Rheumatic disease Rheumatic disease is not a specific disease, but a group of chronic diseases that affect the bones, joints, surrounding soft tissues (such as muscles, tendons, synovium, bursae, ligaments, cartilage, etc.), and other related tissues and organs. Rheumatic diseases can be caused by various factors including infectious, immune-mediated, metabolic, endocrine, degenerative, genetic, neoplastic, etc. They have a certain disability rate and most commonly affect the joints, blood vessels, heart, kidneys, etc., posing a threat to health and also imposing a heavy economic burden on society and families.

Rheumatic diseases are not a specific disease, but rather a group of chronic conditions that affect the bones, joints, and surrounding soft tissues (such as muscles, tendons, synovium, bursae, ligaments, cartilage, etc.) as well as other related organs. Rheumatic diseases can be caused by various factors including infectious, immune-related, metabolic, endocrine, degenerative, genetic, and neoplastic causes. They have a certain degree of disability and most commonly affect the joints, blood vessels, heart, kidneys, etc., posing a significant economic burden on both society and families.

The causes and mechanisms of rheumatic diseases are complex and diverse, and there is no perfect classification to date. Currently, the widely used classification method in clinical practice is the one established by the American Rheumatism Association (ARA) in 1983. Rheumatic diseases can be categorized into 10 classes, encompassing hundreds of diseases. These classes include:

Spinal Joint Diseases

Including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, enteropathic arthritis, undifferentiated spondyloarthropathy, etc.

Degenerative Changes

Such as primary osteoarthritis, secondary osteoarthritis, etc.

Rheumatic Diseases Related to Metabolism and Endocrine System

Gout, pseudogout, Marfan syndrome, immunodeficiency diseases, etc.

Rheumatic Diseases Related to Infection

Reactive arthritis, rheumatic fever, etc.

Rheumatic Diseases Related to Tumors

Including primary (such as synovial sarcoma, synovial chondrosarcoma, etc.) and secondary tumors (such as multiple myeloma, metastatic tumors, etc.)

Neurovascular Diseases

Neurogenic arthropathy, compressive neuropathies, reflex sympathetic dystrophy, etc.

Bone and Cartilage Diseases

Including osteoporosis, osteomalacia, hypertrophic osteoarthropathy, etc.

Non-Articular Diseases

Including periarticular lesions, intervertebral disc lesions, idiopathic low back pain, etc.

Other Diseases

Including periodic rheumatic diseases, intermittent joint effusion, etc.

Various rheumatic diseases can present with different types of arthritis. Several diffuse connective tissue diseases may have specific clinical manifestations such as rashes, dry mouth and eyes, Raynaud's phenomenon, and organ damage.

Joint Pain

Generally, different rheumatic diseases affect different joints and manifest different types of pain. Joint soreness and pain often exhibit characteristics that change with the weather and seasons. For instance, rheumatic fever typically presents as migratory pain in large joints such as knees, hips, ankles, elbows, shoulders, and wrists. Rheumatoid arthritis mainly manifests as symmetrical, persistent swelling and tenderness in small joints such as wrists, hands, fingers, and toes, which worsens after rest. Ankylosing spondylitis mainly presents as asymmetric, persistent pain in joints such as hips, sacrum, knees, and ankles, and osteoarthritis mainly manifests as unilateral or bilateral knee pain that worsens after activity and improves at rest.

Morning Stiffness

Patients often experience stiffness and pain in the affected joints, limbs, and lower back upon waking up or after prolonged rest. Joints may feel sticky and stiff, and the symptoms can last for several hours, particularly prominent in rheumatoid arthritis and ankylosing spondylitis but of shorter duration in other types of arthritis.

Joint Swelling and Tenderness

Swelling may manifest in three types: due to bony proliferation, the swelling feels hard and immobile; due to thickening of intra-articular or periarticular soft tissues, the swelling feels different from healthy tissues; and due to effusion or hematoma, the swelling feels fluctuant. Tenderness points can accurately locate the lesion site and reflect the severity of the condition, but some functional diseases often lack obvious tender points or exhibit mild tenderness.

Joint Deformity and Functional Impairment

Refers to the abnormal shape and limited range of motion in joints, such as inability to fully extend the knee joint, ulnar deviation of the metacarpophalangeal joints, and subluxation. These changes are related to cartilage and bone destruction, and are most common in rheumatoid arthritis.

Other Symptoms

As rheumatic diseases progress, they can cause damage to multiple systems and organs in the body, including the brain, eyes, heart, lungs, kidneys, skin, blood, and nervous system. This may lead to specific symptoms such as muscle pain, dry mouth and eyes, rapid heartbeat, shortness of breath, chest pain, gastrointestinal discomfort, loss of appetite, vomiting, diarrhea, anemia, etc.

Rheumatic diseases are often chronic and difficult to cure, with a certain degree of disability. Patients should learn relevant medical knowledge and manage their psychological well-being. For example, they can alleviate anxiety through activities such as listening to music, reading, and chatting. Family members should also provide psychological support.

Diet should be healthy and balanced, ensuring adequate nutrition with high protein, fiber, and vitamin intake, while low in fat, sugar, and salt. It is advisable to consume various fruit and grain products, and to eat plenty of fresh vegetables and fruits, while avoiding the consumption of animal organs such as heart, liver, and kidneys.

Balancing work and rest, and developing a habit of regular rest and moderate exercise. Appropriate activity and exercise can maintain and promote joint function, enhance physical fitness, and help manage weight to prevent conditions such as gout caused by obesity. Recommended activities include walking, practicing Tai Chi, jogging, cycling, etc.

Take precautions to keep warm, especially when going out; avoid mental stress, maintain a happy mood, and promptly relieve negative emotions; develop good hygiene habits, such as avoiding smoking and alcohol, frequent hand washing, and keeping the skin clean to prevent infection.

Regular participation in physical exercise, such as health exercises, Tai Chi, radio exercises, walking, etc., to enhance the body's ability to resist diseases.

Prevent exposure to cold, rain, and dampness, and pay attention to keeping joints warm, avoiding wearing wet clothes, shoes, and socks. In the hot summer, avoid seeking coolness and consuming excessive cold drinks. In the dry and cool autumn weather, prevent exposure to cold winds, and in winter, pay attention to keeping warm.

Maintain a disciplined diet and daily routine, such as balancing work and rest, moderate activity and rest, eating more vegetables, fruits, and high-quality proteins, and abstaining from smoking and alcohol.

Pay attention to environmental hygiene, ensure good ventilation in living spaces, and take protective measures during epidemics such as wearing masks when going out to prevent throat infections.