In sum, I believe that we have not adequately prepared the public for the potential calamity of developing RA. Regrettably, the disease has very little identity unto its own. Despite all the good efforts and intentions of the ACR and the AF, the average individual still has very little appreciation for the vast differences between the two polar opposites: osteoarthritis (OA) and RA. There is no sense of proportionality between the two, no perspective. Only those stricken with the latter quickly learn to distinguish it from the former, the hard way.
Despite the numerous advances in treating rheumatic diseases over the past few decades, a major communication gap still exists regarding the complexity and gravity of rheumatic diseases.
Nomenclature
Confusion of nomenclature remains, in large part, for this failure of insight. Surely, at some point, we should admit mission: impossible! The current classification is simply too archaic and uninformative to expect nonprofessionals to comprehend. Its one thing to teach medical students to distinguish between OA and RA, but its quite another to expect the media or the public to “get it.” It’s past time that we should consider making changes for the sake of clarity for both our patients and the public.
Verbiage and nomenclature certainly do matter. Recently, one of my more erudite golfing buddies asked me (with only a bit of tongue in cheek), “What is it you rheuma-tologists study, phlegm?”
We must face the reality that anything with “arthritis” as part of its name is likely to be relegated to a second tier of human suffering. And, as aforementioned, adding the prefix “rheumatoid” frequently adds little additional impact or insight. Looking back, I believe humanity would have been better served had our forefathers originally designated RA as “rheumatic arthritis” rather than “rheumatoid” (i.e., rheumatic-like) to distinguish it from rheumatic fever. The “rheumatic” connotation would imply a more dynamic and potentially serious illness and would have better distinguished it from OA. “Rheumatoid” sounds indolent, retiring, and yes, more like “rheumatism.”
A Humble Suggestion
As an initial salvo towards better understanding for all, I suggest it is time for some simple, but significant, name changes. The current nomenclature is simply too arcane and misleading. We are using 18th century nomenclature for 21st century bioscience. We are dealing with catastrophic disease here, under the guise of “rheumatism.” It just doesn’t make good sense, and I feel is no longer appropriate.
