Rheumatology Care :
Rheumatology is the branch/specialty of Medicine that deals with the diagnosis and treatment of patients with Rheumatic or musculo-skeletal diseases- in simple terms, Arthritis.
A rheumatologist is an internist or pediatrician, who treats musculoskeletal disease and systemic autoimmune conditions commonly referred to as rheumatic diseases. These diseases can affect the joints, muscles and bones causing pain, swelling, stiffness and deformity. Autoimmune conditions occur when the immune system sends inflammation to areas of the body when it is not needed causing damage/symptoms. These diseases can also affect the eyes, skin, nervous system and internal organs.
Rheumatic Diseases comprise a heterogeneous group of disorders of the connective tissue, joints and bones in which musculo-skeletal pain and stiffness are the prominent symptoms. Rheumatic diseases affect people of all ages and ethnic groups and are the commonest cause of physical impairment in the community. The most common symptom of rheumatic disease is joint pain and if it is due to an inflammatory cause, then the pain may be associated with joint swelling and stiffness and perhaps other systemic complaints.
TREATMENT RECOMMENDATIONS MAY INCLUDE :
Medications, referral to physical therapy, referral to other specialists, or joint/tendon injections. Some rheumatic diseases can be difficult to diagnose and may require several visits.
Rheumatologists are aware of the current treatment guidelines for managing a patient with arthritis and are familiar with the use of disease modifying drugs, immunosuppressant therapy and also the use of currently available Biologic agents. Anti TNF agents like Infliximab and Etanercept and Anti CD 20 agents like Rituximib, Anti IL 6 agents like Actemra and Co- Stimulity blocker like Abatacept.
This is an autoimmune 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 of 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 antirheumatic drugs – DMARDs (Methotrexate, sulfasalazine), corticosteroids and biological therapies like white blood cell modulators, Tumor necrosis factor (TNF) inhibitors and Interleukin-6 (IL-6) inhibitors. Surgery is indicated in the late stages.
It 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 tumor necrosis factor (TNF) inhibitors can improve the symptoms of Ankylosing Spondylitis. Surgery is only required in the late stages to correct spinal deformities or allow hip movements.