The pitfalls in the diagnosis and treatment of rheumatic diseases

Yi Chun Lin, Hsien Tzung Liao, Toong Hua Liang, Hsiao Yi Lin

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Rheumatism is defined as any abnormalities related to bone, joint, muscle or other connective tissues. It is presented as different clinical symptoms/signs and even atypical ones during the disease progressed. Besides, the highly overlapping characteristics exist between many rheumatic diseases and some doctors may fall into the unnecessary pitfalls in daily practice. These factors lead to over-, under- or mis-diagnosis occasionally. The two major pitfalls are that individual carrying an immunological marker is sometimes considered as a victim of rheumatic disease and some kind of rheumatic diseases affects only specific age group or gender exclusively. The examples of the former are rheumatoid factor is looked as the same meaning as rheumatoid arthritis; anti-nuclear antibody is equivalent to systemic lupus erythematosus; human leukocyte antigen HLA-1327 equals to ankylosing spondylitis; and hyperuricemia means gouty arthritis. The instances of the latter are systemic lupus erythematosus affect young females only; ankylosing spondylitis solely involve young male; gouty arthritis seldom happen in young people. In fact, these concepts are all misunderstanding. There are several out-of-date or wrong notions about the treatment of rheumatic diseases which may induce ineffective results. For example, treating rheumatoid arthritis according to the conventional pyramid model may lead to the missing of golden treatment period; prescribing large amount of corticosteroid in patients of systemic lupus erythematosus for afraid of potential side effects of immuno-suppressive agents and eventually lead to un-wanted side effects of steroid; abuse of non-steroidal anti-inflammatory drugs leads which severe complications such as upper gastro-intestinal bleeding; prescribing hypouricemic agents promptly for any patients of asymptomatic hyperuricemia. The purpose of this article is to discuss and clarify the pitfalls frequently encountered in the daily medical practice.

Original languageEnglish
Pages (from-to)147-160
Number of pages14
JournalJournal of Internal Medicine of Taiwan
Volume15
Issue number4
Publication statusPublished - 2004
Externally publishedYes

Fingerprint

Rheumatic Diseases
Gouty Arthritis
Systemic Lupus Erythematosus
Hyperuricemia
Ankylosing Spondylitis
Rheumatoid Arthritis
Therapeutics
Rheumatoid Factor
HLA Antigens
Connective Tissue
Signs and Symptoms
Anti-Idiotypic Antibodies
Adrenal Cortex Hormones
Anti-Inflammatory Agents
Age Groups
Joints
Steroids
Hemorrhage
Bone and Bones
Muscles

Keywords

  • Anti-cyclic citrullinated peptide antibody
  • Anti-nuclear antibody
  • Human leukocyte antigen-B27
  • Hyperuricemia
  • Quantitative sacroiliac scan
  • Rheumatoid factor

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Lin, Y. C., Liao, H. T., Liang, T. H., & Lin, H. Y. (2004). The pitfalls in the diagnosis and treatment of rheumatic diseases. Journal of Internal Medicine of Taiwan, 15(4), 147-160.

The pitfalls in the diagnosis and treatment of rheumatic diseases. / Lin, Yi Chun; Liao, Hsien Tzung; Liang, Toong Hua; Lin, Hsiao Yi.

In: Journal of Internal Medicine of Taiwan, Vol. 15, No. 4, 2004, p. 147-160.

Research output: Contribution to journalArticle

Lin, YC, Liao, HT, Liang, TH & Lin, HY 2004, 'The pitfalls in the diagnosis and treatment of rheumatic diseases', Journal of Internal Medicine of Taiwan, vol. 15, no. 4, pp. 147-160.
Lin, Yi Chun ; Liao, Hsien Tzung ; Liang, Toong Hua ; Lin, Hsiao Yi. / The pitfalls in the diagnosis and treatment of rheumatic diseases. In: Journal of Internal Medicine of Taiwan. 2004 ; Vol. 15, No. 4. pp. 147-160.
@article{e505c7c7b24a4b3782066adde576efa3,
title = "The pitfalls in the diagnosis and treatment of rheumatic diseases",
abstract = "Rheumatism is defined as any abnormalities related to bone, joint, muscle or other connective tissues. It is presented as different clinical symptoms/signs and even atypical ones during the disease progressed. Besides, the highly overlapping characteristics exist between many rheumatic diseases and some doctors may fall into the unnecessary pitfalls in daily practice. These factors lead to over-, under- or mis-diagnosis occasionally. The two major pitfalls are that individual carrying an immunological marker is sometimes considered as a victim of rheumatic disease and some kind of rheumatic diseases affects only specific age group or gender exclusively. The examples of the former are rheumatoid factor is looked as the same meaning as rheumatoid arthritis; anti-nuclear antibody is equivalent to systemic lupus erythematosus; human leukocyte antigen HLA-1327 equals to ankylosing spondylitis; and hyperuricemia means gouty arthritis. The instances of the latter are systemic lupus erythematosus affect young females only; ankylosing spondylitis solely involve young male; gouty arthritis seldom happen in young people. In fact, these concepts are all misunderstanding. There are several out-of-date or wrong notions about the treatment of rheumatic diseases which may induce ineffective results. For example, treating rheumatoid arthritis according to the conventional pyramid model may lead to the missing of golden treatment period; prescribing large amount of corticosteroid in patients of systemic lupus erythematosus for afraid of potential side effects of immuno-suppressive agents and eventually lead to un-wanted side effects of steroid; abuse of non-steroidal anti-inflammatory drugs leads which severe complications such as upper gastro-intestinal bleeding; prescribing hypouricemic agents promptly for any patients of asymptomatic hyperuricemia. The purpose of this article is to discuss and clarify the pitfalls frequently encountered in the daily medical practice.",
keywords = "Anti-cyclic citrullinated peptide antibody, Anti-nuclear antibody, Human leukocyte antigen-B27, Hyperuricemia, Quantitative sacroiliac scan, Rheumatoid factor",
author = "Lin, {Yi Chun} and Liao, {Hsien Tzung} and Liang, {Toong Hua} and Lin, {Hsiao Yi}",
year = "2004",
language = "English",
volume = "15",
pages = "147--160",
journal = "Journal of Internal Medicine of Taiwan",
issn = "1016-7390",
publisher = "臺灣內科醫學會",
number = "4",

}

TY - JOUR

T1 - The pitfalls in the diagnosis and treatment of rheumatic diseases

AU - Lin, Yi Chun

AU - Liao, Hsien Tzung

AU - Liang, Toong Hua

AU - Lin, Hsiao Yi

PY - 2004

Y1 - 2004

N2 - Rheumatism is defined as any abnormalities related to bone, joint, muscle or other connective tissues. It is presented as different clinical symptoms/signs and even atypical ones during the disease progressed. Besides, the highly overlapping characteristics exist between many rheumatic diseases and some doctors may fall into the unnecessary pitfalls in daily practice. These factors lead to over-, under- or mis-diagnosis occasionally. The two major pitfalls are that individual carrying an immunological marker is sometimes considered as a victim of rheumatic disease and some kind of rheumatic diseases affects only specific age group or gender exclusively. The examples of the former are rheumatoid factor is looked as the same meaning as rheumatoid arthritis; anti-nuclear antibody is equivalent to systemic lupus erythematosus; human leukocyte antigen HLA-1327 equals to ankylosing spondylitis; and hyperuricemia means gouty arthritis. The instances of the latter are systemic lupus erythematosus affect young females only; ankylosing spondylitis solely involve young male; gouty arthritis seldom happen in young people. In fact, these concepts are all misunderstanding. There are several out-of-date or wrong notions about the treatment of rheumatic diseases which may induce ineffective results. For example, treating rheumatoid arthritis according to the conventional pyramid model may lead to the missing of golden treatment period; prescribing large amount of corticosteroid in patients of systemic lupus erythematosus for afraid of potential side effects of immuno-suppressive agents and eventually lead to un-wanted side effects of steroid; abuse of non-steroidal anti-inflammatory drugs leads which severe complications such as upper gastro-intestinal bleeding; prescribing hypouricemic agents promptly for any patients of asymptomatic hyperuricemia. The purpose of this article is to discuss and clarify the pitfalls frequently encountered in the daily medical practice.

AB - Rheumatism is defined as any abnormalities related to bone, joint, muscle or other connective tissues. It is presented as different clinical symptoms/signs and even atypical ones during the disease progressed. Besides, the highly overlapping characteristics exist between many rheumatic diseases and some doctors may fall into the unnecessary pitfalls in daily practice. These factors lead to over-, under- or mis-diagnosis occasionally. The two major pitfalls are that individual carrying an immunological marker is sometimes considered as a victim of rheumatic disease and some kind of rheumatic diseases affects only specific age group or gender exclusively. The examples of the former are rheumatoid factor is looked as the same meaning as rheumatoid arthritis; anti-nuclear antibody is equivalent to systemic lupus erythematosus; human leukocyte antigen HLA-1327 equals to ankylosing spondylitis; and hyperuricemia means gouty arthritis. The instances of the latter are systemic lupus erythematosus affect young females only; ankylosing spondylitis solely involve young male; gouty arthritis seldom happen in young people. In fact, these concepts are all misunderstanding. There are several out-of-date or wrong notions about the treatment of rheumatic diseases which may induce ineffective results. For example, treating rheumatoid arthritis according to the conventional pyramid model may lead to the missing of golden treatment period; prescribing large amount of corticosteroid in patients of systemic lupus erythematosus for afraid of potential side effects of immuno-suppressive agents and eventually lead to un-wanted side effects of steroid; abuse of non-steroidal anti-inflammatory drugs leads which severe complications such as upper gastro-intestinal bleeding; prescribing hypouricemic agents promptly for any patients of asymptomatic hyperuricemia. The purpose of this article is to discuss and clarify the pitfalls frequently encountered in the daily medical practice.

KW - Anti-cyclic citrullinated peptide antibody

KW - Anti-nuclear antibody

KW - Human leukocyte antigen-B27

KW - Hyperuricemia

KW - Quantitative sacroiliac scan

KW - Rheumatoid factor

UR - http://www.scopus.com/inward/record.url?scp=9144233575&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=9144233575&partnerID=8YFLogxK

M3 - Article

VL - 15

SP - 147

EP - 160

JO - Journal of Internal Medicine of Taiwan

JF - Journal of Internal Medicine of Taiwan

SN - 1016-7390

IS - 4

ER -