Rheumatoid Arthritis Health Center

An Overview of Rheumatic Diseases

Rheumatic diseases (rheumatism) are painful conditions usually caused by inflammation, swelling, and pain in the joints or muscles.

Some rheumatic diseases like osteoarthritis are the result of "wear and tear" to the joints. Other rheumatic diseases, such as rheumatoid arthritis, happen when the immune system becomes hyperactive; the immune system attacks the linings of joints, causing joint pain, swelling, and destruction.

Almost any joint can be affected in rheumatic disease. There are more than 100 rheumatic diseases but we'll focus on some of the common types.

Osteoarthritis

About 27 million Americans have osteoarthritis (OA), the "wear-and-tear" arthritis. OA causes damage to the cartilage over time. Cartilage is a material that cushions the end of bones and allows joints to move smoothly.

As cartilage of a joint wears down, this movement becomes painful or limited. 

OA can be a normal part of aging that can affect all parts of the body. However, it usually affects the knees, hips, lower back, neck, and fingers.

The signs and symptoms of OA, depending on the joints involved, include:

• Pain in joint
• Joint swelling
• Joint may be warm to touch
• Joint stiffness
• Muscle weakness and joint instability
• Pain when walking
• Difficulty gripping objects
• Difficulty dressing or combing hair
• Difficulty sitting or bending over 

To diagnose OA, your doctor will ask about your medical history and symptoms and do a physical exam. Blood tests may help rule out other types of arthritis or medical problems. A joint fluid sample from an affected joint may also be examined to eliminate other conditions.

Usually by the time someone with OA seeks treatment, there are changes visible on an X-ray of the joint. The X-ray may show narrowing of the joint space or the presence of bone spurs. In some cases, MRI (magnetic resonance imaging) may be done.

Rheumatoid Arthritis

Rheumatoid arthritis affects about 1.3 million Americans; about 75% of those affected are women.

In RA, the body's immune system attacks its own tissues, causing joint pain, swelling, and stiffness that can be severe. The condition can result in permanent joint damage and deformity.                                                                               

RA signs and symptoms include:

• Joint pain and swelling
• Involvement of multiple joints (usually in a symmetrical pattern)
• Other organ involvement
• Joint stiffness, especially in the morning
• Fatigue
• Fevers
• Lumps called rheumatoid nodules                                                                 

To diagnose RA, your doctor will ask about your medical history and do a physical exam. Also, X-rays and blood tests will likely be taken. One blood test may be for rheumatoid factor; it is positive in 70% to 80% of those with RA.

Lupus

SLE or systemic lupus erythematosus is another autoimmune disease; the cause of SLE is unknown.

Lupus signs and symptoms include:

• Joint pain
• Fatigue
• Joint stiffness
• Rashes, including the"butterfly rash" across the cheeks  
• Sun sensitivity
• Hair loss
• Discoloration of the fingers or toes when exposed to cold (called Raynaud's phenomenon)
• Internal organ involvement, such as the kidneys
• Blood disorders, such as anemia and blood clots
• Chest pain from inflammation of the lining of the heart or lungs
• Seizures or strokes                                                                             

To diagnose lupus, your doctor will ask about your medical history, do a physical exam, and order lab tests of blood and urine samples. One blood test is the antinuclear antibody test (ANA).  Most people with lupus have a positive ANA blood test.