What is chronic inflammation?
Inflammation is a coordinated reaction in which blood flow, vessels and immune cells change to deal with damage or threat. Locally, the area may become tender, warm, red and swollen.
In chronic inflammation, the process continues for weeks, months, or longer. It can be found in the joints, intestines, skin, nervous system, blood vessels, or other organs.
There are also changes that are discovered during examination without clear symptoms. Read more about inflammation and MRI and how imaging findings need to be put into clinical context.
What can cause long-term inflammation?
Autoimmune and inflammatory diseases are an important group. Examples include rheumatic diseases, inflammatory bowel disease, psoriasis and certain neurological conditions.
Long-term infections can keep the immune system activated. Tissue damage, foreign material, and certain metabolic diseases can also contribute to a local inflammatory process.
The term low-grade inflammation is sometimes used broadly in health marketing. Vague symptoms such as fatigue, stress, or weight change should not be interpreted alone as evidence of hidden inflammation.
When should suspected inflammation be assessed?
Contact healthcare if you have prolonged fever, significant morning stiffness, recurrent joint swelling, blood in the stool, persistent diarrhea, unexplained weight loss, night sweats or prolonged pain with general effects.
A red, hot, and very painful joint with fever should be evaluated quickly to rule out infection in the joint. Chest pain, shortness of breath, or neurological symptoms also require urgent evaluation.
People with a weakened immune system or immunosuppressive treatment should often seek medical attention earlier if they have a fever and new symptoms.
Seek medical attention on the same day if you have a fever along with a red, warm and severely swollen joint or other rapidly worsening general condition.
How is long-term inflammation investigated?
The investigation begins with a medical history and physical examination. The pattern is important: which organs are affected, how long have the symptoms been present, and is there a family history or medications that affect the immune system?
CRP, erythrocyte sedimentation rate and blood count may show signs of inflammation but are not disease-specific. Liver and kidney tests, autoantibodies, stool samples and infection samples are selected based on the symptom picture.
Sometimes tissue samples or synovial fluid samples are needed and may be more conclusive than a broad diagnostic imaging examination.
What role do MRI and other diagnostic imaging play?
Ultrasound can show inflammation in superficial joints, tendons, and some abdominal organs. CT is quick and is often used for acute abdominal and pulmonary issues.
MRI can show inflammation and tissue damage in, for example, joints, spine, brain, spinal cord, muscles and intestines. The examination is chosen when the question concerns a specific area.
Imaging can show where the process is, but not always what is causing it. Blood tests, endoscopy, or biopsy may still be needed.
How is an inflammatory disease followed over time?
Follow-up is based on symptoms, function, clinical findings and sometimes repeated tests. A higher CRP may be positive but does not necessarily mean that all organ inflammation is gone.
Treatment depends on the cause and may include antibiotics for bacterial infection, anti-inflammatory or immunosuppressive drugs for autoimmune disease, and treatment of the affected organ.
Do not change immunosuppressive treatment on your own. Fever or signs of infection during such treatment should be discussed with the responsible healthcare provider.