Rheumatology & Arthritis

What is Rheumatology?

Rheumatology is a super-speciality in medicine that deals with inflammatory and auto-immune disorders affecting the connective tissues and joints. Rheumatic diseases usually affect joints resulting in joint swelling, stiffness, reduced movement of joints etc. They are disorders of immune system.

Rheumatologists are doctors who specialize in treatment of rheumatological disorders like Rheumatoid arthiritis, Ankylosing Spondylitis, Psoriatic arthiritis, Gout, SLE, Scleroderma etc.

Which Joints are affected in Rheumatic diseases?

Any joint in the body may be affected – from small joints to hands to large joints like knee and shoulder. They also involve the spine (back bone). Adults & Children both can be affected.

Rheumatic diseases do not involve joints alone

In addition to joints and bones, rheumatic diseases can affect multiple organs like lungs, eyes, heart, kidneys, brain, stomach and intestines. They can affect outcome of pregnancies and interfere with conception and child bearing. They affect daily living of person and lead to disability and loss of work. Osteoporosis (“Holes in bones”) is another important problem that exists in patients with rheumatic diseases.

Treatment of Rheumatic diseases

The treatment of Rheumatic diseases is usually long-term. They can be controlled well with disease-modifying drugs and biologics. In addition to specialized medicines as per your Rheumatologist’s prescription, regular exercises and good life-style measures are very important.

Common Rheumatic Diseases

 Rheumatoid Arthritis

Rheumatoid Arthritis is an auto immune disease, which means the body’s immune system mistakenly attacks healthy tissue leading to inflammation of the joints and surrounding tissues. RA affects other organs also and is more common in middle aged women. The classic symptoms of rheumatoid arthritis are morning stiffness and swelling o the joints (especially hand joints) and it usually affects the same joint of both sides of the body. Rheumatoid arthritis can be treated with anti-inflammatory medications (Ibuprofen, Diclofenac); Disease modifying anti-rheumatic drugs – DMARDs (Methotrexate, Sulfasalazine); Corticosteroids and biological therapies. Surgery is indicated in the late stages.

Ankylosing Spondylitis

Ankylosing Spondylitis is another condition that causes inflammation in the spinal and hip joints leading to these bones to join together. Eventually this leads to stiffness and loss of mobility in the joints. The disease affects males between ages 20 and 40 more often than females. Ankylosing Spondylitis presents with joint/back pain and stiffness that is worse at night and improves with activity or exercise. Corticosteroids and tumour necrosis factor (TNF) inhibitors can improve the symptoms of ankylosing spondulitis. Surgery is only required in the late stages to correct spinal deformities or allow hip movements.

Gout

Gout is a rheumatic disease related to uric acid levels in blood. Gout affects ankles, feet, big toe commonly with sudden onset of pain, swelling, redness – it is more common in men. Gout is due to elevated levels of uric acid in the blood. This occurs due to a combination of diet and genetic factors. At high levels, uric acid crystallizes and the crystals deposit in joints, tendons and surrounding tissues, resulting in an attack of gout. Gout occurs more commonly in those who eat a lot of meat, drink a lot of beer, or are overweight. Diagnosis of gout may be confirmed by seeing the crystals in joint fluid or tophus. Blood uric acid levels may be normal during an attack.