The most common rheumatological conditions in the general population include osteoarthritis, low back pain, and soft tissue rheumatism, often initially managed in Primary Care. However, the Rheumatology department focuses on inflammatory diseases like rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, as well as connective tissue diseases such as lupus and scleroderma, and gout. While less frequent, these latter conditions require more specialized treatments.
While a drastic increase in young patients hasn't been observed, certain inflammatory and autoimmune diseases are suspected more frequently. Most diagnoses occur in middle-aged individuals, predominantly women. The specialist highlights a growth in cases of gout and knee osteoarthritis, linked to sedentary lifestyles, obesity, and processed food consumption.
The last decade has seen significant therapeutic advancements, particularly in inflammatory diseases of immunological origin. Advanced therapies, targeting specific inflammation molecules, have revolutionized the management of rheumatoid arthritis, lupus, and vasculitis, allowing patients to lead more normal lives and reducing the need for intensive treatments or prolonged corticosteroid use, known for their side effects.
Early diagnosis is crucial, especially for rheumatoid arthritis and psoriatic arthritis. Initiating treatment within the first few months of symptom onset significantly improves prognosis. Therefore, coordination with Primary Care to identify warning signs is essential.
Lifestyle choices play a critical role. Smoking and obesity increase the risk of developing and worsening conditions like rheumatoid arthritis, lupus, and osteoarthritis. The department collaborates with case management nurses to educate patients on healthy habits and will launch a project for obesity management using new drugs.
High patient demand and the efficient management of costly advanced therapies are key challenges for the specialty. Research in systemic lupus erythematosus, cardiovascular risk, interventional rheumatology, and osteoporotic fractures are priority areas within the department.
Projects are underway to enhance patient connection through digital platforms and nursing staff, facilitating remote query resolution and consultations. The promotion of patient education programs, combining in-person and online sessions, aims to provide updated information.
Population aging has increased healthcare demand, particularly concerning osteoporotic fractures, such as hip fractures, which primarily affect elderly women. Deficiencies in socio-sanitary resources and hospital beds adapted for this patient profile have been identified.
Although the role of the rheumatologist is more widely recognized, confusion with traumatologists and rehabilitation physicians persists, especially for back or shoulder conditions. Patients with active inflammatory diseases or poor prognoses, such as severe arthritis or lupus, require closer monitoring with monthly or quarterly check-ups.
