Rheumatology Conditions We Treat

Inflammatory Arthritis

There are many forms of arthritis linked with inflammation that causes pain, stiffness, swelling and warmth. Autoimmune types of arthritis cause long-lasting stiffness in the morning or after not moving for long periods of time. Inflammation can affect the small joints of the hands and feet, the larger joints or the spine. Some forms of inflammatory arthritis are linked with other diseases such as Irritable Bowel Disease or other autoimmune diseases. Inflammatory arthritis can also be caused by infections or crystals.

Rheumatoid Arthritis: Rheumatoid arthritis (RA) is an autoimmune form of arthritis that usually affects the the hands and feet. RA can affect people of any age and is more common in women. There are blood tests that can help diagnose RA. The inflammation of RA can damage the joints if left untreated, but new treatments have improved outcomes for patients with RA. Early diagnosis and treatment are important to manage symptoms and prevent damage.

Ankylosing Spondylitis: Ankylosing spondylitis (AS) is a form of arthritis that involves pain and stiffness in the back and neck that is more severe in the morning. It usually appears during early adulthood and affects men more than women. AS can run in families. New treatments can treat the symptoms of AS and prevent it from getting worse.

Psoriatic Arthritis: Psoriatic arthritis (PsA) is the arthritis that affects people who have psoriasis. Patients with arthritis will often have psoriasis-related nail changes. It comes in many forms and the symptoms do not always follow parallel skin symptoms. PsA can be treated with medicines that also treat skin disease.

Gout: The symptoms of gout are extreme tenderness, redness and swelling of joints. It often affects the big toe or other joints in the feet and legs. It's caused by uric acid crystals that build up in the joints and can be prevented by lowering uric acid levels. Treatment for acute gout can shorten the length of an attack. Frequent gout attacks can lead to joint damage and deformity.

Autoimmune Diseases
Autoimmunity is when the body's immune system attacks its own tissues and organs. Each form of autoimmune disease affects particular tissues and organs.

The different autoimmune diseases are also oftenlinked with autoantibodies that show up in blood tests. Autoantibodies are immune system proteins that attack a person's own proteins rather than proteins from infections.

The symptoms of systemic autoimmune diseases depend on which tissues and organs are involved. Rheumatologists are experts in diagnosing systemic autoimmune disease and should coordinate care for patients who suffer from these kinds of diseases. This often involves working closely with other providers.

Lupus (Systemic Lupus Erythematosus): Systemic lupus erythematosus (SLE, lupus) involves periods of inflammation that can affect different tissues and organs. Severity varies widely; some forms may not need treatment and other forms can be life-threatening. Lupus can run in families, affects women more than men, and is more frequent in African-Americans and Latinos than whites.

Lupus often causes fatigue, skin rashes and arthritis. It can involve the blood cells, kidneys and brain. Blood tests for autoantibodies can be help diagnose lupus. Lupus can be treated with medicines that should be adjusted to the severity of the disease.

Sjögren Syndrome: Sjögren Syndrome (SjS) is an autoimmune disease that affects the glands that produce tears and saliva. The most common symptoms are dryness of the eyes and mouth, but patients may also have parotid gland enlargement, arthritis or damage to other organs. SjS mostly affects older people, women more than men. It may co-occur with RA and SLE. Blood tests for autoantibodies can diagnose SjS. SjS that affects only the glands may be treated with eye drops and treatments to stimulate saliva or moisturize the mouth.

Scleroderma (Systemic Sclerosis): Systemic sclerosis (SSc, scleroderma) is an autoimmune disease where the immune system triggers deposition of scar-like tissues in the skin, blood vessels, and sometimes in other organs like the lungs, heart, and kidneys. Patients with scleroderma often have a condition called Raynaud's Disease where the fingers and/or toes turn whitish or purplish when exposed to cold or during stress. Scleroderma sometimes starts with puffiness of the hands and stiffness of the fingers. There are different forms of SSc classified by how much of the skin is involved and associated with specific autoantibodies. It is critical for patients with SSc to be managed by a team of physicians familiar with the disease and its management.

Polymyositis/Dermatomyositis: Polymyositis (PM) and dermatomyositis (DM) are autoimmune inflammatory diseases of the muscles that cause weakness. Patients with DM have a rash that can occur around the eyes, over the knuckles, and/or on the chest and upper back. People with these conditions may have a hard time swallowing; and their voices can become hoarse.

PM and DM are often linked with inflammation in the lungs, which can cause shortness of breath and cough. Blood tests showing autoantibodies and other substances can help diagnose the diseases. Electrodiagnostic testing, imaging of the muscles using MRI, or muscle biopsy may also be necessary. These are rare diseases, so it's very important to receive care from specially trained rheumatologists.

Vasculitis: Vasculitis refers to conditions that are linked with inflammation of the blood vessels. The signs and symptoms depend on the size of the blood vessel and the organs affected. Some forms of vasculitis can affect the large blood vessels like the aorta and its branches.

In younger people, Takayasu's Arteritis can cause pain in the arms, legs or back. In older people, giant cell arteritis (or temporal arteritis) can cause fever, night sweats, weight loss, pain with chewing and visual changes. It is often linked with polymyalgia rheumatic, an inflammatory disease that causes pain and stiffness in the shoulders and hips.

Other forms of vasculitis involve medium-sized blood vessels and are linked with fever, night sweats and weight loss. These forms of vasculitis can cause skin rashes or ulcers, numbness or weakness, kidney damage and lung damage.

Granulomatosis with Polyangiitis (GPA, formerly called Wegener's Granulomatosis) is often linked with chronic sinus problems. Patients with GPA often have lung and kidney problems as well.

Microscopic Polyangiitis (MPA) usually involves the kidneys and/or the lungs.

Eosinophilic Granulomatosis with Polyangiitis (EPA, formerly called Churg-Strauss Vasculitis) usually affects patients who have a history of asthma and allergic diseases.

There are many other forms of vasculitis. A rheumatologist can help tell which form you have, which organs are likely to be affected, and how best to treat your disease.

Bone and Muscle Disorders

Osteoporosis: Osteoporosis is the gradual loss of bone density and bone tissue thinning. Sometimes your body cannot form enough new bone or your bone is absorbed too quickly. When this happens, the thickness and tissue are lost. Both problems can take place at the same time.

Osteoporosis can affect a person of any age or sex. It occurs most often in men and women over the age of 50. One in five of all American women over age 50 have this condition.

Paget's Disease: Paget's Disease of the bone is a chronic bone disorder in which bones become enlarged and deformed. Bone may become dense, but fragile, because of excessive breakdown and deformation of bone. The disease is the most common bone disorder after osteoporosis in people over age 50.

Metabolic Bone Disease: Metabolic bone diseases are problems with the strength and structure of bone. These disorders are often caused by imbalanced levels of vitamins and minerals such as calcium, phosphorus and vitamin D. The most common metabolic bone disorder is osteoporosis.

Osteoarthritis: Osteoarthritis is the most common form of arthritis.

Osteoarthritis causes pain and swelling in the joints and leads to stiffness and reduced motion in the joints. The joints most commonly affected are those in the hands, knees, hips, and spine.

Osteoarthritis is also called degenerative joint disease because it breaks down the cartilage where bones meet. This loss of cartilage causes the bones to rub together at the joint, and the joint becomes damaged.

Fibromyalgia: Fibromyalgia causes tiredness and discomfort. People who have this condition experience muscle pain and "tender points" that hurt when touched. There is no known cause for Fibromyalgia. Pain medicines and antidepressants also are often used to treat fibromyalgia.