Rheumatology: Rheumatic Disease, Symptoms, Diagnosis, Surgery & Treatment | Narayana Health


Narayana Health provides Compassionate Care and Service to all patients seeking Bone, Muscle and Joint Care. Our dedicated team of doctors’ work together to create Personalized treatment care plans for Rheumatic diseases.

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Rheumatology in modern terms is called Clinical Immunology. It is now acknowledged that the underlying cause for a disease like rheumatism is a dysregulation of the normal functioning of the immune system. 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 (meaning altered regulation) of the normal functioning of the immune system, ( which often results in the immune system - which is meant to protect the body - turning on its own body and hence causing disease of the immune system ) can affect virtually any organ of the body, however the systems most commonly involved are:

Joints Disease of joints is called ARTHRITIS (which in turn are of many varieties)
Blood Vessels Diseases of blood vessels are called VASCULITIS (and since blood vessels are ubiquitous in the body, any organ like the brain, heart, lungs, kidneys, gut, skin joint, muscle, etc can be affected)
Muscles Disease affecting muscles is called MYOSITIS
Skin Disease affecting the skin is called Systemic SCLEROSIS
Eyes Disease of the kidney is collectively called NEPHRITIS
Kidney Disease of the kidney is collectively called NEPHRITIS
Soft Tissue Rheumatism A group of conditions which are not included in the above but which can cause tremendous pain over the entire body called FIBROMYALGIA which is fairly commonly.
Chronic Fatigue Syndrome A rarer condition in our country, the disorder causes pain at the insertion of muscles, tendons called ENTHESOPATHY or TENDINITIS respectively
Tenosynovitis Inflammation around tendons and ligaments called TENOSYNOVITIS which can manifest as CARPAL TUNNEL SYNDROME or TRIGGER FINGERS
SLE (Systemic Lupus Erythematosus) A chronic generalized inflammatory condition which is characterized by fever and affecting all or any combination of organs mentioned above. This condition is diagnosed by the presence of typical antibodies in the blood called ANA antibodies.

Narayana Health provides world-class, compassionate care and service to all patients seeking bone, muscle and joint care. Our doctors work together to create personalized treatment care plans for rheumatic diseases.

Diagnosis of Rheumatic Diseases: What to expect?

There are several types of rheumatic diseases and disorders affecting the joints, muscles, bones and other connective or supporting structures of the body. Usually, rheumatic diseases, including all forms of arthritis and inflammatory spinal conditions, are painful, 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. But your doctor will start the diagnosis by asking about your medical history and symptoms. Next, they may ask about your current and past health, exercise habits, family’s 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 further move on to test your range of motion and reflexes. If they suspect any symptom of rheumatic disease, they will order a few laboratory tests to eliminate other potential causes and come to a reliable diagnosis.

You may have to undergo blood tests 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 are necessary to 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. Depending on the condition, the following medications may be prescribed.

- Oral analgesics or painkillers like acetaminophen and prescription narcotics like 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) that can affect the immune responses and inflammatory processes of the body and slow down 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

Rheumatology FAQ's

What does a rheumatology doctor treat?

A rheumatology doctor or a rheumatologist is trained in the treatment and diagnosis of autoimmune conditions that affect the muscle and skeletal system; these diseases are commonly known as rheumatic diseases. They mostly affect the joints, muscles, and bones, causing inflammation, pain, stiffness, and deformity.

Autoimmune diseases occur when the immune system sends inflammation signals to various body parts when it’s not needed; this inflammation can affect the internal organs as well.

What diseases does a rheumatologist diagnose?

Rheumatology doctors treat common autoimmune diseases like osteoarthritis, rheumatoid arthritis, gout, lupus, tendonitis, and chronic back pain. When muscle and joint pain is not resolved for a prolonged period of time, then you may need additional evaluation by a rheumatologist. They also treat conditions like unexplained rashes that can cause a high fever, arthritis, anaemia, fatigue, unexplained weight loss, joint pain, and anorexia. They also have skills in evaluating over a hundred forms of arthritis, including spondylitis, Still’s disease, mixed connective tissue disease, Lyme disease, sympathetic dystrophy, and so on.

Why would you consult a rheumatologist?

If you experience a flare-up that is sudden and inexplicable, then its time to meet your rheumatologist. This is because the problem can be joint damage, and if left untreated, can lead to deformity. If your eyes or mouth suddenly get dry and uncomfortable, and you start developing a skin rash, then you may be experiencing Rheumatoid Arthritis symptoms. A change in sleeping and eating habits that are caused due to muscle or joint pain needs to be shown to your doctor as soon as possible. Sometimes rheumatic diseases can cause mental health issues like depression and anxiety. Your doctor will provide you with medication and the best way to treat it.

What is a rheumatic disease?

There are approximately 100 rheumatic diseases, and they are mostly characterized by swelling and inflammation that mostly affects the ‘connectors’ of the body; this includes joints, ligaments, tendons, muscles, and major organs. The diseases include arthritis, and it can affect the spine, which results in spondyloarthropathies. Experts say that rheumatic diseases can be caused due to various factors, and mostly because of a combination of environmental and genetic factors. Generally, genetic factors can be a significant reason for rheumatic diseases. The disease can be triggered by hormonal spikes, viral or bacterial infections, or excessive weight gain.

What is the most common rheumatic disease?

The most common rheumatic diseases are:

Osteoarthritis: symptoms include pain, swelling, stiffness, and warmth within the affected area. The patient will experience muscle weakness, which will make normal motor functions difficult to perform.

Rheumatoid arthritis: The symptoms include pain and inflammation in multiple joints, trouble breathing, impaired vision, and fatigue.

Lupus: Popular symptoms are a “butterfly” rash that spreads from one facial cheek to another, sensitivity to sun rays, excessive hair loss, kidney problems, anaemia, inflammation within the chest, and so on.

Gout: symptoms are swollen joints, less range in motion, tendon pain, rash, and inflammation within the eyeball.

Infectious arthritis: It occurs due to bacterial or viral infection at the joint, it can cause severe arthritis-like symptoms.

Juvenile idiopathic arthritis: It is the most common form of arthritis found in children under the age of 16. It can cause swelling, stiffness, reduced motility and prolongest pain.

What are the first signs of rheumatism?

The first signs of rheumatism include:

Fatigue- This when you feel tired even after a good night’s sleep, and it can increase in intensity after a couple of weeks. Lethargy is usually accompanied by weak physical and mental health.

Stiffness- When your body gets stiff, especially in the mornings, it can be an early sign of arthritis. If it lasts for more than a few minutes, it can get worse over time if not treated immediately.

Joint stiffness- If it occurs for more than one joint, then it is a common symptom for rheumatoid arthritis. It can happen at any time of the day, whether you’re active or not.

Fever- If you consistently experience joint pain and inflammation, you may get a low-grade fever as well. This is an early symptom of rheumatism, and you have to get it checked.