Rheumatology & Clinical Immunology is the medical super-specialty that deals with arthritis and other connective tissue disorders or autoimmune disorders. There are at least 100 different types of arthritis and rheumatism. These include diseases like

  • Rheumatoid arthritis
  • Osteoarthritis
  • Ankylosing spondylitis
  • Psoriatic arthritis
  • Reactive arthritis
  • Gout
  • Still's disease
  • Post infectious arthritis & Other connective tissue disorder like systemic lupus erythematosus
  • Systemic sclerosis
  • Sjogren's syndrome
  • Sarcoidosis
  • Myositis like polymyositis
  • Dermatomyositis
  • Systemic vasculitis like wegner's granolomatosis,polyarteritis nodosa , takayasu arteritis, etc
  • Metabolic bone diseases like osteomalacia,osteoporosis
  • Chronic musculoskeletal pain disorders like chronic pain syndrome, fibromyalgia
  • Amyloidosis
  • Primary immunodeficiency syndromes
  • Rare autoimmune disorders,etc.

Patient suffering from joint pain with or without swelling in joints (hands/wrist/elbow/ shoulder/knee ankle & feet) or pain over back or neck, with early morning stiffness should see a rheumatologist. Also if a patient is having any of the symptoms like recurrent fever, rash, photosensitivity, recurrent painful oral ulcers, reddish or bluish discoloration of hands especially in winters, severe dryness of mouth or eyes, non- healing ulcers with or without joint pains, then also he/she should consult a rheumatologist. Few of these are chronic and disabling type if not treated early and properly (e.g. rheumatoid arthritis, ankylosing spondylitis, osteoarthritis). Some diseases can even be life-threatening (e.g. lupus, scleroderma, polymyositis, vasculitis etc.) if not diagnosed or not treated optimally particularly at the time of flare.

Rheumatic diseases affect your joints and muscles. Some, like osteoarthritis, are the result of wear and tear. Others, such as rheumatoid arthritis, are immune system problems.

Your treatment plan will likely include medications, regular exercise, a healthy diet, stress management, and rest.

A doctor who specializes in these conditions, called a rheumatologist, can help you find the best ways to manage your condition.

Years ago, conditions like this fell under the broad heading of rheumatism. Now there are more than 100 distinct rheumatic diseases. Following are few common conditions.

Osteoarthritis (OA)

What it is: Osteoarthritis damages cartilage, the cushiony material on the end of bones. As it wears down, joints hurt and it becomes harder to move. It usually affects the knees, hips, lower back, neck, fingers, and feet.


  • Pain
  • Swelling
  • Warmth
  • Stiffness

Muscle weakness can make joints unstable. Depending on what parts of the body it affects, OA can make it hard to walk, grip objects, dress, comb hair, or sit.

Diagnosis: Your doctor will ask about your medical history and symptoms. You’ll also get a physical exam. You may also need to getblood tests or let your doctor take a sample of fluid from an affected joint.

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

What it is: rheumatoid arthritis is commonest form of arthritis with multiple joint symmetric involvement, mainly joints of fingers, wrists, feet, knees, elbows etc.


  • Joint pains
  • Swelling
  • Morning Stiffness
  • Fatigue
  • Anorexia
  • Mild Fever
  • Joint Deformities

Diagnosis: Your doctor will ask about your medical history, do a physical exam, and order lab tests of blood samples and urine . Two blood tests are RA factor level and anti-CCP level . Most people with lupus have a positive RA and anti-CCP.


What it is: Lupus (also called SLE or systemic lupus erythematosus) is an autoimmune disease. It can affect many organs in your body.


  • Joint Pain
  • Fatigue
  • Joint stiffness
  • Rashes, including a "butterfly" rash across the cheeks
  • Sun sensitivity
  • Hair loss
  • Blue or white fingers or toes when exposed to cold (called Raynaud's phenomenon)
  • Problems in other organs such as the kidneys
  • Blood disorders, such as anemia and low levels of white blood cellsor platelets
  • Chest pain from inflammation of the lining of the heart or lungs
  • Seizures or strokes

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

Ankylosing Spondylitis

What it is: Ankylosing spondylitis usually starts gradually as lower back pain. It usually involves the joints where the spineattaches to the pelvis, known as the sacroiliac joints.

Ankylosing spondylitis is more common in young men, especially from the teenage years to age 30.


  • 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 when getting up
  • Pain and stiffness get better after activity
  • Pain in the middle back and then upper back and neck (after 5-10 years)

If the condition worsens, your spine may become stiffer. It may become hard to bend for everyday activities.

Diagnosis: Your doctor will give you a physical exam and ask you about your medical history. You may get X-rays of your back, looking at the sacroiliac joints. A blood test for a protein called HLA-B27 may help confirm a diagnosis.

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