Rheumatology
With the latest treatments to manage rheumatic arthritis and improve the quality of your life, we aim to provide world-class treatment and care for rheumatoid arthritis, lupus and other autoimmune conditions.
Overview
Rheumatology, in modern terms, is called Clinical Immunology. It is now acknowledged that a dysregulation of the normal functioning of the immune system is the underlying cause of rheumatic diseases. However, for the sake of continuity and ease of identification among patients, the term rheumatology is still retained, and this branch is often referred to as Clinical Immunology and Rheumatology.
Therefore, diseases resulting from the dysregulation of the normal functioning of the immune system (which results in the immune system damaging healthy tissues) can affect virtually any organ of the body.
Narayana Health provides world-class and compassionate care to all patients seeking bone, muscle and joint care. Our rheumatology specialists work together to create personalised treatment care plans for rheumatic diseases.
Types of Rheumatic Disease
Depending on the part of the body affected, several types of rheumatologic conditions exist. The signs and symptoms of these conditions also differ accordingly.
Some of the common rheumatic diseases are:
- Ankylosing Spondylitis: It affects the joints and ligaments in the spine and back, causing severe stiffness. The joints and bones may fuse due to inflammation, making it difficult for the person to move normally.
- Bursitis: This disease causes pain in the location of bursae, small fluid-filled sacs that exist between joints to reduce friction during movement.
- Crohn's Disease: It’s an inflammatory bowel disease that affects the colon, small intestines and digestive tract. It can cause weight loss, chronic diarrhoea and abdominal pain.
- Gout: This disease occurs when urate crystals (microscopic crystals produced due to high uric acid levels) accumulate around joints. It can cause joint swelling and inflammation.
- Infectious Arthritis: Refers to different forms of arthritis that occur due to a bacterial or viral infection. It causes severe damage to the joints.
- Osteoarthritis: The most common form of arthritis is caused by the degeneration of joint cartilage. Worn-down cartilage causes friction in bones during movement, stiffness, pain, and loss of movement.
- Rheumatoid Arthritis (RA): It is a chronic autoimmune disease that affects joints. It is characterised by inflammation of the lining of joints, usually affecting the hands and feet on both sides of the body. It can lead to loss of movement, permanent disability and other severe medical complications. The treatment for rheumatoid arthritis might continue for life to manage the complications.
- Scleroderma: It is caused by the overproduction of collagen, which affects skin, blood vessels, and internal organs, including the lungs and kidneys.
- Sjogren's Syndrome: It’s a complication of rheumatic diseases that causes severe dryness in the eyes and mouth. Other autoimmune diseases often accompany it.
- Systemic Lupus Erythematosus: Also known as SLE or lupus, this autoimmune disease occurs when the immune system attacks healthy tissues in any organ of the body. It can affect almost any body part, including skin, blood cells, heart, lungs and joints. The most common symptoms are fever, skin rashes, and joint inflammation.
Diagnosis of Rheumatic Diseases: What to expect?
Several types of rheumatic diseases affect the joints, muscles, bones, and other connective or supporting structures of the body. Rheumatic diseases, including all forms of arthritis and inflammatory spinal conditions, are usually painful and chronic and may get worse over time. They might also lead to other potentially serious complications or increase the risks of cancers and nerve dysfunction.
There’s no single test that can diagnose rheumatic diseases. However, your doctor will start the diagnosis by asking about your medical history and symptoms. They may also ask about your lifestyle, exercise habits, and family medical history related to rheumatic diseases and autoimmune disorders.
They will then conduct a physical exam to check for any signs of swelling, stiffness, or redness in your joints and test your range of motion and reflexes. If they suspect any symptoms of rheumatic disease, they will order a few laboratory tests for an accurate diagnosis.
Blood tests are necessary to identify any signs of inflammation, the presence of antibodies related to certain diseases, abnormal blood counts, abnormal organ function, etc. Imaging tests of the joints and bones help detect inflammation, cartilage loss, fluid build-up, soft tissue tears, and bone or joint erosion. Other tests that may be ordered are CT scans, MRI scans, ultrasounds, and X-rays.
Treatment of rheumatic conditions
The treatment options for patients with rheumatic conditions may range from drug administration, physical and occupational therapy, rehabilitation and surgery in some cases. The rheumatology specialist may prescribe the following medications depending on the condition:
- Oral analgesics or painkillers like acetaminophen and prescription narcotics such as oxycodone and hydrocodone.
- Topical analgesics.
- NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen and naproxen sodium.
- COX-2 inhibitors, which are prescription-grade drugs to alleviate pain and inflammation.
- Corticosteroids.
- DMARDs (disease-modifying anti-rheumatic drugs) can regulate the body’s immune responses and inflammatory processes and slow the progression of rheumatic diseases. A subclass of DMARDs called biologics might also be prescribed. Biologics target specific steps in the body’s inflammatory processes.
- Janus kinase inhibitors that target the JAK pathways, which are involved in the immune response of the body