Zusammenfassung
Die Fortschritte der Rheumatologie haben aus fast regelhaft zu Invalidität und frühem Tod führenden chronischen entzündlich-rheumatischen Erkrankungen gut behandelbare Krankheitsbilder gemacht. Dieser Fortschritt bringt aber auch ein paar Herausforderungen mit sich. Diese CME-Arbeit fasst den aktuellen Stand der Rheumatologie prägnant und anhand der wesentlichen Erkrankungsbilder zusammen und beleuchtet ihre Schnittstellen.
Abstract
Progress in Rheumatology has turned inflammatory rheumatic entities that usually led to disabilities and early death into well treatable diseases. The same success, however, has brought a couple of challenges. One, the normalization of the patientsʼ life expectancy leads to an increase in the prevalence and is demanding on available rheumatologic therapeutic capacities. Two, an early start of disease-modifying anti-rheumatic drugs, optimally within six weeks after the onset of complaints, is of greatest importance – longer delays diminish chances for remission and increase the risk of permanent damage. Three, an exact diagnosis has become more important, since many of the modern therapies work for one or two of the inflammatory rheumatic entities only. Four, the spectrum of orthopedic Rheumatology has changed; previously common surgical interventions are performed in relevant frequencies predominantly in specialized centers today. All this, within Rheumatology,
constantly stresses the interdisciplinary collaboration between (orthopedic) surgeons and internists (rheumatologists). Still, the interdisciplinary approach is essential for optimal care for rheumatic patients. This CME article tries to give a short overview of the current state of Rheumatology, taking the most relevant inflammatory rheumatic diseases as examples, and to highlight important interfaces.
Schlüsselwörter
Differenzialdiagnose - immunmodulierende Basistherapie - rheumatoide Arthritis - Spondyloarthritiden - Gicht - perioperatives Management - präventive Operation - rekonstruktive Operation
Key words
differential diagnosis - disease modifying anti-rheumatic drugs - rheumatoid arthritis - spondyloarthritis - gout - perioperative management - preventive surgery - reconstructive surgery
