Behçet's disease, lupus erythematosus and vasculitis, etc.
Although it is easy to diagnose some of the rheumatological diseases, it can be very challenging in some others. When diseases appear with typical findings, examination, a few blood tests and sometimes imaging tests are sufficient to make a diagnosis. But unfortunately, in some of this group of diseases, which are not rare, the findings may be very faint at first. In such cases, the patient's clinical findings are mild and laboratory and imaging tests may not yield anything initially. In such cases, some clinicians may diagnose the patient they suspect and start medication. Actually, this is not the right approach. Because rheumatic diseases are caused by a disorder in the person's immune system. In this type of patients, the faint findings may regress in some of the patients and the patient may return completely to normal. Therefore, criteria have been developed for definitive diagnosis in rheumatic diseases. If the patient does not meet these criteria, the diagnosis should not be made and medication should not be started. Otherwise, the patient may have to use medications that may have serious side effects for a long time.
Differential diagnosis of conditions such as normal rheumatisms (joint calcifications) and soft tissue rheumatisms (fibromyalgia), which can cause similar findings to inflammatory joint rheumatism, is also required. Likewise, in inflammatory spinal rheumatism (ankylosing spondylitis), pain in the spine causes symptoms similar to herniated discs and degenerative disc diseases. It is very possible to sometimes encounter confusing situations during MRI and X-ray examinations. In such cases, the clinician should evaluate the patient well and use the necessary tests for differential diagnosis, including imaging methods, if necessary.
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