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Rheumatology

Rheumatology

Rheumatology is a medical specialty dedicated to medical (non-surgical) disorders of the locomotor system and connective tissue, in general to medical problems that affect the heart, bones, joints, kidneys, skin and lungs, covering a large number of entities clinics, known collectively as “rheumatic diseases” to which are added a large number of diseases with systemic involvement: connective tissue diseases. Rheumatologists (specialists in rheumatology) mainly treat patients with clinical entities of affectation that generally damage the joints, bones, muscles, tendons, etc., and even diseases with systemic expression.
Today, many of these diseases are now known as autoimmune system disorders, and rheumatology is increasingly the study of immunology.

Classification of rheumatological diseases

Rheumatology is dedicated to a wide range of diseases, most of them of unknown etiology and not very well defined pathophysiological mechanisms. This has made it quite difficult to structure a general classification of clinical entities that fall within the domain of rheumatology. However, with effort and years of study and research, classifications have been developed to achieve a more complete approach to the patient with rheumatological pathology.

1) Degenerative arthropathies:
Osteoarthritis (degenerative joint disease) = osteoarthritis, osteoarthritis syndrome
Primary (idiopathic):
– Localized: Heberden’s nodules; Bouchard’s nodules; rhizarthrosis of the thumb; gonarthrosis; coxarthrosis; others.
– Generalized.
Secondary (to other pathological processes): post-traumatic, congenital, localized or generalized.
Spondyloarthrosis: dyscarthrosis, interpophyseal arthrosis, uncarthrosis.

2) Inflammatory artopaties:
Rheumatoid arthritis and Felty’s syndrome
Spondyloarthropathies:
– Ankylosan spondyloarthritis
– Psoriatic arthritis (psoriatic arthropathy)
– Reactive arthritis
– Arthritis associated with inflammatory bowel diseases
– Others: undifferentiated spondyloarthropathy, Sappho syndrome, acute anterior uveitis.
Juvenile idiopathic arthritis
Microcrystalline diseases: gout
Septic arthritis

3) Systemic conditions and connective tissue diseases
Systemic lupus erythematosus
Systemic sclerosis
Sjogren’s syndrome
Polymyositis
Dermatomyositis
Polymyalgia rheumatica
Mixed connective tissue disease
Sarcoidosis
Vasculitis:
– Schönlein-Henoch purpura
– Polyarteritis nodosa
– Temporal arteritis
– Serum sickness
– Wegener’s granulomatosi
– Giant cell arteritis
– Takayasu arteritis
– Behçet syndrome
– Kawasaki disease
– Microscopic polyangiitis
– Thromboangiitis obliterans: Buerger’s disease

4) Soft tissue rheumatism
Juxtaarticular lesions: bursitis, tendinitis, enthesopathies, cysts
Intervertebral disc alterations
Low back pain
Miscellaneous pain syndromes: fibromyalgia, rheumatism, psychogenic rheumatism, neck pain
Tennis elbow, golfer’s elbow, and oleocranial bursitis

5) Diseases associated with bones
Osteoporosis
Osteomalàcia
Renal osteodystrophy
Fluorosi
Rickets
Hypertrophic osteoarthropathy
Ankylosing hyperostosis
Paget’s disease
Osteolysis / chondrolysis
Costochondritis (Tietze)
Condensing iliac osteitis
Congenital hip dysplasia
Chondromalacia patella

6) Congenital and familial diseases that affect the joints
Ehlers-Danlos syndrome
Joint hypermobility syndrome
Marfan syndrome
Osteogenesis imperfecta

7) Rheumatic syndromes associated with infectious agents
For direct mechanism
Reagents

8) Metabolic / endocrine diseases associated with rheumatism
Other biochemical abnormalities: amyloidosis, hemophilia
Hereditary disorders: familial Mediterranean fever

9) Neoplasms
Primary
Secondary: paraneoplastic syndrome, metastasis

10) Neurovascular disorders
Charcot joint
Compressius syndromes
Reflex sympathetic dystrophy
Erythromelalgia
Raynaud’s syndrome

11) Miscellaneous with joint manifestations
Palindromic rheumatism
Intermittent hydrarthrosis
Drug-related rheumatisms (except lupus)
Multicentric reticulohistiocytosis
Pigmented vllosonodular synovitis
Vitamin C deficiency (scurvy)
Pancreatic disease
Active chronic hepatitis
Musculoskeletal trauma

12) Others:
Antiphospholipid syndrome
Undifferentiated connective tissue disease
Lupus-like syndrome or probable lupus
Syndromes associated with the Jo-1 antigen
Midline granuloma
Panniculitis and other disorders of skin fat (lipodystrophies).
Recurrent polychondritis
Idiopathic fibrosis or systemic fibrosis
Berger’s disease IgA nephropathy
Churg-Strauss syndrome
Cryoglobulinaemic purpura
Cutaneous leukocyte vasculitis
Hypersensitivity vasculitis
Primary vasculitis of the central nervous system
Diffuse fasciitis with / without eosinophilia
Adult Stil’s disease
Necrotizing Vasculitis and Variants of Vasculopathy
Erythema nodos
Spondylitis

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