The chronology of rheumatic disorders

By Marian Moraa

Rheumatic disease is an illness that attacks the joints and surrounding tissues. It can affect anyone, male or female, the elderly, or children. This disease has been around for a long time and has even been known for thousands of years.

Newsline spoke to Dr. Etau Ekwom, a Senior Medical specialist in internal medicine and rheumatology under the department of medicine, currently, Ag. Head of Unit-Rheumatology at Kenyatta National Hospital (KNH) to get further insights on rheumatic disorders.

What is Rheumatology in clinical terms?

Rheumatology is a unique specialty of internal medicine that deals with auto-immune and generative diseases. Rheumatology comes from rheumatic diseases which include illnesses associated with bones, joints, and muscles. Some of the common diseases include rheumatoid arthritis affecting multiple joints and elderly people, gout, muscle diseases, and lupus (an autoimmune disease that commonly affects women).

What causes rheumatic diseases?

Most of these conditions happen when a person’s immune system is low and attacks their tissues. Sometimes it is in their genes while other times it is a result of something in the surrounding environment, like cigarette smoke, pollution, or something that causes an infection. Gender also plays a role; rheumatic diseases seem to affect women more than men.

What are the common symptoms of rheumatic diseases?

Patients mainly complain of intense pain, swelling, warmth, and body stiffness. Muscle weakness can make joints unstable. Depending on what parts of the body is affected, it can be hard to walk, grip objects and even sit.

How do you diagnose rheumatic diseases?

We usually ask about the patient’s medical history and symptoms. A physical exam is then carried out thereafter. By the time a patient seeks treatment, there are changes visible on an X-ray of the joint. The X-ray may show narrowing of the joint space or the presence of bone spurs. In some cases, lab tests and an MRI (Magnetic Resonance Imaging) is required to provide a clearer picture of the inside of the joint.

What are the common misconceptions and facts regarding rheumatic diseases? Unfortunately, many things associated with this rheumatic disease are not necessarily true (myths) but are believed in our society. Knowledge of the facts regarding rheumatic diseases is important and can help find appropriate therapy and solutions for patients so that disabilities that often occur in rheumatic diseases can be prevented and the patients quality of life can be equal to that of healthy people.

Some of the myths and facts include:

Myth: Rheumatic disease is caused by frequent bathing at night or being in an air-conditioned room or cold weather.

Fact: Getting a night shower or cold weather does not cause rheumatic disease. However, in certain rheumatism patients, the cold factor can exacerbate complaints so that when exposed to cold, pain feels in the joints, this can be explained by changes in atmospheric pressure increases the pressure in the joint space, cold temperatures that cause disruption of synovium flow and stimulate nerve nociceptors around them. Joints that cause arthritis to become painful and or stiff.

Myth: Rheumatism can be caused by eating green vegetables and nuts

Fact: Green vegetables and nuts do not cause joint pain. The only rheumatic diseases associated with food (alcohol, shellfish, large amounts of red meat) are gout disease or gout joint disease (caused by gout).

Myth: Rheumatic disease is a hereditary disease

Fact: Rheumatic diseases are not directly passed on from parents to children, although in some types of rheumatic diseases there are genetic factors that influence the tendency of the offspring to suffer from the same disease.

Myth: Rheumatism is a disease of old people

Fact: Rheumatic disease is not dominated by old people, because children and even babies can get rheumatism. For example, rheumatoid arthritis can affect children. On the other hand, not all parents will suffer from rheumatism.

Myth: Rheumatic disease only affects the joints and bones

Fact: All the tissues around the joints can be affected by rheumatism, such as bones, muscles, tendons, and others, besides that, other symptoms can also be obtained such as fever, tiredness, weakness, etc.

Myth: Rheumatic disease only affects women

Fact: It is not always women who experience this disease. Men have more frequent gouty arthritis, while women have more lupus, osteoarthritis, and rheumatoid arthritis.

Myth: Nothing can be done to prevent rheumatic disease

Fact: The causes of rheumatic disease are very varied, some of which are not even known, but many factors influence the onset of rheumatic disease and some of them can be prevented so that they do not cause joint pain or aggravate existing diseases, including maintaining ideal body weight, exercising regularly, avoiding prolonged physical and psychological stress and avoiding smoking.

What are the risk factors for rheumatic diseases?

The likelihood of rheumatic disorders increases with age, genetics, smoking, gender (more profound in women than men), history of live births (women who have never given birth are at higher risk), obesity, and early life exposures such as children whose mothers smoked have higher risks of developing rheumatic disorders.

What are the treatment options for rheumatic diseases?

Rheumatic illnesses can be treated through medication, surgery, weight management (exercise), massage, joint immobilization (use of splint or brace to help joints rest and prevent further injury), and use of heat or cold to ease the pain.

How can we prevent rheumatic illnesses?

There is no sure way to prevent rheumatic diseases. However, getting physically active through exercise, stopping to smoke, and managing a healthy weight are some of the ways that can reduce the risks.

Kenyatta National Hospital has rheumatology clinics on Tuesdays (for patients with rheumatic tissue diseases) and Thursdays for arthritis and other related illnesses and pain disorders. Pediatric rheumatology clinic services are also offered. Additionally, there is a fully-fledged ward that offers care for rheumatic patients.

Dr. Etau attending to a patient at clinic 17

PHOTO | STEVE ARWA

Dr. Etau- Senior Medical Specialist

PHOTO | STEVE ARWA