Differential diagnosis in immune-mediated rheumatic diseases

Dr Christian Dejaco is an associate professor in the Department of Rheumatology at the Medical University of Graz (Austria) and author of the European League Against Rheumatism (EULAR) recommendations for the management of polymyalgia rheumatica and large vessel vasculitis.

What conditions have to be excluded in the diagnostic workup of immune-mediated rheumatic diseases?

Christian Dejaco, MD, PhD: This depends on which type of rheumatic disease we are talking about. In arthritis, definitely the most important differential diagnoses are degenerative and mechanic disorders. However, there are also infections or neoplasms that can mimic inflammatory rheumatic joint disease.

In the field of vasculitis and connective tissue diseases it is particularly important to exclude neoplasms and infections in the first place and sometimes also other diseases from internal medicine that might induce damage of organs and mimic rheumatic diseases.