The shortage of rheumatologists will worsen in the coming years due to retirements, warned Priv.-Doz.Dr. Valerie Nell-Duxneuner at a press conference on the occasion of a specialist congress of the European Alliance of Associations for Rheumatology (EULAR), which is taking place in Vienna this year from 12 to 15 June. There is also a lack of doctor's surgeries, especially in rural areas.

Early detection and specific, modern treatment are particularly important for rheumatic diseases. Otherwise there is a risk of long-term damage, inability to work and loss of quality of life.

Long road to diagnosis
Patient Ariane Schrauf reported on this. In 2017, at the age of 41, she was diagnosed with diffuse systemic scleroderma (a rare, chronic autoimmune disease of the connective tissue), associated with severe pain, restricted movement, difficulty swallowing and gastrointestinal problems.

But it took a long time for the diagnosis to be confirmed. It was hell. "Then, in June 2018, I had a complete breakdown. The examinations initially pointed to a possible heart attack. Despite extensive heart examinations in hospital, which confirmed a healthy heart, the cause of my symptoms remained unclear. A doctor finally referred me to the Clinical Department of Rheumatology and Immunology at Graz Regional Hospital (LKH). After numerous examinations, a capillary examination revealed the diagnosis. That plunged me into a psychological hole."

Dependent on help
The then single mother from Burgenland had to ask her teenage son to help her get dressed or open the jam jar. In the morning, it took up to an hour to get out of bed. Schauf: "Getting up in the morning was a particular problem because my joints were stiff. Movement was hardly possible, I couldn't bend my fingers."

A new treatment method with a so-called anti-CD20 antibody (acts on the immune system) as a long-term therapy then helped her. Physiotherapy and psychological relief are also important. Now the patient can even cycle again and finds courage and confidence in it: "Cycling is now just as important a part of the therapy for me as the infusions. It gives me a break from the illness".

Austrian researchers at the forefront
This makes further scientific work and more awareness of rheumatic diseases all the more important, as Prof. Dr. Daniel Aletaha, Head of the Clinical Department of Rheumatology at Vienna General Hospital and President of EULAR, also emphasized. "In the past two decades, an extraordinary leap in knowledge has been made in rheumatology, in which Austrian scientists have played a key role. In rheumatology therapy, we are no longer just concerned with making patients feel better - they really have to feel better! We are continuing to work and research on this."

Rheumatism is not just a joint disease in older people, but an inflammatory systemic disease that can occur at any age, emphasized Assoc. Prof. Dr. Helga Lechner-Radner from the Department of Rheumatology at Vienna General Hospital and Head of the Science Section of the Austrian Rheumatology Society (ÖGR): "Early diagnosis and adequate treatment are therefore essential to reduce the burden on individual patients and society in general."

Inflammatory rheumatic diseases not only cause pain, they also lead to restricted movement and reduced physical and cognitive performance and even permanent disability. Musculoskeletal diseases are the main cause of disability in Europe and are responsible for more than 50 percent of years spent in disability. According to the World Health Organization (WHO), a third of all patients with rheumatoid arthritis (chronic inflammation of the joints due to misdirected immune processes) lose their jobs within five years of being diagnosed, and the majority experience a significant reduction in productivity at work and in everyday life.

How can the lack of care be stopped? The profession of rheumatologist is already being made attractive to young doctors through targeted information and training programs. The ÖRG and patient organizations are calling for the establishment of a "rheumatism specialist unit to support the interdisciplinary care of those affected. In addition, the use of artificial intelligence, medical apps and robotic systems (e.g. for ultrasound examinations) will bring faster results.

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