Rheumatoid Arthritis or Rheumatoid Disease

Does the Name Really Matter?

Woman experiencing fatigue.
David DeLossy/Digital Vision/Getty Images

Rheumatoid arthritis is a frustrating disease. It's complicated. It's difficult to understand. It's difficult to live with and get under control. It's nearly impossible for others to fully understand. It's no wonder that people with the disease become annoyed and frustrated.

Some people with rheumatoid arthritis are bothered by the name of the disease. They believe "rheumatoid arthritis" over-simplifies the disease and doesn't distinguish it from other types of arthritis, especially osteoarthritis.

Interestingly, some people with osteoarthritis have their own complaint -- they think rheumatoid arthritis gets all of the media attention and research dollars. They think osteoarthritis is essentially overlooked. This tells us that everyone feels a little bit misunderstood. Human nature perhaps. With that realization, let's try to look at this objectively.

What's in a Name?

Most chronic diseases are complex, especially those that are chronic and without a cure. Unless you or someone very close to you has a specific disease, it's unlikely that you fully understand it. Alzheimer's versus dementia -- are they the same, similar, or different? Type 1 Diabetes versus Type 2 Diabetes -- how are they different? Cancer -- many types with long confusing names. And, Parkinson's disease, too. Does its name give you any clue what symptoms are involved?

If you know about any of these diseases and conditions, it is because you took the time to learn about them.

There is no shortcut for learning, taking the time to find a quality resource, reading, and asking questions. In fact, rheumatoid arthritis is an autoimmune, inflammatory, disabling type of arthritis. Rheumatoid arthritis is a systemic disease. Osteoarthritis is the most common type of arthritis and it is degenerative (the cartilage of the affected joint deteriorates).

Osteoarthritis is not a systemic disease. To add to the confusion, did you know you could have both rheumatoid arthritis and osteoarthritis? There are said to be over 100 types of arthritis. About a dozen are well-known, the rest are more rare.

Back to my point, the name of a disease reveals next to nothing by itself. If you want to know more and understand it, you need to dig deeper. Does it matter if we call it rheumatoid arthritis, rheumatoid disease, RA, or RD? Is one really any more telling than the other?

There is also another matter to be considered -- the already existing term "rheumatic diseases".  According to EULAR (European League Against Rheumatism), "Rheumatic diseases, also called musculoskeletal diseases, are characterized by pain and a consequent reduction in the range of motion and function in one or more areas of the musculoskeletal system; in some diseases there are signs of inflammation: swelling, redness, warmth in the affected areas. Rheumatic diseases can also affect internal organs.

Some people use the word arthritis to refer to all rheumatic diseases. Arthritis, which literally means joint inflammation, is just part of the rheumatic diseases." So if we want REAL confusion, bring on the term "rheumatoid disease" to compete with "rheumatic diseases."

Did You Know?

The first description of rheumatoid arthritis in modern medicine occurred in 1800 by a French doctor Dr. Augustin Jacob Landré-Beauvais from Salpêtrière Hospital. But, while he is credited with describing the disease, he incorrectly identified it as a form of gout. Even before him, several other doctors had discovered that it was likely different than gout. The name "rheumatoid arthritis", as we know it today, was coined in 1859 by British rheumatologist Dr. Alfred Baring Garrod.

So, there was confusion back then. We are not likely going to escape confusion with the complicated rheumatic diseases, some of which mimic rheumatoid arthritis because of overlapping symptoms. And, it is unlikely that you will be able to change the name of a disease that has been entrenched since 1859.

The Bottom Line

While the efforts of some to change the name from rheumatoid arthritis to rheumatoid disease seem futile to me, their motivation and frustration is understandable. The goal is to have people better understand rheumatoid arthritis. We all want people to understand that rheumatoid arthritis is a systemic disease and associated with extra-articular manifestations of the disease (i.e., involvement other than the joints).  It should be noted that not all rheumatoid arthritis patients develop extra-articular involvement. The prevalence of extra-articular involvement is about 40% of patients at any time during the course of the disease. Extra-articular involvement is more likely in patients who have rheumatoid factor and/or are positive for HLA-DR4.

It is important to know that extra-articular involvement is a possibility, though not a certainty for all rheumatoid arthritis patients. People will know that by learning about the disease and reading about the disease. There is no other way to gain full understanding.

I will end with an analogy. My friend's name is Kathleen. I call her Kathy. Some other friends call her Kay or Kat. Four names for the same person. It works because it doesn't matter. There's only one way to get to know Kathleen -- and that's to learn about Kathleen.

Sources

The first description of rheumatoid arthritis. Unabridged text of the doctoral dissertation presented in 1800. Joint Bone Spine. March 2001.
http://www.ncbi.nlm.nih.gov/pubmed/11324929

Alfred Baring Garrod (1819–1907). Rheumatology. (2001) 40 (10): 1189-1190.
http://rheumatology.oxfordjournals.org/content/40/10/1189.full

Extra-articular Manifestations in Rheumatoid Arthritis. Maedica (Buchar). Cojocaru M. et al. 2010 Dec; 5(4): 286–291.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152850/

Continue Reading