Clinical Immunology & Rheumatology

Rheumatology is the branch of medical science that deals with the investigations, prevention, management and treatment of Rheumatological conditions. Rheumatological conditions include Autoimmune and Inflammatory Musculoskeletal diseases and disorders that affect your bones, joints, muscles, tendons and ligaments.

In some cases, rheumatological conditions may also affect your skin, blood vessels, nerves and other internal organs. A large variety of these conditions are the ones that affect a person’s own immune system or are considered immune system abnormalities. These conditions can affect any person irrespective of their age group.

About Immunity and autoimmune diseases:

Autoimmune disease occurs when the immune system or our immunity attacks self-molecules or cells or organs. Immunity or immune cells protect us from various infections. In autoimmune diseases, our immune cells starts damaging our own body due to various reasons. The reasons can be genetic, infectious, and/or environmental predisposing factors. It deals with multiple disorders and symptoms ranging from organ-specific to systemic features like fatigue, low grade fever, weight loss, decreased appetite and myalgia.

Few examples of autoimmune diseases are Rheumatoid arthritis (RA), Ankylosing spondylitis (AS), Psoriatic arthritis (PsA), Reactive arthritis , Spondyloarthritis, Juvenile idiopathic arthritis (JIA), Systemic lupus erythematosus (SLE or Lupus), Systemic Sclerosis (Scleroderma), Sjogren syndrome, Multiple vasculitis diseases, Myositis diseases , Sarcoidosis, Thyroiditis, and Multiple sclerosis.

Autoimmune disorders affect approximately 1- 3% of the population (75% of those affected being women) but not known to many persons or even many primary care medical health personals. Our department is fully equipped for the management of all autoimmune diseases by expert heath care professional.

About arthritis:

Arthritis is a symptom only ; the term refers to joint pain and or swelling or stiffness in the joints. There are more than 100 diseases that can cause arthritis. People of all ages (even children), races and sexes can have arthritis. It is the leading cause of disability in world. It’s most common among women. Usually we think that it’s a diseases of aging but contrast to common belief , it can affect any age group. Few types of arthritis are more common in older people.

Common symptoms of arthritis include pain or swelling or stiffness in joints and diminished range of motion in joints. Symptoms vary from mild to severe and may come and go. Some may stay about the same for years, but symptoms can also progress and get worse over time. Severe arthritis can result in chronic pain, difficulty performing daily activities and make walking and climbing stairs painful and gruelling. Arthritis can also cause permanent joint changes. These may be visible, such as knobby finger joints, but often the damage can be seen only on X-rays. Some types of arthritis affect the heart, eyes, lungs, kidneys and skin as well as the joints.

Here is a list of some common types of conditions treated by doctors specialising in rheumatology. 

• Inflammatory joint disease: Inflammatory joint disease is a chronic condition also known as rheumatoid arthritis. It is a disease caused by an overactive immune system. This disease usually affects several joints throughout the body. In this condition, the body’s immune system attacks its own tissues and joints causing pain and swelling. If not treated timely, this disease can cause bone deformity and erosion.
• Autoimmune disease: An autoimmune disease is a condition in which the body’s immune system mistakenly attacks itself. The immune system is responsible for safeguarding your body from bacteria, viruses and harmful external agents. In autoimmune diseases, the immune system begins to target and attack the body’s healthy cells. Common autoimmune diseases include lupus, coeliac disease and multiple sclerosis.
• Degenerative joint disease: Degenerative joint disease or osteoarthritis occurs when the joints in your body wear down due to degenerative changes such as ageing leading the bones to rub against each other and cause painful symptoms.
• Soft tissue disorders: Soft tissue rheumatism is connective tissue disorders causing inflammation of the joints. In this condition, the symptoms such as pain and swelling are not caused by arthritis but repeated low-grade trauma on the muscles, tendons and ligaments.
• Metabolic bone disorders: Metabolic bone disorders are bone deformities caused as a result of insufficient bone strength or abnormalities in bone minerals. Common metabolic bone disorders include osteoporosis, rickets, fluorosis and primary hyperparathyroidism.
• Crystal arthropathies: It is a group of joint disorders developed as a result of the deposition of crystals in and around the joints and soft tissues. This condition can lead to joint destruction and soft tissue masses. Common types include gout and calcium pyrophosphate deposition.
• Musculoskeletal infections: Musculoskeletal infections are infections that can develop in the bones, joints or muscles. These infections can affect anyone at any age and usually spread quickly in children as compared to adults.

The common rheumatological & autoimmune diseases: (Must visit a Rheumatologist)

Common Symptoms of Rheumatological & Autoimmune diseases:

1. Joint pain
2. Stiffness in joints
3. Swelling in one or more joints
4. Chronic low back pain or chronic neck pain
5. Low grade persistent fever
6. Muscle pain or muscle weakness
7. Persistent tiredness or fatigue or deceased appetite
8. Weight loss
9. Nonscarring alopecia
10. Photosensitivity rash or multiple skin rash or ulcers
11. Dryness in eyes or mouth
12. Skin thickening or tightening
13. Deformities in hands
14. Blue or white discoloration of fingers in winter
15. Recurrent oral ulcer
16. Recurrent abortions
17. Recurrent ocular inflammation
18. Recurrent infections
19. Unexplained kidney failure
20. Persistent dry cough and shortness of breath

Your rheumatologist will evaluate your condition. You will be expected to discuss your medical history and symptoms in detail. Your doctor will order a range of tests to further reach a diagnosis for your problems. Common tests include X-rays, bone density tests, CT scans and more. Additional tests may be ordered if your doctor suspects the need for them. 

After a thorough evaluation of your condition, your rheumatologist and care team will offer your different treatment options best suited for your health. Common treatment protocols used to treat above given conditions include:

• Medication
• Exercise and physical workout 
• Dietary control
• Use of appliances, such as splints or braces
• Procedure done: (in Minor OT under anaesthesia)
  • Skin biopsy
  • Muscle biopsy
  • Nerve Biopsy
  • Sublingual gland biopsy
  • Intraarticular joint aspiration
  • local intralesional injection