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Until a decade ago, anyone with issues related to joints, muscles or ligaments would often go to an orthopedic or any other practicing physician only to be recommended to a rheumatologist much later. Sometimes the delay caused worsening of a health condition which could have been handled better by doctors who are especially trained to deal with these issues – the rheumatologists. However, it is only recently that people are becoming more aware of the field of rheumatology. Dr. Uma Kumar, Sr. Rheumatologist and Head of Rheumatologists Department, AIIMS shares how these diseases pose a tremendous burden on the society and are on rise due to environmental factors.

According to WebMD, rheumatic diseases affect your joints, tendons, ligaments, bones, and muscles. They also include many types of arthritis, a term used for conditions that affect your joints. Sometimes they are also referred to as musculoskeletal diseases. To put it simply, most of the rheumatic diseases occur when your immune system goes wrong and starts to attack your own tissues – these are also commonly known as autoimmune diseases.

Rheumatic diseases affect more women than men


Gender plays a significant role in rheumatic diseases. Several studies have shown that the autoimmune disorders are more common in women than men. Dr Ruma explains, “Women have a more strong immune system than men- and that is the reason the mortality rate of a female child is less than a male child. This is because most of the immune related genes are located on the X chromosome and because women have two X chromosomes, their immune system is considered stronger.” In an ideal case scenario, our body is prohibited from attacking its own cells but when it goes haywire, they start attacking their own cellular system, leading to autoimmune disorders. “Moreover, estrogen hormone is pro inflammatory, which makes it all the more risky for women in case the cells self attack.”

Why are rheumatic disorders becoming common?


While there is no concrete data on why these disorders are becoming common, a lot of it is a result of factors around you. The rate of infections have gone up tremendously. Cases of chikungunya, dengue, bacterial and fungal infections are all going up. Then air pollution, smoking, stress, exposure to toxic chemicals and pesticides through the food we eat is also leading to an increase in rheumatic disorders. Sometimes the incidence is also genetic.

The hygiene hypothesis


Dr Kumar feels that our overly cautious approach towards hygiene is to be blamed too! “As a child I remember walking and playing barefoot. But today parents ensure that their kids maintain the highest levels of hygiene while playing and so these kids are not exposed to good and bad bacteria. Such children, when they grow, have higher tendencies of bacterial infections.”

There are primarily two types of rheumatic diseases – organ specific and systemic (involving multiple organs). Osteoarthritis, rheumatoid arthritis, spondyloarthropathies, lupus, gout, celiac disease, multiple sclerosis are some of the diseases.

Symptoms that are often missed


Like most medical conditions, some rheumatology conditions creep in silently – sometimes these conditions are often ignored or misunderstood. Dr Kumar shares, “Sometimes prolonged fever is mistaken for TB, or people tend to ignore pain and swelling around joints, oral and genital ulcerations, excessive hair fall, dryness of eyes and mouth among others.”

COVID and rheumatology patients


When COVID struck, Dr Kumar was extremely worried about her patients. However, she was happy to see that COVID didn’t impact her patients the way she was fearing. “The few patients who tested COVID positive recovered easily.” She feels it could also be because of the medications they are on – like hydroxychloroquine.



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