Call us directly: (203) 453-0361

385 Church St Guilford, CT 06437 View Location

Office Hours: Mon-Fri 8am-5pm

Rheumatology

Rheumatic diseases (rheumatism) are painful conditions usually caused by inflammation, swelling, and pain in the joints or muscles. Some rheumatic diseases like osteoarthritis are the result of “wear and tear” to the joints. Other rheumatic diseases, such as rheumatoid arthritis, happen when the immune system becomes hyperactive; the immune system attacks the linings of joints, causing joint pain, swelling, and destruction. Almost any joint can be affected in rheumatic disease.
The role of the rheumatologist is to diagnose (detect), treat and medically manage patients with arthritis and other rheumatic diseases. These health problems affect the joints, muscles, bones and sometimes other internal organs (e.g., kidneys, lungs, blood vessels, brain). Because these diseases are often complex, they benefit from the care of an expert. Only rheumatologists are experts in this field of medicine.

Most Common Rheumatic Diseases

Osteoarthritis

About 27 million Americans have osteoarthritis (OA), the “wear-and-tear” arthritis. OA causes damage to the cartilage over time. Cartilage is a material that cushions the end of bones and allows joints to move smoothly.As cartilage of a joint wears down, this movement becomes painful or limited. OA can be a normal part of aging that can affect all parts of the body. However, it usually affects the knees, hips, lower back, neck, and fingers.

The signs and symptoms of OA, depending on the joints involved, include:
-Pain in joint
-Joint swelling
-Joint may be warm to touch
-Joint stiffness
-Muscle weakness and joint instability
-Pain when walking
-Difficulty gripping objects
-Difficulty dressing or combing hair
-Difficulty sitting or bending over

To diagnose OA, your doctor will ask about your medical history and symptoms and do a physical exam. Blood tests may help rule out other types of arthritis or medical problems. A joint fluid sample from an affected joint may also be examined to eliminate other conditions. Usually by the time someone with OA seeks treatment, there are changes visible on an X-ray of the joint. The X-ray may show narrowing of the joint space or the presence of bone spurs. In some cases, MRI (magnetic resonance imaging) may be done.

Rheumatoid Arthritis

Rheumatoid arthritis affects about 1.3 million Americans; about 75% of those affected are women.In RA, the body’s immune system attacks its own tissues, causing joint pain, swelling, and stiffness that can be severe. The condition can result in permanent joint damage and deformity.

RA signs and symptoms include:
-Joint pain and swelling
-Involvement of multiple joints (usually in a symmetrical pattern)
-Other organ involvement
-Joint stiffness, especially in the morning
-Fatigue
-Fevers
-Lumps called rheumatoid nodules

To diagnose RA, your doctor will ask about your medical history and do a physical exam. Also, X-rays and blood tests will likely be taken. One blood test may be for rheumatoid factor; it is positive in 70% to 80% of those with RA.

Lupus

SLE or systemic lupus erythematosus is another autoimmune disease; the cause of SLE is unknown.

Lupus signs and symptoms include:
-Joint pain
-Fatigue
-Joint stiffness
-Rashes, including the”butterfly rash” across the cheeks
-Sun sensitivity
-Hair loss
-Discoloration of the fingers or toes when exposed to cold (called Raynaud’s phenomenon)
-Internal organ involvement, such as the kidneys
-Blood disorders, such as anemia and blood clots
-Chest pain from inflammation of the lining of the heart or lungs
-Seizures or strokes

To diagnose lupus, your doctor will ask about your medical history, do a physical exam, and order lab tests of blood and urine samples. One blood test is the antinuclear antibody test (ANA). Most people with lupus have a positive ANA blood test.

Ankylosing Spondylitis

Ankylosing Spondylitis (AS) usually starts gradually as lower back pain. The hallmark feature of AS is the involvement of the joints at the base of the spine. This is where the spine attaches to the pelvis, also known as the sacroiliac joints. Ankylosing spondylitis is more common in young men, especially from the teenage years to age 30.

AS symptoms include:
-Gradual pain in the lower back and buttocks
-Lower back pain that worsens and works its way up the spine
-Pain felt between the shoulder blades and in the neck
-Pain and stiffness in the back, especially at rest and on arising
-Pain and stiffness get better after activity
-Pain in the middle back and then upper back and neck (after 5-10 years)

With progression of AS, the spine may become stiffer. It may become difficult to bend for common everyday activities. To diagnose AS, your doctor will ask about your medical history and perform a physical exam. X-rays of the back looking at the sacroiliac joints may help in making an AS diagnosis. A positive blood test for HLA-B27 protein may help confirm a diagnosis as well.

Sjogren’s Syndrome

Sjogren’s syndrome is an inflammatory, autoimmune disease. It can occur with other autoimmune diseases such as RA and lupus, but also on its own. Although the cause of Sjogren’s is unknown, it is more common in women.

Sjogren’s signs and symptoms include:
-Dry eyes (the glands in eyes do not make adequate tears)
-Eye irritation and burning
-Dry mouth (the glands in mouth do not give adequate saliva)
-Dental decay, gum disease, thrush
-Swelling of the parotid glands on the sides of the face
-Joint pain and stiffness (rarely)
-Internal organ diseases (rarely)

To diagnose Sjogren’s syndrome, your doctor will do a physical exam and ask about your medical history. Blood tests and other tests may also be performed. A simple biopsy of the inner lip or other area may help confirm the diagnosis.

Treatments for Rheumatic Diseases

Treatments for rheumatic diseases include rest and relaxation, exercise, proper diet, medication, and instruction about the proper use of joints and ways to conserve energy. Other treatments include the use of pain relief methods and assistive devices, such as splints or braces. In severe cases, surgery may be necessary. The doctor and the patient develop a treatment plan that helps the patient maintain or improve his or her lifestyle. Treatment plans usually combine several types of treatment and vary depending on the rheumatic condition and the patient.