The shared debt of art and rheumatology

Medicine is not part of the fine arts. However, it is the art, scientifically informed, of care. Rheumatology in particular requires the ability to observe, listen, feel and interpret with humanity to care for people with musculoskeletal diseases. This narrative review explores the reciprocal links between art, artists, and musculoskeletal systems to seek to balance the debt of rheumatology to art with the debt of art to rheumatology over time. Before the Renaissance, knowledge about rheumatology was relatively poor and was largely restricted to Hippocratic theories and animal descriptions provided by Galen, and therefore poorly represented by artists. From 1480 to 1520, painters began to establish the field of artistic anatomy, focusing on the science of external forms. Although its impact on understanding rheumatic diseases was minimal, it led to the identification of anatomical structures affected by these conditions. Thus, human anatomy was born. After 1700, poor hygiene, a lack of physical activity, and overeating by the middle class were believed to be likely external causes of joint diseases, particularly gout, which was often conflated with other arthritis. Inspired by painters who idealised thermal baths, spas and seaside facilities were developed, promoting sports, hygiene, wellness, and healthy gastronomy. This gave birth to hydrotherapy. Patients with rheumatic diseases began congregating in balneological and thermal cities, allowing physicians to better describe the nosology of musculoskeletal diseases. Thus, rheumatology was born. More than 200 musculoskeletal conditions were documented between 1800 and 2000. Art and rheumatology share a debt, and rheumatologists began to engage with patients through art.