A Rheumatologist is a specialist who is an expert in diagnosis and treatment of diseases affecting the joints, bones, muscles, ligaments, soft tissue and autoimmune diseases.
Joint diseases which can be treated with medicines, are treated by a Rheumatologist. Orthopedic surgeons specialize in surgical treatment of joints and management of fractures.
There are more than 100 different Rheumatological diseases, some of the common ones include – Rheumatoid arthritis, psoriatic arthritis, Osteoarthritis, Ankylosing spondylitis, gout, osteoporosis, fibromyalgia, lupus, vasculitis and other autoimmune diseases.
Most Rheumatic diseases are autoimmune in nature. An autoimmune disease develops when your immune system, which normally defends your body against diseases by mistake attacks the healthy tissues and organs of your body resulting in various symptoms and diseases.
Rheumatoid arthritis is a common inflammatory disease that affects the joints. Rheumatoid arthritis causes severe pain and swelling in your joints, as a result, it becomes difficult to bend and use them.
Rheumatoid arthritis can affect other organs too such as eyes, lungs, heart or skin.
Rheumatoid arthritis can affect all age groups including children. It affects people in 30’s 40’s with higher frequency over 50 years of age. The disease is 3 times more common n females than males.
- Swelling, redness, warmth in joints
- Stiffness in the joints worse in morning getting better with movement
- Some people can experience tiredness, weight loss, fever.
Yes, there are certain conditions like fibromyalgia which cause generalized pain in muscles and soft tissue.
Patients use phrases like “I hurt all over” or “I have head to toe pain”. They also describe poor sleep and feeling tired all the time. Patients may also have difficulties with headaches, irritable bowel syndrome, or mood.
Rheumatoid arthritis affects all joints but particularly tends to affect small joints first of hands and feet. As the disease progresses it involves the wrists, knees, ankles, elbows, hips and shoulders.
If the disease is left untreated it causes significant pain and disability in the person limiting day to day activities. Also, in the future, the disease can cause significant irreversible damage to the underlying joints resulting in deformities.
With early diagnosis, treatment can be initiated with medicines which reduces pain and prevents damage in joints.
Rheumatoid arthritis is a clinical diagnosis made by your Rheumatologist based on medical history and findings on physical examination. Blood tests can be ordered to look for inflammation and antibodies associated with Rheumatoid arthritis.
Rheumatoid arthritis is an autoimmune disease which causes inflammation in the joints whereas Osteoarthritis is the disease of “wear and tear”.
In most people with osteoarthritis cartilage in the joints can wear out because of mechanical damage from years of use.
Osteoporosis is a “silent disease”. It is very common in women over the age of 55 years. Most people who have osteoporosis do not know it
until they develop a fracture. It is very important to get a bone density scan done in women to detect and treat osteoporosis effectively.
Systemic Lupus Erythematosus called SLE or lupus for short is an autoimmune disease. The immune system in the body is normally responsible for fighting foreign substances in the body like germs and viruses, however, an autoimmune disease, the immune system makes a mistake and attacks healthy tissues of your body causing different symptoms. In Lupus, it can attack different parts of the body including joints, skin, kidneys, liver, blood cells, brain or even the gastrointestinal tract.
The exact cause of the disease remains unclear but lupus is felt to be a result of both genetic and environmental factors resulting in abnormalities in the immune system.
Lupus is a complicated disease that can look different in any given person, that is why it is often called “disease of 1000 faces”. The disease can range from very mild to severe.
The common signs and symptoms of lupus are:
- Joint pain, swelling and stiffness (especially small joints of hands and feet)
- Fatigue, low-grade fevers (sometimes high fever), loss of appetite, weight loss;
- Rashes, which characteristically involve the shawl area and backs of the upper arms, the finger pulps, and the base of nails, as well as facial rash, often in response to sunlight;(butterfly-shaped rash on face)
- Hair loss is common.
- Sores in mouth and nose
- Painful fingers or toes in cold associated with colour changes
- Kidney disease
- Difficulty in breathing, chest pain
- Blood clots or history of miscarriages
In addition to discussing these and other symptoms with you, the physician will order a variety of tests to confirm a diagnosis of lupus. These may include blood, urine, and biochemical tests.
Lupus is most likely to affect women although men can have lupus too. The ratio of women to men is 9 to 1 or 90%.Lupus can often trigger after childbirth, at menopause or puberty due to hormonal activity and change.
It is more common in Asian and black women than Caucasians.
Lupus is more common in younger people between 15 years to 44 years of age.
Only 1 in 15 cases begin after 50 years of age when it tends to be less severe. Lupus can affect children too.
The most common internal organ affected in lupus is kidneys. Lupus affecting the kidney called lupus nephritis is sometimes said to be the most severe lupus. As in most kidney disease, symptoms are rare in the early part of lupus affecting the kidney but abnormalities like protein and blood leak can be detected by testing urine regularly.
In more severe cases of inflammation affecting the kidneys- blood pressure can rise, blood tests of kidney function become abnormal, and eventually, the amount of urine produced may fall and kidneys may fail completely. Hence, it is very important to have regular monitoring of the disease with a Rheumatologist to pick up kidney disease in lupus early.
Depending on your symptoms, blood test results, and what organs are involved, you may receive one or more of the following:
Non-steroidal anti-inflammatory drugs (NSAIDs), hydroxychloroquine also known as an antimalarial drug; corticosteroids, such as prednisone and methylprednisolone by mouth, injection, or intravenously.
If the disease is severe immunosuppressive drugs such as azathioprine, methotrexate, cyclosporine, mycophenolate mofetil and Cyclophosphamide can be used.
- Systemic lupus erythematosus, or SLE, is the most common form of lupus.
- Discoid lupus erythematosus causes a skin rash that doesn’t go away.
- Neonatal lupus affects newborns.
- Drug-induced lupus can be caused by certain medicines.
Periods of time when you have lupus symptoms are called flares or relapses. Periods of time when your symptoms are under control are called remissions. Flares and remissions can occur abruptly, unexpectedly, and without a clear cause. There is no way to predict when a flare will happen, how bad it will be, or how long it will last. When you have a lupus flare, you may have new symptoms in addition to those you have had in the past.
Hence it is very important to continue your medications under the supervision of your Rheumatologist to identify symptoms of relapse and treat early to prevent complications.
Heredity does seem to play a role. Ten percent of lupus patients have a first-degree relative (sister, daughter, son, mother) or a second-degree relative (aunt, uncle, first cousin) with lupus. Therefore, 90 percent of lupus patients DO NOT have relatives with lupus. Even in identical twins, when one sibling has lupus and the other twin does not, it is believed there are environmental factors that play an important role.
No. It is not contagious and does not get transmitted sexually.