Diagnosis

The Diagnsoe of a rheumatologische illness is often difficult to place, because sometimes an unnoticed rheumatism hides itself also behind numerous untypical complaints. The initial examination consists of the patient questioning. The morning stiffness of the joints over 30 minutes already gives a first indication of a rheumatologic happening.

This is followed by the physical examination, in which the finger joints, the back, etc. are examined. Swollen and/or reddened joints indicate the presence of rheumatism.

As a rule, a rheumatological disease can be proven by a blood test. In all cases of a rheumatic disease, increased inflammation values are found in the blood. Usually the so-called CRP is increased many times over, as are the white blood cells and the blood sedimentation rate.

In the second step, further blood tests, such as rheumatoid factor control and the determination of specific autoantibodies should be carried out. There are numerous autoantibodies that appear in the blood count and can indicate an autoimmune disease. The most important values are ANA and ANCA.

However, there are also numerous disease courses in which the blood count is not shown in the classical way. Imaging is also part of the diagnosis of a rheumatic disease, especially when joints are affected. Thus, the classic X-ray of the hands is the standard examination.

Here joint malpositions can be seen and assessed. Above all, one can see joint damage that has already occurred and a definitive distinction can be made to degenerative joint disease (arthrosis), especially the distinction to finger arthrosis. To recognize rheumatism is not so easy.

Many factors can speak for such a disease and provide indications, but the actual proof is often missing and can usually only be provided after a long time. Very typical signs for the presence of a rheumatological illness is the morning stiffness of certain joints for more than 30 minutes. The joints, mostly the finger, often become more mobile when some time has passed in the morning.

The joints are swollen and usually reddened in the morning. Rheumatic nodules occur relatively rarely compared to the other symptoms. Accompanying systemic complaints such as fever, tiredness and general malaise can also always occur.

If the rheumatological joint disease has progressed, there is also joint malposition with sometimes very severe impairment with corresponding movements in the joint. The complaints are usually somewhat alleviated by cold. The skin is also very often affected by a rheumatic disease, such as characteristically reddened cheeks in lupus erythematosus. The most common cause that leads to the suspicion of a rheumatological event is joint pain together with increased inflammation values and the presence of certain autoantibodies.