Rheumatology & Clinical Immunology

Inflammatory Arthritis: In this disease inflammation occurs in and around the joints, thereby damaging the tissues, causing pain, stiffness and swelling. Inflammatory type of arthritis affects several joints. The different manifestations of this type of arthritis are:

• Rheumatoid Arthritis
• Psoriatic Arthritis
• Ankylosing Spondylitis
• Reactive Arthritis
• Gout and Psuedogout
• Juvenil Idiopathic Arthritis (JIA)

 

More on Rheumatoid Arthritis (RA)

What is Rheumatoid Arthritis?

Rheumatoid arthritis is a disease that affects the joints. It causes pain, swelling, and stiffness. If one knee or hand has rheumatoid arthritis, usually the other does too. This disease often occurs in more than one joint and can affect any joint in the body. People with this disease may feel sick and tired, and they sometimes get fevers.

Some people have this disease for only a few months or a year or two. Then it goes away without causing damage. Other people have times when the symptoms get worse (flares), and times when they get better (remissions). Others have a severe form of the disease that can last for many years or a lifetime. This form of the disease can cause serious joint damage.

Who can get Rheumatoid Arthritis?

Anyone can get this disease, though it occurs more often in women. Rheumatoid  arthritis often starts in middle age and is most common in older people. But  children and young adults can also get it.

What are the causes of Rheumatoid Arthritis?

Doctors don’t know the exact cause of rheumatoid arthritis. They know that with this arthritis, a person’s immune system attacks his or her own body tissues.

Researchers are learning many things about why and how this happens. Things that may cause rheumatoid arthritis are:

• Genes (passed from parent to child)
• Hormones

What are the signs and symptoms of Rheumatoid Arthritis?

RA usually starts over a period of weeks to months, with more joints affected over time. You should see your doctor if you experience any of the following symptoms for more than two weeks:

• You start to feel unusual pain and stiffness in your joints.
• Swelling of the wrists, knuckles or small joints of the fingers or toes, including the ball of the foot.
• Pain and stiffness in the morning, typically lasting more than 30-60 minutes before you “loosen up” and start feeling better.
• Unexplained tiredness.
• Weight Loss
• Unexplained fever
• Loss of appetite
• Dry eyes and mouth from a related health problem, Sjogren’s syndrome
• Firm lumps, called rheumatoid nodules, which grow beneath the skin in places such as the elbow and hands

Why is early diagnosis and treatment of Rheumatoid Arthritis essential?

RA causes inflammation (swelling, pain and warmth) in the affected joints. You can think of this inflammation like a “fire” burning in the joints. If the fire of inflammation is left “burning,” it can permanently damage the joint. To emphasize, RA can cause permanent joint damage quickly when it is not treated and controlled. This damage can occur even when the pain is not severe.

Once damage occurs, it is not reversible and can cause significant pain and disability. Fortunately, we know that much research has confirmed that treating RA early and aggressively often improves the long-term outcome and significantly reduces damage.

Connective Tissue Disease: This disease includes tendons, ligaments and cartilage that supports, binds and separates the body tissues and organs. Inflammation in these tissues can make one feel a range of other symptoms. The different manifestations of this type of CTD are:

• Systemic Lupus Erythematosus (SLE)
• Scleroderma
• Dermatomyositis & Polymyositis
• Sjogren's Syndrome
• Mixed Connective Tissue Diseases (MCTD)
• & Many more

Vasculitis is the designation given to a group of uncommon diseases which result in inflammation of the blood vessels. Symptoms of vasculitis vary greatly and depend upon the organs affected and the severity of the disease. Diagnosis of vasculitis can be confirmed by a biopsy of involved tissue or angiography. Treatment is directed toward decreasing the inflammation of the blood vessels and improving the function of affected organs.

  Examples of Vasculitis include:

• Takayasu's Arteritis
• Temporal Arteritis (GCA)
• Wegener's Granulomatosis (GPA)
• Microscopic Polyangitis (MPA)
• Churg-Strauss Syndrome (EGPA)
• Polyarteritis Nodosa (PAN)
• Kawasaki Disease
• Behçet's Disease
• Cryoglobulinemic Vasculitis

 

Soft Tissue Conditions: Soft tissue disorders are medical conditions affecting the soft tissues.

Often soft tissue injuries are some of the most chronically painful and difficult to treat because it is very difficult to see what is going on under the skin with the soft connective tissues, fascia, joints, muscles and tendons. The different manifestations of soft tissue conditions are:

• Tennis Elbow
• Carpel Tunnel & Tarsal Tunnel Syndrome
• Fibromyalgia

 

 

Metabolic Bone Disorders: This refers to an umbrella term that is used to describe allthe abnormalities in the bones. It could be due to hormonal imbalance or due to the deficiency of an essential minerals, such as – phosphorus, magnesium or vitamin D leading to dramatic clinical disorders that are commonly reversible once the underlying defect has been treated. The teams of experts carefully understand the underlying issues to distinguish the same from any genetic or hereditary disorders. The different manifestations of Metabolic Bone Disorders are:

• Osteoporosis
• Vitamin D Deficiency (Osteomalacia)
• Paget’s Disease