Common Rheumatological Conditions
Rheumatological conditions encompass all disorders affecting bones, joints, periarticular structures, and muscles, with the most common being osteoarthritis, rheumatoid arthritis, and back pain, which collectively represent the greatest socioeconomic burden. 1
Major Categories of Rheumatological Conditions
Inflammatory Arthritides
- Rheumatoid arthritis is the most commonly diagnosed systemic inflammatory arthritis, with a lifetime prevalence of up to 1% worldwide, predominantly affecting women, smokers, and those with family history. 2
- Ankylosing spondylitis represents a chronic inflammatory condition primarily affecting the spine and sacroiliac joints. 3
- Psoriatic arthritis occurs in patients with psoriasis, combining features of inflammatory arthritis with skin manifestations. 3
Degenerative Joint Disease
- Osteoarthritis ranks as one of the top ten causes of disability in the European Union, with prevalence rates of 6.8-21.5% in surveyed populations, increasing dramatically after age 45. 1, 4
- This condition is the fourth most frequent predicted cause of problems worldwide in women and eighth in men when measured by disability-adjusted life years. 1
Systemic Connective Tissue Disorders
- Systemic disorders of connective tissue include conditions like systemic lupus erythematosus and other autoimmune diseases that affect multiple organ systems beyond joints. 1, 5
- These conditions are associated with extra-articular manifestations including bone loss, fractures, and involvement of lungs, skin, and eyes. 5, 6
Bone Diseases
- Osteoporosis represents a major burden with a 40% lifetime fracture risk for women over 50 years in Europe, increasing with life expectancy. 1
- Bone diseases often coexist with inflammatory rheumatic conditions, creating compounded morbidity. 5
Regional Pain Syndromes
- Back pain is identified as a major cause of work incapacity by the WHO Global Burden of Disease Monitoring Programme. 1
- Soft tissue rheumatism includes conditions like bursitis and tendinitis affecting periarticular structures. 1, 7
- Regional and widespread pain syndromes encompass localized musculoskeletal complaints that may be self-limiting or chronic. 1
Clinical Impact and Burden
Prevalence and Disability
- In Europe, 20-30% of adults are affected by musculoskeletal pain at any given time. 1
- Two in five people with musculoskeletal problems experience limitations in everyday activities. 1
- These conditions are the most common cause of severe long-term pain and physical disability. 1
Healthcare Utilization
- Musculoskeletal conditions are the second most common reason for consulting a doctor, constituting 10-20% of primary care practice in most countries. 1
- One in five Europeans are under long-term treatment for musculoskeletal conditions. 1
- Up to 60% of people on early retirement or long-term sick leave cite musculoskeletal problems as the reason. 1
Important Clinical Considerations
Disease Complexity
- Many rheumatological conditions affect multiple organ systems beyond the musculoskeletal system, making management complex. 1
- Cardiovascular disease is the most common cause of death in patients with rheumatoid arthritis, with twice the risk of myocardial infarction compared to the general population. 6
- Respiratory disease occurs in 30-40% of rheumatoid arthritis patients and represents the second major cause of death. 6
Management Principles
- The greatest socioeconomic burden comes from back pain, osteoarthritis, and rheumatoid arthritis, with most costs being indirect (social care, pensions, workers' compensation). 1
- Effective management requires integrated, coordinated multidisciplinary care focused on individual needs. 1, 7
- Early diagnosis and treatment with disease-modifying antirheumatic drugs is associated with better outcomes, particularly for inflammatory conditions. 2, 8