CONDITIONS

COMMON RHEUMATOLOGICAL CONDITIONS

Rheumatoid Arthritis
Rheumatoid arthritis is a chronic autoimmune condition which presents with pain and swelling of multiple joints. It usually affects small joints in a symmetrical fashion but other presentations can occur. Although joints are the main area involved, it can affect other organs of body like lungs, heart and skin. It’s a condition which in most patients is easily treatable. Therefore, if you are experiencing any symptoms of joint stiffness and swelling, please consult a rheumatologist sooner than later as early treatment with the right drug is the key to a successful outcome.

https://www.versusarthritis.org/about-arthritis/conditions/rheumatoid-arthritis/

Psoraitic Arthritis
This is an inflammatory arthritis seen in patients with personal or family history of psoriasis. It can present as pain and swelling of joints which can later turn into deformity. It can affect joints in an asymmetrical pattern. It can also involve your spine. Treatment is not just anti-inflammatory drugs and pain killers. DMARDS (Disease Modifying Antirheumatic Drugs) like Methotrexate and Leflunomide may need to be started.

Reactive Arthritis
In this form of arthritis, one can get joint pain and swelling triggered by infection in another part of the body. Most common infection involves the gastrointestinal tract (diarrhea), Gastrointestinal tract and urogenital system. It usually affects large joints like shoulder, knees and ankles. Presents as swelling and stiffness in joints and one can have a red eye and urinary symptoms. It’s a very treatable condition however it’s important to see a rheumatologist early so that the correct diagnosis is made and early treatment started.

Gout and Pseudogout
These are called as crystal arthropathies:

• Gout
  Gout most commonly presents as attacks of severe pain, swelling and redness of any joint but especially the great toe. It happens due to deposition of uric acid crystals in the joints which causes inflammation and hence intense pain. It’s more common in males. Treatment involves treating the acute attack which can be extremely painful and then lowering the uric acid levels so that a recurrent flare doesn’t happen.

• Pseudogout
  Pseudogout is another form of crystal arthropathy. It is caused by deposition of calcium pyrophosphate crystals in the joint. It can occur in both males and females. It usually affects large joints like knees, wrist, knuckles or hands but hardly ever affects the great toes. Treatment of an acute attack is similar to the treatment of gout but does not require long term lowering of uric acid crystals

• Ankylosing Spondylitis
  This is a form of arthritis which causes pain and stiffness of your back. It can affect any part of the spine as well as sacroiliac joints. Pain is worst first thing in the morning and usually gets better with activity. It can affect young and old. Treatment can be quite different from how we treat other back conditions. Apart from exercise and anti-inflammatories, it can involves use of biological medications. Please see a rheumatologist if you have stiffness in your spine especially in the mornings and you feel your flexibility in the back is reducing as early treatment would prevent any long-term damage.

• Connective Tissue Diseases
  These are a group of autoimmune conditions which can affect multiple sites of body including joints, skin, kidneys, lungs, gastrointestinal tract and central nervous system. Depending on the condition a patient can present differently depending on which organ is involved. Management involves prompt diagnosis and treatment with steroids and immunosuppressive agents. Some of the connective tissue diseases are listed below.

1. Systemic Lupus Erythematosus
   It is an autoimmune disease which can affect any organ of the body. Can present as butterfly rash on face, swelling of the body (kidney involvement), sore eyes, mouth ulcers, chest pain or arthritis. Seeing a specialist early is the key to diagnosis which will lead to appropriate treatment.
2. Sjogren’s Syndrome
   It is an autoimmune condition which affects part of the body which produces fluids like tears and saliva. Therefore, it can present as dry eyes, mouth or skin. It can cause swollen glands, joint pains and tiredness. It affects women more than men. It is a chronic condition and treatment is dependent on symptoms.
   https://www.versusarthritis.org/about-arthritis/conditions/sjoegrens-syndrome/
3. Systemic Sclerosis
   It’s an autoimmune connective tissue disease. It can present as thickening of skin in most cases. Other symptoms include raynaud’s phenomenon and involvement of other organs like lungs, gastrointestinal tracts, kidneys and blood vessels. Unfortunately there is no cure for it but immunosuppressive medications can slow down the progression of the disease.

Common Conditions of Elbow

• Tennis Elbow (Lateral Epicondylitis)
  It’s a condition in which the outer part of elbow becomes tender and painful. Pain can spread into the forearm and wrist. Contrary to what it’s name suggests you do not have to be a tennis player to get it. It can be caused by repetitive motion of the wrist and arm in anyone. NSAIDs and rest can help along with physiotherapy and injections.
• Golfer’s Elbow (Medial Epicondylitis)
  It’s a condition in which the medial part of elbow is affected with pain and tenderness. It seems to occur commonly in golfers hence the name. However, it can affect anyone. Treatment involves rest and anti-inflammatories along with physiotherapy. In persistent cases, injections can be given.
• Osteoporosis
• Osteoporosis makes the bones weak and brittle which causes them to break easily after a fall. It can affect both men and women but post-menopausal women are at highest risk and usually involves the spine, forearm and hip. Bone densitometry can give the diagnosis. Treatment is with bisphosphonates and other medicines along with a good intake of calcium and vitamin D and weight bearing exercises.
• Osteoarthritis of knee
  Osteoarthritis is the most common form of arthritis and affects millions of people. It is the degenerative arthritis “wear and tear kind” and commonly affects people after the age of 50 yrs. It is caused by thinning of the cartilage in your knee joint with the surfaces of the joint becoming rougher leading to reduction in joint space, which means that the knee doesn’t move as smoothly as it should, and it may feel painful and stiff especially on walking or climbing stairs. Management involves of weight loss, physiotherapy and pain control with anti-inflammatories. In some cases intraarticular injection with steroids, hyaluronic acid and PRP may be helpful. Some patients may need surgery depending on the joint damage and symptoms.
• Degenerative Spine
  This simply means osteoarthritis of the spine.  Osteoarthritis is the most common form of arthritis. It most commonly affects the neck and lower back. With time, discs which are in between the vertebrae dry out and shrink causing narrowing of the spaces between vertebra. This can cause spine to stiffen and loose flexibility. Sometimes bone spurs on the spine or herniated can pinch a nerve root — causing pain, weakness or numbness. Management can be varied depending on the symptoms and can involve physiotherapy, anti-inflammatories and in some cases surgery.
• Planter Fascitis
  It is one of the most common causes of heel pain. It is caused by inflammation of the fibrous tissue (planter fascia) which connects the heel of the foot to the toes. It commonly occurs first thing in the morning when you get out of bed. It usually gets better as you move but can come back when you stand for prolonged period of time or stand after sitting.