Rheumatology Diagnosis and Treatments
The diagnosis of a rheumatic condition can include a full blood workup, tests such as synovial fluid analysis, specific immunologic studies, and various imaging studies (such as X-Ray or MRI). Following the diagnosis, factors such as age, overall health, and the severity of the disease are taken into consideration to tailor a personalized treatment plan for each patient.
With the goal of improving function and reducing pain, our range of treatment options includes the following:
Depending on the type of rheumatic condition there are a number of non-medical strategies that can be used to treat it. These include dietary changes, physical therapy, massage, heat or cold therapy, weight loss measures (to reduce stress on joints), exercise (to improve muscle strength and decrease stiffness), and support devices such as a cane or brace. Complimentary medicine therapies such as acupuncture could also be helpful.
Medications to treat rheumatic conditions could be administered in the form of an oral pill, topical cream, or injection, and include the following:
- Anti-inflammatory medications: Medications that work to decrease pain and swelling include non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen.
- Disease-modifying antirheumatic drugs (DMARDs): Intended to slow the progression of disease and relieve symptoms, these drugs include hydroxychloroquine, sulfasalzine, and methotrexate.
- Biologicals: A newer generation of antirheumatic drugs, these medications can target the areas of the immune system and the signals that produce inflammation and damage. They include etanercept and infliximab (which interfere with proinflammatory cytokines) and rituximab (which causes B-cell depletion).
- Corticosteroids: Used to decrease inflammation thereby minimizing tissue damage, corticosteroids reduce immune system activity by affecting white blood cell function.
- Topical treatments: Various creams and gels such as capsaicin and lidocaine can be used to relieve pain.
- Injection therapies: Sometimes administered with the assistance of an interventional radiologist, therapeutic injections include cortisone/corticosteroid injections and viscosupplementation injections (which involve injecting a natural substance called hyaluronic acid into a joint to improve lubrication and help to relieve pain).
Additional treatment options for certain conditions include the following therapies:
- Sjogren's syndrome treatments: Therapies are intended to minimize the worst symptoms, and include drops to help dry eyes, saliva substitutes to relieve dry mouth, and nasal saline irrigation to improve dryness in the nose.
- Lupus treatments: This challenging condition can sometimes be treated with anti-malarial drugs (which can help relieve symptoms such as rashes, fatigue, and joint pain) and immune suppressants.
- Surgery: In severe cases of conditions such as osteoarthritis in which significant joint damage has occurred, a minimally invasive arthroscopic procedure may be recommended to repair the damage.