Specialty Care for Joints, Muscles, Bones and Tendons
Rheumatology is a subspecialty of internal medicine that cares for a variety of rheumatic diseases. Rheumatologists diagnosis and treat a variety of rheumatic diseases. These conditions are usually characterized by inflammation, swelling and pain in the joints or muscles.
There are more than 100 rheumatic diseases, including common conditions such as osteoarthritis and rheumatoid arthritis.
Please click on the items below to learn more about rheumatic diseases.
Abnormal Antinuclear Antibody (ANA) Titer
The presence of antinuclear antibodies often indicates the immune system is attacking the body’s own tissue. A positive ANA test can suggest an autoimmune disease, such as lupus or rheumatoid arthritis, but individuals with positive ANA tests also can be healthy.
If your physician suspects you may have an autoimmune disease, he or she will most likely order additional tests to confirm the suspected diagnosis.
Ankylosing Spondylitis is a condition where inflammation can lead to some of the vertebrae in the spine fusing together. Early symptoms of this condition include stiffness and pain in the lower back and hips. If the ribs are affected, patients may experience difficulty taking deep breathes.
Ankylosing Spondylitis is diagnosed through a physical exam and imaging tests. Medications, physical therapy, and in some cases, surgery can be used to treat this condition.
Antiphospholipid Antibody Syndrome
Antiphospholipid Antibody Syndrome, or APS, is an autoimmune disease, which typically presents in young women. Phospholipids are a type of fat present in all cells and cell membranes. Some individuals produce abnormal antibodies, or proteins, in the blood, which attack these fats. This can lead to improper blood flow and clotting.
APS can cause problems for a developing fetus, resulting in pregnancy complications or miscarriage. Patients with untreated APS also may be at an increased risk for strokes and blood clots. APS typically is managed using blood thinners.
Behcet’s Syndrome, or disease, is a rare disorder characterized by inflammation in blood vessels throughout the body. Symptoms vary from person to person, and may include sores or lesions in the mouth or on the skin, blurred vision, join swelling and a number of other symptoms.
The cause of Behcet’s Syndrome is unknown, but research indicates there may be a genetic component. Treatment depends on severity and the individual patient’s symptoms.
Calcinosis, Raynaud Phenomenon, Esophageal Dysmotility, Sclerodactyly & Telangiectasia (CREST) Syndrome
CREST Syndrome, also known as limited scleroderma, is a form of scleroderma, a condition where the skin hardens or tightens. CREST Syndrome typically is characterized by skin changes in the lower extremities, and occasionally in the skin on the face and throat. The condition also can affect the digestive tract.
Like many autoimmune disorders, diagnosing CREST Syndrome can be difficult. Diagnosis typically is based on a physical exam, lab tests and sometimes a skin biopsy. CREST Syndrome can be treated using medication, physical and/or occupational therapy, and in some cases, surgery.
Calcium Pyrophosphate Dihydrate Deposition (CPPD) Disease
Formerly known as Psueodgout, Calcium Pyrophosphate Dihyrdate Deposition Disease is a form of arthritis. The condition is characterized by sudden, painful swelling in one or more joints. The inflammation is caused by crystal deposits in the joint. Episodes can last for several days, or even weeks.
Since CPPD can present like gout and other similar conditions, lab and imaging tests typically are used to confirm the diagnosis. Flare ups of CPPD are treated using nonsteroidal anti-inflammatory drugs (NSAIDs), colchicines, corticosteroids and sometimes joint drainage procedures.
Dermatomyositis is a rare inflammatory disease marked by muscle weakness and a unique skin rash. Muscle weakness typically occurs in the muscles closer to the core, including the hips, thighs, shoulders, upper arms and neck. Patients with Dermatomyositis often also develop a purple or red rash on the face or around the nails, knuckles, elbows, knees, chest and back.
Dermatomyositis may be diagnosed by performing blood tests, a chest x-ray, electromyography, an MRI and/or a skin or muscle biopsy. Treatment may include medication, therapy, intravenous immunoglobulin and/or surgery.
Elevated Antinuclear Antibody (ANA)
See Abnormal Antinuclear Antibody (ANA) Titer
Elevated Rheumatoid Factor
Sometimes the immune system produces proteins that attack healthy tissue in the body. These proteins are called rheumatoid factors. A blood test can be done to assess an individual’s rheumatoid factor levels. High levels sometimes indicate an autoimmune disorder, such as rheumatoid arthritis or Sjogren’s Syndrome.
Elevated Sedimentation Rate
A sedimentation rate blood test analyzes how quickly red blood settle in a test tube. The more red blood cells settle to the bottom of the tube over an hour period, the higher the sedimentation rate. An elevated sedimentation rate may indicate that proteins associated with inflammation are present and causing the blood cells to stick together and fall more quickly. A high sedimentation rate can have a number of causes, so your physician will most likely perform additional tests to confirm a diagnosis.
High C-reactive protein (CRP) levels in the blood indicate inflammation in the body, and generally indicate the presence of an infection or disease. The CRP test alone cannot show where the inflammation is located or what is causing it.
If you have an elevated CRP, your physician will run additional tests to determine the cause and location of the inflammation.
Giant Cell Arteritis
Giant Cell Arteritis is an inflammatory disease that affects the blood vessels that carry blood through the neck to the head. The vessels in the eyes, temple and jaw are most commonly affected. Symptoms include a headache, vision problems, tenderness of the temple or scalp and/or pain or aching of the tongue or jaw.
This condition usually is diagnosed via a physical exam and blood tests. Giant Cell Arteritis is typically treated with steroid medicines.
Gout is a type of arthritis caused by having too much uric acid in the blood. The high levels of uric acid can cause hard crystals to form in the joints, resulting in a sudden attack of burning pain, stiffness and swelling in a joint. Gout usually affects the big toe, but also can occur in the foot, ankle, knees or other joints.
After gout is diagnosed, your physician can prescribe medications to treat the attack and prevent future attacks.
See Rheumatoid Arthritis
Myositis refers to any condition that causes inflammation in muscles. Symptoms of myositis include weakness, swelling and pain. Myositis can be causes by infection, injury, autoimmune conditions and drug side effects.
Treatment of myositis depends on the underlying cause of the condition.
Mixed Connective Tissue Disease
MTCD is a rare connective tissue disorder that is thought to be a combination of multiple connective tissue disorders, such as systemic lupus erythematosus, polymyositis and scleroderma. Individuals with MTCD usually have symptoms of these different disorders, which may include arthritic, cardiac, pulmonary and skin manifestations, kidney disease, muscle weakness and dysfunction of the esophagus.
Osteoarthritis is caused by the degeneration or “wearing out of joints” due to aging, injury or obesity. Individuals with osteoarthritis experience joint pain, swelling and stiffness.
Osteoarthritis usually is diagnosed using blood tests, X-rays and MRIs. Treatment for osteoarthritis depends on the joint affected and the severity of the condition.
Polyarthralgia refers to when a patient experiences arthritic pain in more than one joint. Symtpoms of polyarthralgia include swelling or thickening of the skin on the hands and fingers and/or pain and stiffness in the joints. This condition usually develops between the ages of 30 and 50.
Polymyalgia rheumatic is an inflammatory disease where the joints become stiff and ache. The joints in the neck, shoulders and hips are mostly commonly involved. Symptoms include muscle pain, tiredness and lack of energy, fever and/or weight loss.
Polymyositis is similar to dermatomyositis in that it is a rare inflammatory condition marked by muscle weakness; however, polymyositis does not affect the skin. Both conditions are common with sclerosis, and sometimes lupus. The exact cause of polymyositis unknown.
This condition typically is treated with corticosteroids.
See Calcium Pyrophosphate Dihydrate Deposition (CPPD) Disease
Psoriatic arthritis is a condition that affects some individuals with psoriasis. Psoriasis is a skin condition characterized by patches of red, scaly skin. The symptoms of psoriatic arthritis are joint pain, stiffness and swelling. This condition can affect any part of the body.
Treatment focuses on controlling inflammation in the affected joints, and typically includes anti-inflammatory medications. Treatment also can include steroid injections and/or joint replacement surgery.
Reactive arthritis is caused by an infection in another part of the body, including the intestines, genitals or urinary tract. The condition usually affects the knees, ankles and/or feet, but inflammation also can occur in the eyes, urethra or other joints. Symptoms of the condition typically come and go, eventually disappearing completely.
Treatment focuses on treating the underlying infection or infections and managing symptoms.
In Raynaud’s Disease, the small arteries that supply blood to the skin narrow, reducing circulation and causing affected areas to feel cool and numb. Symptoms typically occur in response to cold temperatures and/or stress.
Treatment of Raynaud’s depends on the severity of the condition and coexisting conditions.
Rheumatoid arthritis is a chronic inflammatory disorder characterized by painful swelling in the small joints in the hands and feet. Rheumatoid arthritis is caused by an autoimmune disorder, unlike osteoarthritis, which is caused by wear-and-tear on the joints. In addition to joint pain, rheumatoid arthritis also can affect the skin, eyes, lungs and blood vessels.
Rheumatoid arthritis can be difficult to diagnosis since the symptoms are similar to many other diseases. Treatment varies depending on the severity of the condition, and resulting damage to joints.
Spondyloarthritis is an overarching term for the family of inflammatory rheumatic diseases, which affect the spine. Some of the types of spondyloarthritis are ankylosing spondylitis, psoriatic arthritis, reactive arthritis, enteropathic arthritis and undifferentiated spondyloarthritis.
Still’s Disease – Adult Onset
Still’s Disease is a rare condition characterized by a sore throat, a salmon-colored rash and a high fever that spikes once or twice a day. Joint pain usually follows these initial symptoms. The cause of this condition is unknown, but it is thought to be triggered by some kind of infection.
Treatment for this condition typically involves anti-inflammatory medications. Some patients only have a single episode of the disease, while others have multiple recurrences.
Systemic Lupus Erythematosus (SLE)
Lupus is a chronic autoimmune disease a wide variety of symptoms and can range from mild to serious. Symptoms include pain and swelling, fatigue, rashes and fever. Lupus is more common in women and typically presents when the patient is in his or her 20s or 30s. Lupus can mimic other inflammatory or autoimmune conditions; one of the distinct symptoms is a butterfly-shaped rash over the cheeks. Lupus can have serious complications including heart and lung inflammation, kidney problems and neurological problems, such as seizures, strokes or psychosis.
Lupus typically is diagnosed by a series of blood tests. Treatment of lupus depends on the patient’s symptoms and the severity of the condition.
Systemic sclerosis, also known as scleroderma, is characterized by issues with the skin, vascular system and the immune system. Typically, patients with scleroderma experience excessive scarring, swollen, tight or hard skin. These skin issues are caused by excess collagen being deposited in the skin. This condition also can affect the digestive system, the heart, lungs and/or kidneys.
Treatment depends on the specific type of systemic sclerosis and the severity, but typically includes medications and physical or occupational therapy.
Uveitis is a condition characterized by inflammation of the uvea, the middle layer of the eye. Infections, injury and/or autoimmune disorders are thought to be associated with the development of uveitis. Symptoms include eye redness, eye pain, light sensitivity, blurred vision, floaters, decreased vision and/or a whitish area (hypopyon) inside the eye in lower part of the iris.
The condition can lead to permanent vision loss; so early diagnosis and treatment are essential to achieving a positive outcome.
Patients with vasculitis experience thickening, weakening, narrowing and scarring of the blood vessels. The condition can be long-lasting (chronic) or only last a short amount of time (acute). Severe cases of vasculitis can restrict blood-flow causing organ and tissue damage. There are a number of kinds of vasculitis, but generally symptoms include fever, fatigue, weight loss, muscle and joint pain, loss of appetite and/or never problems, such as numbness or weakness.
Treatment depends on the patient’s specific type of vasculitis. Some types improve on their own, while others require treatment with medication.
Wegener’s Granulomatosis – Granulomatosis with polyangiitis (GPA)
Wegener’s granulomatosis is an inflammatory disease that affect the blood vessels. The inflammation can restrict blood flow to tissues and organs. The kidneys, lungs and upper respiratory tract are most commonly affected. The cause of this condition is unknown.
Wegener’s granulomatosis can have serious complications, including kidney failure, so early diagnosis and treatment is important. The condition is diagnosed using a physical exam, blood tests, urine tests, x-rays and/or a biopsy of the affected tissue.
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