Rheumatology Conditions We Treat
Rheumatologists address a variety of degenerative, inflammatory, and musculoskeletal conditions, most centering on the joints and surrounding soft tissues. While many of these conditions are not yet curable, they are manageable.
Symptoms of conditions can overlap, but treatments may differ. Therefore, diagnosis is complex and must draw not only on rigorous training but also experience in the field.
Pain and stiffness in joints caused by osteoarthritis may be the result of aging, past bone fractures, and wear and tear on joints and ligaments. Over time, cartilage that protects the bones at the joints wears away, allowing bones to rub together.
While symptoms of this degenerative form of arthritis most often occur in those older than 70, they can also appear in patients as young as 55. Although there is as yet no cure, the painful symptoms can be relieved and degeneration can be stemmed to allow the patient a more active lifestyle, forestalling a need for joint replacement surgery.
RA, an autoimmune disease, allows a person’s immune system to break down the membrane that lines bone joints. The result can be debilitating pain that can be persistent or can flare up. In the worst cases, RA can cause joint deformation and disability. Symptoms can include pain, swelling, fatigue, and loss of appetite.
Most patients diagnosed with RA are women, but the disease can affect both men and women, young, middle aged, and old. There is currently no cure for RA, but early diagnosis and treatment allows patients to better control the pain and discomfort associated with the disease.
Psoriatic arthritis is a type of arthritis linked with psoriasis. Psoriasis is a chronic skin and nail disease. It causes red, scaly rashes and thick, pitted fingernails. Psoriatic arthritis is similar to rheumatoid arthritis (RA) in symptoms and joint inflammation. But it tends to affect fewer joints than RA, and it does not produce the typical RA antibodies.
Ankylosing spondylitis (AS) is a type of arthritis that affects the spine. Ankylosing means stiff or rigid, spondyl means spine, and itis refers to inflammation. The disease causes inflammation of the spine and large joints, resulting in stiffness and pain.
Ankylosing spondylitis may result in erosion at the joint between the spine and the hip bone, which is called the sacroiliac joint. It may also cause bony bridges to form between vertebrae in the spine, fusing those bones. Bones in the chest may also fuse.
Reactive arthritis is a type of arthritis that occurs due to an infection. Arthritis is when joints become inflamed and painful. Also known as Reiter’s Syndrome, it mostly affects men ages 20 to 50.
Crystal Arthritis (Gout and Pseudogout)
People used to think of gout as a painful condition that resulted from living too much of the good life. In reality, gout is a form of arthritis where there is a high level of uric acid in one’s system, often caused by the body making too much, or the kidneys not eliminating enough. The excess uric acid creates a buildup of crystallization within the joints, leading to pain and swelling.
Lifestyle changes, diet, exercise and anti-inflammatory medications help patients control flare-ups, while we seek solutions to help each patient reduce the amount of uric acid stored in the body.
Pseudogout is caused by deposits of calcium pyrophosphate crystals that trigger pain, stiffness, tenderness, redness, warmth, and swelling in joints.
Polymyositis and Dermatomyositis
These connective tissue diseases — the first involving muscles, the second muscles and skin — most frequently affect the shoulders, arms, pelvis and thighs. If attacking other muscles, they can also complicate a patient’s health issues. For example, an attack on the diaphragm can affect breathing; on the pharyngeal muscles, a person’s ability to swallow. When the skin is also affected, in dermatomyositis, a rash will often appear on a patient’s eyelids, knuckles and cheeks.
Diagnosis usually involves a biopsy of an affected muscle. Medications can combat muscle inflammation and slow muscle degeneration.
Polymyalgia Rheumatica and Temporal Arteritis
A rare condition, polymyalgia rheumatica causes aches and pain in the larger muscle groups, usually affecting the shoulders and hips. About 15 percent of patients with polymyalgia rheumatica as a primary diagnosis also have temporal arteritis, a condition in which inflammation damages large- and medium-size arteries. About half the patients with a primary diagnosis of temporal arteritis have polymyalgia rheumatica as a coexisting condition.
Vasculitis refers to a varied group of disorders that share an underlying problem of inflammation of a blood vessel or vessels. Many autoimmune diseases have vasculitis as one of their complications. These include systemic lupus erythematosus, rheumatoid arthritis, scleroderma, and polymyositis.
Autoinflammatory diseases are a relatively new category of diseases that are different from auto-immune diseases. However, both autoimmune and autoinflammatory diseases stem from the immune system attacking the body’s own tissues, and they also result in increased inflammation. Autoinflammatory diseases include Familial Mediterranean Fever, Neonatal Onset Multisystem Inflammatory Disease, and Behçet’s Disease.
Scleroderma is a chronic disease that causes abnormal growth of connective tissue. It can affect the joints, skin, and internal organs. It is degenerative (gets worse over time).
An autoimmune disease that causes white blood cells to attack moisture-producing glands, there is not yet a cure for Sjogren’s syndrome, which is estimated to affect four million people in the United States. Symptoms can include dry eyes, dry mouth, fatigue and musculoskeletal pain. Because patients rarely have the same combination of symptoms, and other diseases share similar signs, the disease is often misdiagnosed.
Systemic Lupus Erythematosus
Systemic lupus erythematosus causes a body’s immune system to mistakenly attack healthy tissue. It can appear in children as young as 10, as well as adults.
Symptoms may vary depending upon the part of the body affected, but some common symptoms include sensitivity to sunlight, mouth sores, hair loss, rash, fever, and general fatigue. More advanced symptoms can include numbness, seizures and vision problems, abdominal pain and vomiting, abnormal heart rhythms, coughing up blood and difficulty breathing, and patchy skin color.
Other Musculoskeletal Conditions
From the Greek for “porous bone,” osteoporosis is a fairly common condition of bone deterioration, with an estimated 10 million men and women in America affected by the disease. Weakening of the bones often goes unnoticed until a break occurs. A physical exam and evaluation of a patient’s medical history can highlight risk factors. For those who may be at moderate or high risk, laboratory tests and a bone scan using our in-house DEXA Scan diagnostics can detect the presence and severity of the condition.
Indicators of osteoporosis can be recent bone breaks, height loss, a stooped posture or back pain.