Rheumatology: Introduction and Overview

00:01 Hello, how are you? Well, here's a topic called rheumatology.

00:05 An important topic. There is a lot to discuss, but follow me through this and I'll make sure that you keep your thoughts organized, and we'll take a look at the different pathologies, and where they will be properly categorized. Let's begin.

00:20 Rheumatic diseases.

00:22 What does this even include, and historically, what does it encompass? Well, historically, could have been part of what's known as your collagen-vascular diseases.

00:31 You've heard of issues such as Ehlers-Danlos, maybe Marfan's and so forth? But now, it's been further classified. For example, you've heard of systemic lupus erythematosus or divided into other issues, including immune and non-immune type of it… rheumatologies.

00:47 There'll be several subtypes. For example, we'll take a look at connective tissue diseases.

00:53 Under connective tissue diseases, we shall, look at SLE, Sjögren, and so forth.

00:59 There's a particular category known as seronegative, and what seronegative, spondylarthropathies mean is that the RF factor, in other words, rheumatoid factor, and I'll give you the definition of what that is exactly, is found to be negative in these conditions.

01:18 Example, for…you heard of psoriatic arthritis, you've heard of reactive arthritis, maybe inflammatory bowel disease, as we shall see, moving forward.

01:29 And then, quickly, to recap, we'll take a look at vasculitides.

01:33 Now, technically speaking, of course, vasculitides may come under cardiovascular.

01:39 However, because we're talking about blood vessels, and how it may then affect, not only the blood vessels, but then how that would manifest into the presentation, let's say with Wegener, or nowadays we call it granulomatosis with polyangiitis.

01:55 Next. Well, what about rheumatologists and what kind of disease are you in the U.S. going to encounter the most? Well, as we get older, I will talk to you about a very important condition.

02:08 It's wear and tear type of arthritis called osteoarthritis.

02:13 Or, you've heard of a patient who, during the holidays, Thanksgiving, Christmas and whatnot, may have been drinking quite a bit of alcohol, and the male, in his big toe might then be complaining of pain, gout.

02:27 We will talk about crystalline type of arthropathies.

02:30 Or, maybe the patient got sick, maybe bacteria infection, such as Staph or Strep, feels a lot of pain in the knee, a lot of swelling, maybe redness and maybe even feels warm upon palpation by you, the doctor.

02:45 We'll talk about septic arthritis.

02:51 Now, these rheumatologic diseases will encompass… Now, I need you to picture the following.

02:56 You have the skin, for example, and technically, skin could fall under this but, of course, that's a separate topical term. But the point is, the skin, and then you have the extracellular matrix.

03:08 And then you have the muscles. In other words, the material that anchor our organs, the substances that then anchor our muscle is then known as the extracellular matrix.

03:20 We'll talk about components of that.

03:23 Under this, we'll take a look at joints and different types of arthritides, skin issues…a lot of times there'll be rash manifestation.

03:31 There might be nerve issues, neuritis, myositis.

03:34 Kidney issues, as we shall see.

03:36 Lung, heart, gut, and brain might be affected.

03:38 We're talking about extracellular matrix. As I said, an extracellular matrix is basically the scaffolding that allows for many of our structures to remain stabilized.

03:48 And if this component of the extracellular matrix are compromised, then we'll have issues in all over the body.

03:56 Overall, our outline will be the following.

04:00 Interesting enough, when we talk about osteoarthritis, But it comes under non-autoimmune activity, wear and tear.

04:08 Crystalline gout, talk about accumulation of uric acid in different parts of the body.

04:12 Septic, once again, has nothing to do with autoimmune.

04:16 We'll talk about seronegative.

04:18 We'll talk about these conditions, including psoriatic arthritis, including our inflammatory bowel disease, ankylosing spondylitis.

04:25 And to be seronegative means to be what? Oh, rheumatoid factor negative.

04:30 What is a rheumatoid factor? Because you have to know the details.

04:33 I'll tell you in a little bit. Well, why not introduce this to you? It is the IgM that is in targeting the FC region of the IgG.

04:42 That's what it's meant to be rheumatoid factor positive.

04:46 If you're negative, that is not happening.

04:48 Then under connective tissue disease, long little list here.

04:52 We have rheumatoid arthritis. Now, that is going to be immune, isn't it? SLE will be immune. Scleroderma will be immune.

04:58 Raynaud, we'll talk about the colors of the hand turn into.

05:03 Inflammatory type of issues and so forth.

05:06 Then under vasculitis I will touch upon… Well, I'll divide this into large, medium, and small vessel. For example, you've heard of pulseless disease that's known as Takayasu.

05:16 Or a medium vessel, uch as polyarteritis nodosa, or small vessel disease.

05:21 You've heard of thromboangiitis obliterans.

05:25 And then we'll talk about those conditions in great detail.

05:28 For example, we'll go into definitions, go to pathogenesis, signs and symptoms and diagnosis, and how do you to manage these conditions, respectively.