Types of Rheumatic Disease

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Introduction

Historically, "rheumatism" was a term used to describe a range of painful conditions affecting muscles, tendons, joints, and bones. Nowadays, we prefer the more precise term "rheumatic disease." Rheumatic disease RD is a comprehensive term encompassing arthritis and various other conditions, it encompasses over 200 different conditions, musculoskeletal system be the most affected system it is sometimes named musculoskeletal diseases, some of it's condition involving the immune system when mistakenly attacking the body's own tissues, which can lead to autoimmunity.

It is divided into:

• Autoimmune disease.
• Autoinflammatory disease.
• Degenerative/ metabolic disorders.

General Classification Criteria of Rheumatic Diseases

There is still no accurate solo diagnostic procedures to diagnose or confirm Rheumatic Diseases, the Classification criteria will help to distinguish between similar diseases and confirm or exclude a specific disease based on specific factors. These criteria are guidelines, not the only way to diagnose. Diagnosis of rheumatic disease can be challenging, it relies on clinical assessment, gathering a complete patient history and carefully evaluating the musculoskeletal system is very important, hence match the findings during clinical examination with lab, X-ray, and sometimes tissue samples to confirm the diagnosis.

Diagnostic Criteria for RA.

Rheumatoid arthritis: In 1987, the American College of Rheumatology (ACR) introduced the initial classification criteria for RA, which required meeting 4 out of 7 criteria for over 6 weeks. Subsequently, a new classification criteria set was developed jointly by ACR/ EULAR in 2010. This updated criteria take in consideration the prognostic markers while maintaining high specificity and sensitivity. This allows for early patient identification and timely treatment with disease-modifying antirheumatic drugs DMARDs or inclusion in clinical trials for new therapies, enhancing care for those with early arthritis and enabling personalized treatment strategies.

Autoimmune	Autoinflammatory	Degenerative/ metabolic disorders
Systemic lupus erythematosus Rheumatoid arthritis Psoriatic Arthritis Ankylosing Spondylitis Systemic sclerosis (Scleroderma) Idiopathic inflammatory myopathies Antiphospholipid syndrome Sjogren’s syndrome Primary vasculitis Dermatomyositis	Familial Mediterranean fever Mevalonate kinase deficiencies Muckle-Wells syndrome Familial cold urticaria NOMID syndrome NLRP12-associated syndrome/NLRP12-associated periodic fever syndrome PAPA syndrome Chronic recurrent multifocal osteomyelitis Adult-onset Still disease	OsteoarthritisOsteoporosis Parathyroid disorders Paget’s disease Calcium and phosphorus disorders (Hypercalcemia/ Hypocalcemia/ Hyperphosphatemia/ Hypophosphatemia) Vitamin D deficiency/osteomalacia Renal osteodystrophy Gout Hemochromatosis Ochronosis

Rheumatoid Arthritis and Osteoarthritis

Rheumatoid Arthritis	Osteoarthritis
Autoimmune inflammatory arthritis, more aggressive course. A family history of RA or specific genetic markers like HLA-DRB1 can increase the risk. Smoking, age usually develops between (40-60), females are predisposing factors. Symmetrical joint involved, narrowing in joint space, soft tissue swelling, erosion, and joint deformities are common findings Pain, swelling, and Morning stiffness lasting > 1 hour that improves with use. Systemic symptoms (fever, fatigue, weight loss), and extraarticular manifestations are common.	Degenerative joint disorder/Mechanical—wear and tear that destroys articular cartilage. Age, obesity, joint trauma are risk factors Narrowing in joint space (asymmetric), osteophytes, noninflammatory synovial fluid, and no joint deformities are common findings Pain will aggravate during weight-bearing on joint after activities e.g.: at the end of the day) and improve with rest. No systemic symptoms were involved.