Arthritis & Rheumatic Conditions

By some estimates, 52 million people in the United States suffer from rheumatic conditions which is expected to reach 60 million over the next several years. Rheumatic diseases affect people of all races and ages. Some rheumatic conditions are more common among certain populations.

Rheumatic diseases, including many forms of Arthritis are termed “autoimmune diseases” that are caused by a malfunction of the immune system. The immune system’s normal function is to protect the body against infection by attacking invading organisms such as bacteria or viruses. In the autoimmune diseases, the immune system gets “confused” and mounts an attack against the body’s own tissues which may cause red, swollen joints or inflamed connective tissues such as cartilage, synovial tissue, and tendons. In some cases, inflammation can damage the body’s internal organs such as the skin, kidneys, lungs, liver and even the brain.

Rheumatologists receive 2-3 years of specialized training in the diagnosis and treatment of these diseases. The early you are diagnosed and treated, the earlier you can reduce your chance for pain and disability and live an active and healthy life.

Osteoarthritis : This is the most common type of arthritis. This is often described as degenerative or wear and tear arthritis and is most common in the knees, hips, spine and base of the thumbs. The Providers at GCSP specialize in the prevention and non-surgical treatment of osteoarthritis.

Psoriatic Arthritis : This is a form of an inflammatory arthritis that occurs in people with the skin disorder psoriasis but may also present prior to patient’s developing psoriasis. Additionally, many patients with psoriasis are unaware that they may have psoriatic arthritis. The precise cause has not been identified, but genetic, immunological, and environmental factors all likely play a role. Psoriatic arthritis can affect the joints, tendons and spine and can cause characteristic nail lesions as well. People with psoriatic arthritis may also develop inflammation in the eyes and have an increased risk of cardiovascular disease. A significant percent of patients can develop destructive and disabling disease leading to loss of function and lower quality of life. Fortunately, newer treatment options are available to help reduce arthritis activity and even place the arthritis into remission.

Ankylosing Spondylitis (AS) : This is the most common of the spondyloarthropathies, which are rheumatic diseases that specifically affect the spine. AS is most common in young, male adults and has a strong hereditary component as most people with the disease carry the HLA-B27 gene. The most common symptom of AS is pain and stiffness in the back that worsens with rest and improves with activity. This is in contrast with mechanical forms of back pain such as degenerative arthritis that is often worse with activity and better with rest. Along with spine involvement, AS may also cause inflammation in tendons and joints, especially the hips, knees, and shoulders. In addition, patients may have other organ involvement including eye inflammation, lung involvement, heart problems and rarely kidney disease.

Polymyalgia Rheumatica (PMR) : PMR is an inflammatory disease generally occurring in patients older than 50. Patients with PMR suffer from severe stiffness and pain in the neck, shoulders, hips, and low back. Fatigue, weight loss, and low grade fevers may also occur. Blood testing may show high levels of inflammation and the disease responds dramatically to steroid therapy – a treatment that resolves inflammation rapidly. Unlike many other rheumatic diseases, PMR may resolve after a couple of years or be a chronic condition.. It is sometimes associated with Giant Cell Arteritis (Temporal Arteritis) which can cause headaches and visual disturbances that may lead to blindness.

Gout and Pseudogout : Gout and pseudogout are forms of arthritis referred to as crystalline arthropathies because the inflammation they cause results from crystal deposits forming in the joint and surrounding tissues. Estimates of 3-8 million adults have gout which is a painful arthritis that most often affects the big toe but can involve other joints and tissues as well. Gout is caused by an accumulation of uric acid in blood and tissues that can be brought on by an excess intake of purine rich foods that break down into uric acid, or a decreased ability to eliminate it from the body. A attack of gouty arthritis may be triggered by the release of uric acid crystals causing severe pain, swelling, warmth, and redness. Pseudogout causes similar symptoms, but the crystals are made up of a combination of pyrophosphate and calcium rather than uric acid.

Lupus : Lupus is a chronic, systemic, inflammatory autoimmune disease that most often affects young women of childbearing age, but men and children can develop the disease as well. Lupus most often causes mild symptoms such as joint pain, fatigue or rash, however, it can affect any part of the body and be severe and even life threatening if vital organs such as the kidney, lungs or brain are involved. Fortunately there are effective treatments available for Lupus which, along with good medical care and monitoring, can help reduce its activity or help put it into remission.

Sjogren’s Syndrome : This is identified by its two most common symptoms — dry eyes and a dry mouth. In Sjogren’s syndrome, the mucous membranes and moisture-secreting glands of the eyes and mouth are usually affected — resulting in decreased production of tears and saliva. Sjogren’s syndrome often accompanies other immune system disorders, such as rheumatoid arthritis and lupus but can occur alone as a primary disorder. As a primary disorder, Sjogren’s Syndrome can affect virtually any organ system in the body and certain cancers such as lymphoma are more common compared with the general population.

Inflammatory Myopathies (Polymyositis and Dermatomyositis) : Inflammatory myopathies result from autoimmune mediated inflammation and resultant damage to the muscles which can lead to weakness of muscles. Polymyositis most commonly affects adults in the 3rd through 6th decade of life. Dermatomyositis affects both adults and children and occurs when both the muscle and skin (causing a rash) are involved. Both conditions are more common in women and can be associated with problems swallowing or breathing.

Vasculitis : Vasculitis results when the body’s immune system mounts an attacks against blood vessels causing damage to the tissues that the blood vessels supply. Virtually any organ in the body can be effected. Vasculitis may be associated with autoimmune diseases such as Lupus or Rheumatoid Arthritis, can result from an infection such as hepatitis, or may occur on its own as a primary syndrome such as in Giant Cell Arteritis (Temporal Arteritis) or Granulomatosis with Polyangiitis (GPA) (previously known as Wegener’s Syndrome) to name a few.

Scleroderma (Systemic Sclerosis) : The word “Scleroderma” comes from two Greek words: “sclero” meaning hard, and “derma” meaning skin. Hardening of the skin is one of the most visible manifestations of the disease, but scleroderma can also affect the lungs, GI tract, kidney and other organs. Scleroderma is a rare and complex rheumatic disease which Rheumatologists are trained to manage but patients often require co-management with other specialists such as pulmonologists and gastroenterologists as well.