Rheumatology and Rheumatic Diseases

Medically Reviewed by Shruthi N, MD on June 16, 2024
Written by Debra Fulghum Bruce, PhD, Timothy Gower
17 min read

Rheumatic diseases affect your joints tendons, ligaments, bones, and muscles. They include many types of arthritis, a term used for conditions that affect your joints. Sometimes, they’re called musculoskeletal diseases.

One type of rheumatic disease, osteoarthritis, is very common — it affects about 32.5 million adults in the U.S. However, other types of rheumatic disease are less common. For example, roughly 1.3 million adults in the U.S. have a form called rheumatoid arthritis. Meanwhile, about 200,000 Americans have the rheumatic disease known as lupus.

The medical field that studies these types of conditions is called rheumatology. If your regular doctor thinks you have a rheumatic disease, they’ll probably send you to a rheumatologist — a doctor who’s specially trained to treat them.

Your rheumatologist will diagnose your condition, then oversee a treatment plan for you that will likely include medications, regular exercise, a healthy diet, stress management, and rest.

Most of these conditions happen when your immune system goes awry and attacks your own tissues. Doctors aren’t sure what causes this. However, scientists have discovered that certain risk factors may make you more likely to have a rheumatic disease, including:

Your genes: Some genes may develop changes (or mutations) that seem to increase your risk for certain rheumatic diseases.

Your sex: Some rheumatic diseases are more common in one sex. For example, rheumatoid arthritis and lupus occur more often in women and those assigned female birth (AFAB), while ankylosing spondylitis affects people assigned male at birth more often.

Your weight: Being obese increases your risk for some rheumatic diseases.

Your health history: Some infections, as well as experiencing childhood trauma and distress, are linked to a greater risk for certain rheumatic diseases. Conditions such as gum disease may increase your risk, too.

Your habits: Smoking is a risk factor for rheumatoid arthritis and other rheumatic diseases. 

Your exposure to toxins: There is evidence that being exposed to some pollutants and chemicals makes you more likely to develop a rheumatic disease.

Some common symptoms of rheumatic diseases include:

  • Joint pain, soreness, and tenderness
  • Inflammation, or swelling, redness, and warmth in a joint or affected area
  • Joint stiffness and limited motion in a joint or joints, especially when you get out of bed in the morning
  • Joints feel better after light activity, but worse after strenuous exercise
  • Joints feel worse during stormy or humid weather
  • Frequently feeling tired

What is rheumatism pain like?

If you have a rheumatic disease, you may feel a deep, aching pain in one or more joints. Your joint or joints will be tender and hurt if they’re touched. The painful joint will probably be stiff, too, especially after you have been sitting or lying down for a while. You may notice that the pain is worse on some days than others, for no apparent reason.

Years ago, conditions like this fell under the broad category of rheumatism. Now, there are more than 200 distinct rheumatic diseases. The most common ones include:

Common rheumatic diseases in children

Children can develop rheumatic diseases, which include:

  • Juvenile idiopathic arthritis, which has several forms
  • Childhood-onset lupus
  • Fibromyalgia
  • Juvenile ankylosing spondylitis
  • Rheumatic fever
  • Scleroderma
  • Infectious arthritis
  • Kawasaki disease
  • Childhood vasculitis
  • Henoch-Schönlein purpura

While all of these conditions are rheumatic diseases, each has unique symptoms, signs, and treatment, which are discussed below.

What is it? Unlike most rheumatic diseases, osteoarthritis isn’t linked to problems with your immune system. It results from damage to cartilage — the cushiony material on the end of your bones. As it wears down, your joints hurt and become harder to move. OA usually affects the knees, hips, lower back, neck, fingers, and feet.

Symptoms

  • Pain
  • Swelling
  • Warmth
  • Stiffness

Muscle weakness can make joints unstable. Depending on what parts of the body it affects, OA can make it hard to walk, grip objects, dress, comb your hair, or sit.

Diagnosis

Your doctor will ask about your medical history and symptoms. You’ll also get a physical exam. 

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 a narrowing of the joint space or the presence of bone spurs. In some cases, your doctor might request an MRI to provide a picture of the inside of your joint.

Learn more about osteoarthritis causes, diagnosis, and treatment.

What is it? RA happens when the immune system attacks your own tissues and causes joint pain, swelling, and stiffness. It’s not part of normal aging.

Symptoms

  • Pain and swelling in multiple joints (usually the same joints on both sides of your body, such AS both wrists or both ankles)
  • Problems in other organs such as the eyes and lungs
  • Joint stiffness, especially in the morning
  • Fatigue
  • Lumps called rheumatoid nodules

Diagnosis

You’ll get a checkup and tell your doctor about your health history. The doctor may take X-rays and samples of your joint fluid. They’ll do blood tests that look for different signs of inflammation. These include:

  • Antinuclear antibody (ANA)
  • Anti-cyclic citrullinated peptides (anti-CCP)
  • Complete blood count
  • C-reactive protein (CRP)
  • Erythrocyte sedimentation rate (ESR)
  • Rheumatoid factor (RF)

Find out how rheumatoid arthritis is treated after diagnosis.

What is it? Psoriatic Arthritis (PsA) is a form of autoimmune arthritis, which is sometimes linked to skin symptoms of psoriasis. There are five types:

  • Symmetric affects joints on both sides of your body. It’s the most common, and it’s similar to RA.
  • Asymmetric doesn’t affect the same joints on either side. It may be milder than other forms.
  • Distal affects the ends of your fingers and toes, along with your nails.
  • Spondylitis affects your spine and neck.
  • Arthritis mutilans attacks the small joints at the ends of your fingers and toes. It may be the most severe kind.

Symptoms. They mimic other forms of arthritis:

  • Painful swollen joints
  • Stiffness — loss of range of motion
  • Swollen fingers and toes — they’re often called sausage fingers or toes
  • Tendon or ligament pain
  • Rash
  • Changes to fingernails and toenails
  • Fatigue
  • Inflamed eyes
  • Flares (periods of high disease activity and symptoms)

Most people may have skin symptoms before they get joint symptoms. Sometimes, it affects the joints first. Some people never have skin symptoms.

Diagnosis

It’s a hard disease to pin down. It can resemble RA, gout, and even osteoarthritis.

Genes play a role in this disease, so your doctor will ask about your medical history and that of your relatives. They’ll look at your joints to see if they’re swollen and inflamed, and might draw fluid from one to make sure gout or infectious arthritis isn’t the cause of your problems. They’ll also check your skin for signs of psoriasis. Imaging tests can show if you have joint damage. Blood tests for psoriatic arthritis that look for signs of inflammation include:

  • C-reactive protein
  • Erythrocyte sedimentation rate
  • Rheumatoid factor (people with psoriatic arthritis almost always test negative)

Learn more about psoriatic arthritis symptoms, diagnosis, and treatment.

What is it? Arthritis caused by an infection in a joint.

Symptoms. They start quickly. Look for:

  • Intense joint swelling and pain
  • Usually only one joint affected
  • Most likely in your knee, but it can also affect your hips, ankles, and wrists

Diagnosis

Your doctor will do a complete physical exam and ask about your medical history. They might take a sample of fluid from the joint to figure out what’s causing the infection. They might also X-ray the joint or do other imaging tests, such as an MRI or ultrasound, to see if there’s any damage.

Learn what to expect during a joint fluid test.

What is it? The most common form of arthritis in children. The child’s immune system mistakenly attacks its own tissues, causing inflammation in joints and other organs and systems.

Symptoms. The most common joint symptoms include:

Diagnosis

The doctor will ask about your child’s health history to figure out how long they have been having symptoms. Then they will check the child's joints for swelling, redness, and range of motion. They’ll probably do blood tests that look for different signs of inflammation. These include:

  • Anti-cyclic citrullinated peptides (anti-CCP)
  • Antinuclear antibody (ANA)
  • Complete blood count
  • Erythrocyte sedimentation rate (ESR)
  • HLA-B27
  • Rheumatoid factor (RF)

They'll finish up with imaging tests such as X-rays, an MRI or a CT scan to check for joint damage.

Read more for an overview on juvenile rheumatoid arthritis.

What is it? Reactive arthritis is caused by an infection in another part of your body, such as your intestines, genitals, or urinary tract.

Symptoms. Usually mild at first, you may not notice them for a few weeks. They can come and go for weeks or months.

The urinary tract is often the first place affected, though women may or may not notice symptoms here. They include:

  • Pain when you pee
  • The need to go more often

Eyes are the next place symptoms appear. You’ll notice:

Joints are often the last affected area. Watch for:

  • Painful, swollen knees, ankles, feet, or wrists
  • Swollen tendons (tendinitis)
  • Swelling where tendons attach to bones (enthesitis)
  • Pain in your lower back or buttocks
  • Inflammation in your spine (spondylitis) or the spot where your pelvis and spine connect (sacroiliitis)

Diagnosis

Your doctor will discuss your medical history and current symptoms. They’ll look for signs of joint inflammation and test your range of motion. They’ll examine your eyes, skin, and pelvic/genital area. They’ll take X-rays of your joints, pelvis, and spine to check for swelling, joint damage, and other signs of reactive arthritis. They’ll also take a swab from your urethra (if you were assigned male at birth) or your cervix (if you were assigned female at birth) to help spot signs of the disease. A sample of fluid from your joint can help rule out other conditions. So can lab tests on your pee and poop. Blood tests can show signs of inflammation, including:

  • Erythrocyte sedimentation rate
  • C-reactive protein
  • Complete blood count
  • HLA-B27, a blood test to look for a specific protein on your white blood cells

What is it? Some infections can make your body develop a fever that causes your heart’s valves to become inflamed. Over time, this inflammation can damage your heart valves and cause them to leak. If the inflammation persists, you can develop heart failure and other complications.

Anyone can develop rheumatic heart disease. This form of rheumatic disease is most common in kids who have frequent strep throat infections.

Symptoms

  • Fever
  • Severe pain, swelling, and redness in the joints, often the knees and ankles
  • Lumps under the skin
  • Shortness of breath
  • Feeling tired and weak
  • Chest pain
  • A reddish skin rash, often on the torso

Diagnosis

Your doctor will examine you, review your medical record, and ask questions about your medical history. They will be particularly interested to know if you have had a fever or bacterial infections in the past. Tests that a doctor may use to diagnose rheumatic heart disease include:

  • Blood tests: A lab will check your blood to see if it has high levels of substances that indicate inflammation.
  • Echocardiogram: This exam shows your doctor how well your heart works and if its valves are damaged and leaky.
  • Electrocardiogram: This test checks your heartbeat.

What is it? Lupus (also called systemic lupus erythematosus or SLE) is an autoimmune disease. It can affect many organs in your body.

Symptoms

Diagnosis

Your doctor will ask about your medical history, do a physical exam, and order lab tests of blood and urine samples. Blood tests for lupus include:

  • Antinuclear antibody test (ANA). Most people with lupus have a positive ANA blood test.
  • Anti–double-stranded DNA antibody (Anti-dsDNA)
  • Anti-Smith antibody (Anti-Sm)

Read more about the different lab tests that diagnose lupus.

What is it? A buildup of uric acid crystals in a joint. Most of the time, it’s your big toe or another part of your foot.

Symptoms: They almost always come on quickly. You’ll notice:

  • Intense joint pain: It’ll probably be in your big toe, but it could also be in your ankles, knees, elbows, wrists, or fingers.
  • Discomfort: Even after the sharp pain goes away, your joint will still hurt.
  • Inflammation and redness: The joint will be red, swollen, and tender.
  • Trouble moving: Your joint will be stiff.

Diagnosis: Gout can look like a lot of other diseases. Your doctor will ask if you have:

  • Sudden joint pain, often at night
  • One or two joints affected
  • Pain-free times between attacks

Lab tests for gout include:

  • Synovial fluid analysis, to check for uric acid crystals in your joint
  • Uric acid test, which looks for high levels of uric acid in your blood
  • Basic metabolic panel, to check how well your kidneys work
  • Complete blood count (CBC), which examines white blood cells to rule out other conditions
  • Tests for inflammation such as rheumatoid factor and anti-nuclear antibodies

Find out more about gout symptoms, causes, and treatment.

What is it? Fibromyalgia is a condition that produces pain and other debilitating symptoms. Doctors aren’t sure what causes fibromyalgia, but it seems to be more common in people who have other rheumatic diseases, including rheumatoid arthritis and osteoarthritis. People with certain other conditions, such as depression and chronic back pain, also seem more likely to develop fibromyalgia.

Anyone can develop fibromyalgia, but this condition seems to be more common in women and those assigned female at birth than those assigned male at birth.

Symptoms

  • Persistent pain that can affect your whole body, but especially your head, limbs, back, and butt
  • Nonstop fatigue, though you may also have trouble sleeping
  • Achy, stiff, and tender joints.
  • Tingling or numbness in your arms and legs
  • “Fibro fog,” or fuzzy thinking, trouble concentrating, and forgetfulness
  • Gastrointestinal problems, such as constipation or feeling bloated
  • Feeling ultrasensitive to bright lights, loud noise, smells, and temperature

Diagnosis

Fibromyalgia can be difficult to diagnose. Your doctor will examine you and ask questions about your symptoms and medical history. There are no blood or imaging tests that can detect fibromyalgia. However, your doctor may order certain tests to rule out other medical conditions that may be causing your symptoms.

What is it? Ankylosing spondylitis usually starts gradually as lower back pain. It usually involves the joints where the spine attaches to the pelvis, known as the sacroiliac joints.

Ankylosing spondylitis is more common in young men, especially from the teenage years to age 30.

Symptoms

  • Gradual pain in the lower back and buttocks
  • Lower back pain that worsens and works its way up the spine
  • Pain felt between the shoulder blades and in the neck
  • Pain and stiffness in the back, especially at rest and when getting up
  • Pain and stiffness that get better after activity
  • Pain in the middle back, upper back, and neck (after 5-10 years)

If the condition worsens, your spine may become stiffer. It may become hard to bend for everyday activities.

Diagnosis

Your doctor will give you a physical exam and ask you about your medical history. You may get X-rays of your back to help your doctor look at the sacroiliac joints. A blood test for a protein called HLA-B27 may help confirm a diagnosis.

Get more information on ankylosing spondylitis symptoms, causes, and treatment.

What is it? Sjögren's syndrome causes parts of your body to dry out, such as the eyes or mouth. Some people also have RA and lupus. Others just have Sjögren’s. The cause is unknown, but it happens when your immune system attacks those body parts. It's more common in women than in men.

Symptoms

Diagnosis

Your doctor will do a physical exam and ask about your medical history. You may also get other tests. To confirm the diagnosis, the doctor may do a biopsy, or take tissue from your inner lip to check in a lab.

Read more on how Sjögren's syndrome is diagnosed.

What is it? It means hard skin. There are two conditions:

Localized scleroderma is the most common type affecting children. About 90% of children are diagnosed between the ages of 2 and 14. About the same number of adults also get this type of scleroderma. They are typically diagnosed in their 40s. This type can harden skin and everything beneath it, including fat, connective tissue, muscle, and bone.

Systemic sclerosis can affect many body parts, from skin and blood vessels to organs, muscles, and joints.

Symptoms depend on the type you have. They can include:

  • Calcium lumps under your skin
  • Digestive trouble
  • Dry mouth, eyes, skin, or vagina
  • Heart, kidney, or lung problems
  • Stiff, swollen, warm, or tender joints
  • Weak muscles
  • Thickened skin on your fingers
  • Raynaud’s phenomenon — low blood flow to fingers and toes that may make them turn blue
  • Telangiectasia, small dilated blood vessels you can see through your skin

Diagnosis

The doctor will ask about your medical history and your current symptoms. They’ll probably do blood tests to look for antibodies (proteins) linked to scleroderma. These include:

  • Antinuclear antibody (ANA)
  • Centromere antibody (ACA)/centromere pattern
  • Scl-70 antibody

Get more information on scleroderma diagnosis and treatment.

What is it? An inflammatory condition that mostly affects older adults.

Symptoms. They can come on slowly or suddenly:

  • Stiffness that’s worse in the morning and after sitting or lying still
  • Fever
  • Poor appetite
  • Weight loss
  • Pain and stiffness in at least two of the following body parts:
    • Buttocks
    • Hips
    • Neck
    • Thighs
    • Upper arms and shoulders

Diagnosis

It isn’t easy. Your doctor will ask about your medical history and do a physical exam. Then, they’ll do blood tests to look for different signs of inflammation. The goal is to rule out other autoimmune conditions such as lupus and rheumatoid arthritis. Tests include:

  • Anti-cyclic citrullinated peptides (anti-CCP)
  • Antinuclear antibody (ANA)
  • Complete blood count
  • C-reactive protein
  • Erythrocyte sedimentation rate (ESR)
  • Rheumatoid factor (RF)

What is it? Systemic vasculitis is a rheumatic disease that affects your blood vessels. These tubes carry blood pumped from the heart to every part of your body. If you have systemic vasculitis, your body’s immune system mistakenly attacks your blood vessels. This causes the vessels to swell, which makes it harder for blood to pass through them. That prevents blood from flowing naturally, which can damage tissue.

Systemic vasculitis is a serious condition that can cause strokes and other dangerous complications.

Symptoms

  • Trouble breathing
  • Coughing
  • Tingling or numb skin
  • Skin changes, such as a rash
  • Fever
  • Weight loss
  • Fatigue and weakness
  • Joint pain
  • Stomach pain
  • Dark pee or blood in your pee

Diagnosis

After examining you and taking your medical history, your doctor will likely order several different tests to determine whether you have systemic vasculitis or some other medical condition. Tests may include:

Blood tests. A lab can check your blood to see if it has high levels of substances that cause inflammation, which could be damaging your heart valves.

Angiogram. This test is simply an X-ray of your blood vessels. Before the exam, you will have a special dye injected into your body, which makes blood vessels visible on X-ray.

Imaging tests. Your doctor may use other imaging tools, such as CT or PET scans, to look at your blood vessels.

Biopsy. It is a surgical procedure in which a doctor removes a small piece of tissue from your body so it can be studied in a lab. A biopsy can detect evidence of vasculitis.

Rheumatic diseases respond best to treatment when they are detected early. That’s why you should tell your doctor about aches and pains that won’t go away, as well as any other new symptoms that persist and you can’t explain. The following could be signs of a rheumatic disease:

  • Achy, swollen joints
  • Joint stiffness
  • Persistent fever
  • Lack of energy
  • Feeling weak
  • Skin changes, such as a rash or ulcers (sores)
  • Unintended weight loss
  • Sudden changes to vision (such as blurriness) or eyes (redness or pain)

Getting through your day with a rheumatic disease may present challenges, but following some healthy guidelines can help you enjoy a satisfying, active life.

Be a good patient. Tell your doctor about any changes in your symptoms. Be sure you understand your treatment plan and follow it closely. Educate yourself about your rheumatic disease and the best ways to deal with it.

Maintain a healthy weight. Being overweight or obese makes it harder to manage rheumatic diseases. Losing even a few pounds can make a difference.

Get plenty of exercise. If pain or fatigue keeps you from being active, ask your doctor about ways you can incorporate exercise into your routine.

Don’t skimp on sleep. If pain and other symptoms keep you up at night, you may find your rheumatic disease to be even harder to deal with during the day. Tell your doctor if you’re not sleeping well.

Manage your feelings. Living with a rheumatic disease can cause stress, anxiety, depression, and other difficult emotions. Find a way to relax your mind every day, whether through meditation, listening to music, prayer, or whatever works for you. If you are struggling to manage stress and other psychological challenges, consider seeing a mental health counselor.

Rheumatic diseases include arthritis and other related medical conditions. Most happen when your body’s immune system attacks healthy tissue by mistake. Many rheumatic diseases affect the joints, causing pain and stiffness. But these conditions also cause other symptoms such as fatigue, fever, and skin changes. Telling your doctor about persistent aches, pains, and other symptoms as soon as possible can help them diagnose a rheumatic disease early. While these conditions are challenging, you can maintain an active, satisfying life with a rheumatic disease.

What is rheumatic pain?

Rheumatic pain is discomfort or aches in the joints caused by arthritis and other rheumatic diseases. Rheumatic pain is often accompanied by stiffness and other symptoms.

What are rheumatology diseases?

Rheumatology diseases are medical conditions that affect the joints and the tissues that support them, including muscles, tendons, and ligaments. Some rheumatology diseases include osteoarthritis, rheumatoid arthritis, lupus, and gout.

Can you live a normal life with RA?

Living with RA may require some adjustments to your daily routine. But most people diagnosed with RA and other rheumatic diseases can lead normal, productive lives by educating themselves about their condition, following their treatment plan, and adopting other healthy habits.

How does rheumatism start?

Rheumatism is another word for rheumatic symptoms, which include painful, stiff, and tender joints. These symptoms are caused by rheumatic diseases. One of the most common is osteoarthritis, which occurs when tissue called cartilage that protects joints wears away. Many other types of rheumatism are caused by a glitch in the immune system, which causes it to attack healthy tissue.