Advances in the evaluation and classification of chronic inflammatory rheumatic diseases.

The challenges of diagnosing rheumatic diseases are the high prevalence of certain rheumatic diseases, the existence of orphan disease, and the different pathophysiological backgrounds including infection and autoimmune mechanisms. During recent decades, more and more attention has been drawn to early diagnosis and achievement of full remission. Accordingly, new classification criteria have been developed and more biomarkers introduced into clinical practice. Specific laboratory parameters as well as wider use of functional imaging tools like ultrasound and magnetic resonance further support the early diagnostic process. Besides diagnosis early after disease onset, achievement of remission during follow-up is another important clinical aim of rheumatologists. In parallel with the development of new therapeutic approaches, both quality of life and treatment outcome especially of chronic inflammatory diseases could be improved. Both specific outcome parameters and global disease activity assessments are important to verify treatment goals of (full) remission, and at the same time may also predict response to treatment regimens.