2011年美国布利甘-妇女医院风湿免疫疾病专家意见指南

Rheumatic disease encompasses a wide range of diseases and illnesses that are characterized by their propensity to affect the bones, joints, and soft tissues. Many of the diseases are immunologically mediated. They may be localized strictly to the joints (e.g., osteoarthritis), or they may have extra-articular and systemic manifestations (e.g.,lupus and rheumatoid arthritis).

The practice of rheumatology is critically dependent on the history and physical examination. In rheumatology, lab results are often more confusing than helpful. Objective diagnostic testing in rheumatology remains rudimentary, and most diagnoses require historical and physical examination features. In fact, the vast majority of diagnostic and management decisions hinge on the clinical history and physical examination, because in many cases a gold standard diagnostic test or disease activity assessment is not easily available. Consequently, diagnoses and management decisions might appear arbitrary and subjective to the novice clinician. The result is that rheumatology can be a particularly difficult discipline to master.