Artificial Intelligence and Machine Learning in Rheumatology and Systemic Inflammatory Diseases: From Pattern Recognition to Signal Analysis and Clinical Decision Support

Artificial intelligence (AI) and machine learning (ML) are transforming the landscape of rheumatological and systemic inflammatory disease management, offering unprecedented capacity to integrate complex, multidimensional data for diagnostic support, disease monitoring, and therapeutic decision-making. This comprehensive narrative review, based on a non-systematic literature search of PubMed/MEDLINE and Google Scholar combined with the authors’ clinical expertise, provides a clinically oriented synthesis of current and emerging AI applications across the full spectrum of immune-mediated inflammatory diseases—including rheumatoid arthritis, systemic lupus erythematosus, vasculitis, inflammatory bowel disease, psoriatic arthritis, systemic sclerosis, inflammatory myopathies, and sarcoidosis—with particular attention to applications that have demonstrated or are approaching clinical utility. We discuss deep learning-based image analysis, natural language processing of electronic health records, multi-omic biomarker discovery, and the application of Fourier transform-based signal processing to biological time series as a novel approach to continuous disease monitoring. Fourier transform methods—already foundational in MRI reconstruction, cardiac electrophysiology, and clinical neurophysiology—are here systematically extended to rheumatological and inflammatory disease signals, including accelerometry, electromyography, heart rate variability, and longitudinal biomarker time series. The phenomenon of large language model hallucination—particularly critical in rare inflammatory diseases—is addressed alongside retrieval-augmented generation as a mitigation strategy. We further argue that AI-driven methods do not merely improve the interpretation of clinical data, but fundamentally expand what is observable—with profound epistemological implications for clinical knowledge transmitted through generations of medical tradition. Ethical considerations and future directions toward precision inflammatory disease medicine are outlined.