What to know about inflammatory rheumatism
Rheumatic conditions tend to cause pain in the joints. Some people use the term "inflammatory rheumatism" to refer to rheumatic disorders that involve inflammation.
Rheumatism is a word that doctors historically used for conditions that affect the joints. Doctors no longer use the term. Instead — as there are so many types of rheumatic disorders with different causes — they stress that people should get a specific diagnosis so that a doctor can prescribe the correct treatment.
Inflammatory rheumatic disorders include:
- rheumatoid arthritis (RA)
- psoriatic arthritis (PsA)
- ankylosing spondylitis
- systemic lupus erythematosus (SLE), or lupus
- rheumatic fever
This article looks at the various types of inflammatory rheumatism, how doctors diagnose them, and their treatments.
Inflammatory rheumatism can cause fatigue alongside joint pain.
Many rheumatic disorders are also autoimmune disorders. Autoimmune diseases occur when the immune system attacks healthy cells and tissues in the body. Other rheumatic disorders, such as gout, occur as a result of excess uric acid.
Most forms of inflammatory rheumatism have systemic effects, meaning they can affect all parts of the body and not just the joints.
This leads to symptoms outside the joints, depending on the condition, which can include:
Inflammatory rheumatic conditions can affect a person's daily activities and quality of life. However, effective treatment can help relieve symptoms and reduce the risk of complications. Early treatment can now prevent permanent damage to the joints.
Rheumatoid arthritis (RA) is a common type of inflammatory rheumatism.
RA is an autoimmune disorder that occurs when the immune system mistakenly attacks healthy tissue in synovial joints. Symptoms arise when immune cells attack synovial joints and release inflammatory proteins called cytokines.
Cytokines not only cause inflammation in the joints, but can damage tissues and, over time, erode the synovial membrane and surrounding cartilage.
A person who has RA may experience stiffness, pain, and swelling in their joints. RA commonly affects small joints located in the:
Symptoms of RA include:
- joint pain, swelling, and stiffness, especially in the morning
- muscle aches
- weight loss
- decreased grip strength
Doctors do not know the exact cause of RA, and many factors can affect this complex disorder, such as:
- genetics and family history
- environmental exposures
Psoriatic arthritis is more common in larger joints.
Psoriatic arthritis (PsA) is another form of inflammatory arthritis. This autoimmune condition affects around 15% of people with psoriasis. In rare cases, PsA can affect people who do not have psoriasis.
PsA causes swollen, tender joints. It can affect just one joint or many joints and is more common in:
- larger joints
- fingers and toes
- the back
- sacroiliac (SI) joints in the pelvis
Doctors do not know the exact cause of PsA, but it has links with genetics and family history. People may also develop PsA after an infection that triggers the immune system, such as strep throat.
Ankylosing spondylitis is an inflammatory rheumatic condition that primarily affects the spine. Over time, the bones in the spine gradually begin to fuse in a process called ankylosis.
In the early stages of ankylosing spondylitis, people may experience pain and inflammation in the SI joints located in the pelvis. These joints serve to link the iliac bone (pelvis) to the sacrum, which is the lowest part of the spine. The condition can also affect other joints, such as the:
- less often, the knees
Doctors believe that ankylosing spondylitis is caused by both genetic and environmental factors, though more research is needed to find out what these are.
Though rare, this condition can cause complications involving the heart, lungs, eyes, and nervous system.
Systemic lupus erythematosus
Systemic lupus erythematosus (SLE) is another autoimmune disease that causes inflammation in the joints.
Lupus can have wide-reaching effects throughout the body and can affect the:
Unlike other types of inflammatory rheumatism, lupus occurs in children and adults, according to the American College of Rheumatology.
Lupus attacks can happen suddenly, causing unpredictable symptoms that differ from person to person.
Lupus symptoms can include:
- joint and muscle pain
- rash and sun sensitivity
- sensitivity to artificial light
- kidney problems
- chest pain
- hair loss
- mouth sores
Untreated strep throat or scarlet fever infections can develop into rheumatic fever, or group A Streptococcal (GAS) disease, which is a noncontagious condition.
The body's immune system responds to the initial infection, creating a generalized inflammatory response that may attack healthy cells.
Although people of any age can develop rheumatic fever, this condition typically affects children 5–15 years old.
Symptoms of rheumatic fever include:
- swollen lymph nodes
- painful or tender joints
- chest pain
- shortness of breath
In rare cases, people can develop painless lumps under the skin or a pink ring-shaped skin rash.
People can reduce gout flares by avoiding high-purine foods, such as shellfish.
Gout is a common type of arthritis that causes stiffness and pain in the joints. It occurs when excess uric acid crystals build up in the joints, causing inflammation.
Gout is not an autoimmune condition.
Gout arises when the body is less able to deal with uric acid buildup than usual. The kidneys filter excess uric acid from the body, so impaired kidney functioning may result in gout.
In the beginning, gout usually causes joint pain in the big toe. Over time, it can affect joints in the feet, arms, and legs.
The uric acid crystals that cause gout can form kidney stones and hard lumps under the skin.
Uric acid comes from purines, a substance found in certain foods, such as:
People can reduce gout flares by avoiding high-purine foods. Medications can reduce the pain and frequency of gout attacks.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases state that gout attacks last for 3–10 days and often occur due to:
- alcohol or drug consumption
- other medical conditions
The Centers for Disease Control and Prevention (CDC) estimate that 54.4 million adults in the United States have received a diagnosis of some form of arthritis.
In general, rheumatic disorders can affect people of any age. However, specific conditions may occur more often in certain age ranges than others.
Many types of inflammatory rheumatic diseases produce non-specific symptoms, which can mean that doctors sometimes find it challenging to diagnose .
A doctor will examine a person's medical history and current symptoms. Then they may recommend further testing before making a diagnosis.
Tests that help diagnose types of inflammatory rheumatic disease include:
- blood tests to measure antibody counts and detect excess uric acid levels
- joint fluid tests to identify bacteria, white blood cells, proteins, and uric acid in the synovial fluid of a joint
- culture tests to look for specific bacteria
- imaging tests, such as X-rays, MRIs, and ultrasounds to visualize the joints and assess patterns of damage
Treatment options may vary depending on the type of inflammatory rheumatism a person has. People can work with doctors who specialize in inflammatory rheumatic disorders to develop a personalized treatment plan.
Typically, treatments focus on reducing inflammation and managing pain. Medication options include prescription steroids and nonsteroidal anti-inflammatory drugs (NSAIDs).
Doctors prescribe immunosuppressive drugs to treat many types of inflammatory arthritis conditions. These drugs can interrupt the body's inflammatory response, helping to relieve painful inflammation. However, these medications also lower the body's ability to fight off infections.
Lifestyle and dietary changes can also help relieve symptoms. Gout, for example, may flare up when a person eats a lot of purine-rich foods, such as meat, shellfish, and drinks alcohol.
People can improve their quality of life by getting regular physical exercise and avoiding foods that trigger inflammation.
Inflammatory rheumatic diseases can cause painful swelling in the joints. Many are also autoimmune conditions that affect other body organs and systems.
Inflammatory rheumatism can affect people of all ages. However, some conditions may occur more frequently in certain age groups than others. Having a family history of chronic inflammatory disorders may raise a person's risk for inflammatory rheumatism.
In cases of chronic rheumatic disease, early diagnosis and treatment can help relieve symptoms and prevent permanent tissue damage.