How does a rheumatologist diagnose the disease?
*A detailed clinical history, examination of the patient, laboratory evaluations and imaging are used to diagnose the disease. The most basic of these is the history and physical examination.
*Laboratory tests may differ according to the type of disease the physician is considering. For example, autoantibodies such as ANA and its subgroups may be requested in people with connective tissue disease, while genetic tests such as HLA-B27 may be requested in suspected spondyloarthritis group disease. Similarly, genetic diagnostic tests can be used in autoinflammatory diseases such as familial Mediterranean fever (FMF). In addition to making a diagnosis, laboratory tests are also essential in evaluating the prevalence, activity (severity) of the disease and the side effects of the drugs used. While some patients can be diagnosed with a direct radiography (X-ray), further tests such as tomography, MR or even PET may be required in others. Bone mineral density measurement (BMD) is another frequently requested imaging in terms of accompanying bone resorption (osteoporosis).
*Invasive interventional methods (such as angiography) and biopsy sampling may be needed in some cases.
SYMPTOMS
What are the symptoms of rheumatic diseases?
Joint Pain
The most important finding of rheumatic diseases is the complaint of pain. Pain can be in areas such as joints, muscles, spine. Sometimes symptoms occur in more than one region, while a single region is affected. Some features of rheumatic pain are:
The pain occurs during rest and is relieved by movement
It wakes up from sleep at night and causes the need to move
It is intense when you get up in the morning and tends to decrease during the day. .
Joint Stiffness or Stiffness
In addition to pain, stiffness in the joints and spine is also an important finding. In this respect, when the patient gets up in the morning, he has difficulty in moving his joints, he has difficulty in bending and getting up, and this stiffness is partially relieved with movement. This condition, also known as morning stiffness, is a cure for inflammatory rheumatism for half an hour or more. It takes time and may take up to 3-4 hours in some patients.
Joint Swelling
Swellings in the joint areas accompanying pain. These swellings are persistent and usually persist for six weeks or more. Small joints, such as the joints of the hands and feet, as well as large joints such as the knee and ankle can be affected.
Spine Pain
The presence of spinal pain is also a common finding during the course of rheumatic disease. Inflammatory spine diseases should be considered in spinal pain accompanied by spinal stiffness that decreases with movement, increases with rest or rest and lasts for at least half an hour. Findings such as swelling are also warning signs for rheumatic diseases. The best example of enthesitis is pain in the Achilles tendon (heel) and soles of the feet. The patient has difficulty in standing on his feet, especially when he is still (the most obvious is when he gets up in the morning), and relief is observed over time.
Other Findings
Various organ systems may be affected in the course of rheumatic diseases. The eye is an important target organ in this respect. In the presence of dry eye, eye uveitis and scleritis, the physician may need to make a differential diagnosis.
The incidence of inflammatory rheumatism has increased in individuals with psoriasis or in people with family members with psoriasis, and rheumatic diseases should be considered in unexplained spine and joint pains in these patients.
Familial Mediterranean fever should be investigated in patients with Behçet's disease, unexplained fever, recurrent abdominal or chest pain, or pericardial inflammation in patients with wounds in the mouth and genital area and these findings recur.
Rayno's disease can be considered in people with cold-triggered and sequential findings such as whitening, bruising and redness, antiphospholipid syndrome in pregnant women with unexplained and recurrent miscarriages and recurrent coagulation disorders, butterfly disease (lupus) in people with sun-triggered rash on the skin and painful swelling in the joint.
As a result, rheumatic disease symptoms are very diverse and f May cause effects on different organs and tissues. For this reason, physician examination and differential diagnosis are required in unexplained joint, spine, hip pain and organ system involvement.
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