Rheumatological conditions FAQs
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What are rheumatological conditions?
Rheumatology is a medical specialty which deals with rheumatic and musculoskeletal conditions which are usually caused by immune system disorders, inflammation, infections, or gradual deterioration of body structures. Rheumatological conditions can affect bones and "soft tissues" in and around the joints such as cartilage, tendons, ligaments and muscles.
There are over 200 types of "arthritis" and the word arthritis simply means ‘inflammation of the joint’. The reason for that inflammation varies between the different forms: osteoarthritis (or OA) is by far the most common and is caused by wearing or thinning of the smooth cartilage joint surfaces, as well as stiffening of the soft tissues surrounding the joints.
You wouldn't usually need to see a rheumatologist if you have OA - other members of the team would be able to help - but most other rheumatological conditions are diagnosed by a Rheumatologist in a specialist clinic. The other exceptions to this are Fibromyalgia and Osteoporosis.
Below, we have provided brief information and useful links to reputable websites for the most common rheumatological conditions, which will hopefully help you to understand your symptoms and condition better.
Osteoporosis (and the associated Osteopenia) is a condition where your bones lose strength, making you more likely to fracture (break) a bone, also known as 'fragility fractures'
Having osteoporosis doesn't mean you will break a bone. But it does mean you're at higher risk than the average person without this condition. There are treatments and adjustments to your lifestyle which help you to look after your bone strength.
Osteoporosis is more likely in older age. But it can also be caused by a number of other medical conditions and treatments.
If you think you may have osteoporosis, your GP will likely assess your future fracture risk by using an online risk calculator. They may arrange for you to have a DEXA scan but this may not be necessary. If your risk is above a certain level they will likely start you on treatment to help protect your bones.
Royal Osteoporosis Society - main website
Royal Osteoporosis Society - Newly diagnosed with osteoporosis
Royal Osteoporosis Society - How to build up exercise for your bone strength
Royal Osteoporosis Society - Emotional wellbeing and osteoporosis
Rheumatoid arthritis (RA) is a long-term autoimmune condition that causes inflammation in the joints, leading to pain, swelling, stiffness, and potential joint damage. Unlike osteoarthritis, which is caused by wear and tear, RA occurs when the immune system which is normally there to protect us, mistakenly attacks the lining of the joints.
NRAS | Rheumatoid arthritis charity
NRAS - Steroids Used In Rheumatoid Arthritis
Axial spondyloarthritis (axSpA), previously known as ankylosing spondylitis, is a type of arthritis that mainly causes inflammation in the spine. This can make your back, rib cage and neck stiff and painful.
It often starts in people who are in their late teens or 20s.
While it mainly affects the neck and back, it can also cause pain and stiffness elsewhere in the body, including in the hips, shoulders hands, feet and other joints.
It can cause different symptoms in men compared with women and may start differently: women tend to have more involvement of the joints of the legs and arms rather than the spine early in the onset of the disease.
To check if you have symptoms of axial spondyloarthropathy, click here: Symptoms Checker – Act on axial SpA
National Ankylosing Spondylitis Society homepage
Managing my axial SpA | National Axial Spondyloarthritis Society
This is a condition that causes inflammation (swelling) and pain in your joints. It’s linked to psoriasis, which affects the skin, causing red, scaly patches called plaques on your skin..
Psoriasis and psoriatic arthritis are both autoimmune conditions. This means your immune system attacks healthy body tissue, which leads to inflammation.
This is an inflammatory condition of unknown cause, but it is recognised to be an autoimmune illness. It causes pain, tenderness and stiffness in the large muscles around the shoulders, hips and back. It mainly affects people over the age of 50 and usually comes on very rapidly over a few days. This may be accompanied by flu-like symptoms, unintentional weight loss, depression and tiredness.
While some people recover after a year or two of treatment with corticosteroids (steroids) some individuals may have disease resistant to treatment and need long-term steroids.
Giant Cell Arteritis (GCA) is a disease known as ‘giant cell’ because of the presence of large inflammatory cells in the wall of the arteries, particularly those at the side of the head (the temples), causing them to swell and sometimes become blocked. "Temporal arteritis" specifically refers to inflammation of the artery sitting over the temples.
The main symptoms are: frequent, severe headaches; pain or tenderness at the side of your head (temples) or on the scalp; jaw pain while eating or talking; vision problems, such as double vision or loss of vision in one or both eyes.
This may be accompanied by flu-like symptoms, unintentional weight loss, depression and tiredness.
In can occur in association with PMR (see section above).
This is a serious condition and needs urgent treatment - if you think you may have this condition please request an urgent (same-day) GP appointment or call 111 for further advice.
Giant Cell Arteritis - Arthritis UK
Giant Cell Arteritis - NHS Choices
Fibromyalgia is a long-term condition that causes pain and tenderness all over your body. Unlike arthritis, this isn’t because you have problems with your joints, bones or muscles. Fibromyalgia is thought to be caused by your nervous system (your brain and spine) not being able to control or process pain signals from other parts of your body. The same changes in your brain that affect how you process pain can also affect your memory, mood, and sleep patterns. It may co-exist with other conditions.
This is NOT an inflammatory condition so you will not need to see a Rheumatologist for advice on this condition.
Critically, blood tests will be normal and there is NO diagnostic test. Diagnosis is usually carried out in primary care by a GP and it is a clinical diagnosis based on history and an examination, with no evidence of inflammatory arthritis but often widespread trigger points.
You can find useful information using these links:
Lupus (full name systemic lupus erythematosus, SLE), is a long-term autoimmune condition. This means it is caused by your immune system reacting against your body tissues. Lupus causes inflammation in various parts of your body such as pain in your joints, extreme tiredness, and skin rashes. There are many different potential symptoms as it can affect many different areas in the body. Symptoms vary between people and may come and go over time. Click on the links below for more information.
Sjögren’s syndrome, also known as Sjögren’s disease, is an autoimmune disorder characterized by inflammation and dysfunction of the glands that produce saliva and tears. The most common symptoms are dry eyes, dry mouth, aching muscles and joints and extreme tiredness, but there are others - please click on the links below for more information.
Joint pain is one of the most common symptoms of Sjögren’s disease. Multiple joints are painful, usually coming and going with periods of joint pain, known as “flares”, followed by periods of little or no joint pain.
Gout and Acute CPP Crystal Arthritis (pseudogout) are types of arthritis caused by the accumulation of crystals in the joints: gout is caused by deposits of urate crystals, while pseudogout results from calcium pyrophosphate (CPP) deposition.
Both lead to sudden painful swelling of joints: most commonly the big toe in gout, and the knees/wrists in pseudogout, although other joints can be affected.
If you think you may have either gout or pseudogout, it is important to seek help from a medical professional as quickly as possible so that you can get the right treatment, and to rule out any links with other possible medical conditions. The symptoms are similar between these two conditions but the treatments may be different.
Joint hypermobility means that a person’s joints have a greater range of motion than is expected or usual. Some people have joint hypermobility that does not cause them pain or other issues.
The Ehlers-Danlos syndromes (EDS) are a group of 13 inherited connective tissue disorders. The conditions are caused by genetic changes that affect connective tissue. Each type of EDS has its own set of features with distinct diagnostic criteria. Some features are seen across all types of EDS, including joint hypermobility, skin hyperextensibility, and tissue fragility.
If you think you may have hypermobile joints you can arrange to see your GP, who will usually checking the flexibility of your joints. There's no cure for joint hypermobility syndrome but the main way of managing it is to improve muscle strength and fitness to help protect your joints.
EDS and HSD - The Ehlers Danlos Society