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Rheumatology

APC Icon — Rheumatology

Millions of Americans are affected by some form of arthritis.

This makes it the most common cause of disability in the United States. Rheumatic disease is not a single disorder, though, as people use the term “rheumatoid arthritis” to refer to all rheumatic ailments.

There are over 200 different diseases under the purview of rheumatology, spanning several types of arthritis and other systemic connective tissue diseases. There are also other rheumatic diseases that are considered autoimmune diseases, meaning that the body’s immune system attacks healthy body tissue by mistake.

What are the causes of rheumatic conditions?

Rheumatic diseases and conditions are inflammatory in nature with several considered “autoimmune”. While the actual causes of rheumatic conditions are still not clearly understood, there are factors that can contribute to the early symptoms of certain rheumatic disorders. These include:

  • Pre-existing Medical Conditions
  • Metabolic Conditions
  • Age
  • Wear and Tear
  • Environmental Factors
  • Genetic Factors
  • Lifestyle Choices
  • Pre-existing Medical Conditions
  • Metabolic Conditions
  • Age
  • Wear and Tear
  • Trauma
  • Infections
  • Gender
  • Environmental Factors
  • Genetic Factors
  • Lifestyle Choices

Research also suggests that certain ethnic backgrounds are more disposed to developing certain rheumatic conditions.

It is important to note that while rheumatologists treat osteoarthritis, it is not classified as a rheumatic disease. This is primarily because osteoarthritis is not caused by inflammation or autoimmune conditions but caused by natural wear and tear on the body.

What are the signs and symptoms of rheumatic disorders?

There are over 200 known rheumatic conditions affecting the human body, and the signs and symptoms potentially indicating these rheumatic conditions also extremely varied. Some specific rheumatoid symptoms, though, have very clear markers of a rheumatic condition(s).

Several of these characteristic symptoms are:

  • Pain in the joints
  • Inflammation of the joints
  • Stiffness in the joints, especially in the mornings
  • Low-grade fever
  • Redness or sensations of warmth
  • Reduced movement in the affected regions
  • Unexplained fatigue
  • Tenderness in the affected areas
  • Skin rash (in specific conditions such as lupus)
  • Weight loss
  • Anemia

What are the different types of rheumatic disorders?

There are several different diseases and disorders that are categorized under the medical subspecialty of “rheumatology”. The most common condition is rheumatoid arthritis, although there are several other rheumatic conditions that need to be treated specifically by a rheumatologist.

The common rheumatic conditions include:

Rheumatoid Arthritis

Rheumatoid Arthritis

One of the most prevalent health conditions in the United States, affecting over 1.3 million Americans every year. Rheumatoid arthritis is one of the most commonly facilitated treatments by rheumatologists every year.

Primarily characterized by severe inflammation of the joints of the hands and feet, this condition has a long-term prognosis and can lead to chronic pain and disability. Unlike osteoarthritis, rheumatoid arthritis does not occur naturally in the body due to natural wear and tear but instead results from the immune system attacking the body.

Some of the characteristic symptoms of rheumatoid arthritis (RA) include the following:

  • Lumps called rheumatoid nodules
  • Pain and inflammation in several joints
  • Joint stiffness
  • Conditions affecting other organs (such as the lungs)
Spondyloarthropathies

Spondyloarthropathies

A group of diseases affecting the spine, shoulders, knees, and hips, causing inflammation in the ligaments and tendons. People across age groups can experience varied forms of this disease, with symptoms including rashes, mouth sores, and eye issues. One such condition is ankylosing spondylitis.

Ankylosing Spondylitis

A chronic disease that affects the spine and leads to severe pain, inflammation, and stiffness in the lower back. With this condition, the chances of the bones and joints fusing together are high. The joints that are most affected by this condition are the sacroiliac joints.

Some of the characteristic symptoms of ankylosing spondylitis include:

  • Severe pain and stiffness in the lower back and buttocks that often improves with activity
  • Gradually increasing pain in the middle and upper back regions
  • Stiffness in the spine

Psoriatic Arthritis

Another common autoimmune condition which manifests in five variants:

  • Arthritis mutilans
  • Spondylitis
  • Distal
  • Symmetric
  • Asymmetric
Lupis

Lupus

Lupus (or systemic lupus erythematosus) is a chronic autoimmune condition which affects joints, muscles, bones, organs, and other parts of the body resulting in severe inflammation of the affected areas.

Common symptoms of lupus also include:

  • Rashes
  • Hair loss
  • Blue/white toes and fingers
  • Blood disorders
  • Seizures or strokes
Sjogren’s Syndrome

Sjogren’s Syndrome

An autoimmune disease with primary symptoms being dryness in the mouth and eyes. This condition is thought to be more common in women.

Primary symptoms of Sjogren’s syndrome include:

  • Irritation and burning in the eyes
  • Decay of the teeth
  • Swelling of facial glands
Gout

Gout

This condition predominantly occurs in the big toe (or other parts of the feet) and is the result of a build-up of uric acid in the joints. The main symptoms of gout include pain, stiffness, and inflammation in the affected area(s).

Scleroderma

This condition is divided into “localized” scleroderma and “systemic sclerosis. Localized scleroderma hardens the skin (and the structures beneath it) predominantly affects children. Systemic sclerosis affects organs and blood vessels causing them to harden.

Primary symptoms of scleroderma also include:

  • Trouble in digestion
  • Weak muscles
  • Thickened skin
  • Raynaud’s phenomenon
  • Calcium deposits under the skin

Common forms of rheumatic conditions also include:

  • Bursitis
  • Tendonitis
  • Crohn’s disease
  • Juvenile idiopathic arthritis
  • Infectious arthritis
  • Polymyalgia rheumatica
  • Polymyositis
  • Reactive arthritis
  • Systemic vasculitis
  • Marfan syndrome
  • Fibromyalgia

How can you find the right diagnosis?

The rheumatologists at Advanced Pain Care use cutting-edge technologies and the latest diagnostic and therapeutic procedures to identify and treat a wide range of rheumatic diseases in a multi-specialty setting.

There is no single test to determine if you have a rheumatic condition so symptoms play a vital role in the rheumatologist’s evaluation to help isolate specific and possible conditions.

In order to arrive at a detailed understanding of your condition, rheumatologists will evaluate the following parameters:

  • Genetic markers for predispositions
  • Past medical history
  • Exposure to infections
  • Lifestyle conditions
  • Genetic markers for predispositions
  • Past medical history
  • Exposure to infections
  • Lifestyle conditions

With symptoms playing a major role in identifying your condition, your rheumatologist at Advanced Pain Care will also check for signs of swelling, stiffness and redness while examining pain indicators. Physical examinations will also be done to check for eye problems, range of motion and reflexes, skin rashes, and swollen glands.

To further hone the diagnostic process, common tests rheumatologist prescribe are:

  • Blood Tests — to detect markers of inflammation and antibodies associated with specific conditions – antinuclear antibody (ANA), c-reactive protein (CRP), etc
  • Imaging Tests — X-rays, CT scans, MRIs, ultrasounds are all available to detect fluid build-up, cartilage loss, erosion and tears of structures, and any changes in bone structure(s).
  • Blood tests to detect abnormalities in organ functions
  • Blood tests to detect the presence of specific proteins and uric acid

Depending on the results of a given test, our rheumatoid specialists may ask for additional tests to isolate a specific condition. Some of the tests might include:

  • Biopsy
  • Anti-cyclic citrullinated peptides (anti-CCP)
  • Rheumatoid factor
  • Erythrocyte sedimentation rate (ESR)
  • Anti-Smith antibody test
  • Anti-double stranded DNA antibody
  • Synovial fluid analysis
  • Basic metabolic panel
  • HLA-B27

Conditions such as gout, lupus, and Lyme’s disease, are difficult to diagnose as they have several overlapping symptoms. In these cases, rheumatologists will often rely on a thorough evaluation of the symptoms along with the results of any specific tests administered.

What are the different types of treatments available?

Treatment for rheumatic conditions primarily involves medications. Some medication is used to reduce pain and inflammation while some work to resolve the condition completely.

Specific conditions are also treated with specific medicines. For example, gout is treated using uric acid-depleting medication and corticosteroids. Lyme’s disease is treated with antibiotics, and lupus (a chronic condition) is treated with anti-malarial drugs. While most forms of arthritis are chronic, infectious arthritis can be cured with the right medication. More complex conditions, like fibromyalgia, cannot be completely healed and often needs a multimodal treatment approach to manage the symptoms.

The most common medications prescribed for rheumatic conditions include:

  1. Corticosteroids
  2. Oral analgesics
  3. Topical analgesics
  4. Non-steroidal anti-inflammatory drugs (NSAIDs)
  5. Disease-modifying anti-rheumatic drugs (DMARDs)
  6. Biologics
  7. Janus Kinase inhibitors

Additional treatment options for rheumatic conditions include:

  1. Physical therapy
  2. Occupational therapy
  3. Hot and cold therapy
  4. Exercise
  5. Use of assistive devices
  6. Alternative and complementary therapies
  7. Cognitive behavior therapy
  8. Surgery

Rheumatologists do not usually perform surgeries; that comes under the purview of Orthopedists. Rheumasurgery or rheumatoid surgery is considered a subfield of orthopedics involving a patient that required surgical treatment to address their condition(s).

A rheumatologist and an orthopedist are both trained to treat conditions relating to the patient’s joints, muscles, and bones. While a rheumatologist evaluates, diagnoses, and medicinally treats these conditions, an orthopedist specializes in surgical treatments.

The specialists at Advanced Pain Care are highly-trained to treat a variety of rheumatic diseases with an array of treatment options.

The type of treatment you receive will depend on the severity and extent of your condition and might include medication, joint injections, aspirations, or infusions.

If you have questions about a specific condition or if we treat a condition not listed below, contact us and speak with our specialists. Visit a location near you for more information or call 512-244-4272 to schedule a same or next day appointment with one of our rheumatologists.

FAQS

Q: What does a rheumatology doctor treat?

A: Rheumatologists are specialists who are skilled in internal medicine and pediatrics, dealing with conditions affecting the soft tissues, joints, including autoimmune diseases, vasculitis, and genetic connective tissue disorders. They have the training and experience to evaluate and treat autoimmune, inflammatory, and other musculoskeletal conditions such as rheumatoid arthritis, lupus, ankylosing spondylitis, scleroderma, tendinitis and sarcoidosis.

Q: What is rheumatology disease?

A: Rheumatic disease refers to several medically diagnosed diseases and disorders that affect the joints, bones, tendons, ligaments, cartilage, and muscles in the human body. Rheumatic diseases are also referred to as autoimmune diseases, and a rheumatologist is a specialist who diagnoses and treats these specific conditions.

A rheumatic disease is not a single disorder, although people use the term “rheumatoid arthritis” to refer to all rheumatic ailments. There are over 200 different diseases addressed by rheumatology, spanning several types of arthritis, osteoporosis, and systemic connective tissue diseases. There are other rheumatic diseases that are also considered “autoimmune diseases”, which means the body’s immune system attacks healthy body tissue by mistake.

Q: What diseases do rheumatologists diagnose?

A: Some of the common rheumatic diseases and disorders diagnosed by rheumatologists are:

  • Rheumatoid arthritis
  • Ankylosing spondylitis
  • Bursitis
  • Sarcoidosis
  • Tendinitis
  • Gout
  • Juvenile Idiopathic arthritis
  • Septic arthritis
  • Crohn’s disease
  • Osteoporosis

Q: What does rheumatism pain feel like?

A: Rheumatic pain is a localized pain experienced in the affected joints, tissues, muscles, tendons, and bones. The pain is usually experienced as a deep and aching sensation or as a soreness. While the severity of the pain differs among people, “arthritic pain” is not considered to be as severe as “neuropathic pain”, “visceral pain”, or “ischemic pain”. Levels of pain can also fluctuate, and is usually also accompanied by stiffness, soreness, redness, and reduced motion (often at specific times of the day).

Q: What is the difference between a rheumatologist and an orthopedist?

A: A rheumatologist and an orthopedist are both trained to treat conditions relating to the patient’s joints, muscles, and bones. A rheumatologist evaluates, diagnoses, and medically treats rheumatic diseases and conditions, orthopedists specialize in surgical treatments for treatment of these conditions.