Ankylosing spondylitis (AS) is a type of arthritis that mainly affects the back. It’s one of a group of inflammatory conditions, referred to as spondyloarthritis.
Spondylitis simply means inflammation of the spine. As part of the body’s reaction to inflammation, calcinosis occurs in ligaments that attach to the vertebrae. This causes bone to grow from the sides of the vertebrae. Eventually the individual bones of the spine may fuse and loose flexibility. This is called ankylosis.
It often starts in your late teens or 20s.
Other possible symptoms include:
Most people with ankylosing spondylitis have a gene called HLA-B27, which can be detected by a blood test. However, this gene doesn’t mean you’ll definitely get ankylosing spondylitis. It is estimated that only 1 in 15 people with the gene will actually develop this condition.
No specific test will confirm you have ankylosing spondylitis, so diagnosis involves piecing together:
They are slow-acting so you won’t notice an immediate impact on your condition, but they can make a big difference to your symptoms over a period of time.
It’s especially important to exercise your back and neck to avoid them stiffening into a bent position
Bed rest is certainly not recommended, as this will speed up the stiffening of your spine
WHAT IS FIBROMYALGIA?
Fibromyalgia is a common condition that can cause widespread pain. 1 person in every 25 may suffer from it. Women are affected commonly and the condition varies a great deal from one person to another and from day to day.
What causes it?
No specific physical cause has been found. This doesn’t mean the symptoms are unreal or ‘all in the mind’, but anxiety, physical or mental trauma, and sleep disturbance are thought to play a part. Patient’s anxiety or trauma causesincreased sensitivity to pressure that wouldn’t be painful in healthy persons.
Sleep disturbance also contributes to this increased sensitivity. A number of things may lead to sleep disturbance, such as:
How is fibromyalgia diagnosed?
At present, there aren’t any specific blood tests or scans that can confirm a diagnosis of fibromyalgia – in fact, typically, people with fibromyalgia will have normal results.
Patients usually have specific tender points in certain areas of the body. However, guidelines released in 2010 favor a diagnosis if:
Your doctor can prescribe a variety of medications to help with pain, sleep disturbance or depression. These reduce the symptoms to a level that will enable you to start some gentle physical activity and rehabilitation therapies.
What is the outlook?
Fibromyalgia is a long-term (chronic) condition, and recovery varies from person to person. There’s no known cure, but there are treatments, therapies and self-management techniques that can help to improve your symptoms to a great extent.
Gout is caused by too much uric acid, or urate, in your body. Urate is produced by the breakdown of chemicals called purines in your body; most of which are made naturally by your body but some come from your diet.
People with gout often have kidneys that are unable to flush out extra urate through urine, and when it builds up above a critical level it can form crystals of sodium urate.
What causes an attack of gout:
The urate crystals escape from the cartilage and trigger sudden painful inflammation of the joint lining. Several factors can affect the level of urate in your body:
Symptoms of an attack:
|Organ meats high in purine content (eg. sweetbreads, liver, kidney)||Serving sizes of:
• Beef, lamb, pork
• Seafood with high purine content (eg. sardines, shellfish)
|Low-fat or non-fat dairy products|
|High fructose corn syrup-sweetened sodas, other beverages, or foods||Servings of naturally sweet fruit juices
Table sugar and sweetened beverages and desserts
Table salt, including in sauces and gravies
|Alcohol overuse (defined as more than 2 servings per day for a male and 1 serving per day for a female) in all gout patients
Any alcohol use in gout during periods of frequent gout attacks, or advanced gout under poor control
|Alcohol (particularly beer, but also wine and spirits) in all gout patients|
Initial treatments for acute attacks:
Longer-term treatments aim to lower urate levels and reduce the risk of further attacks. These include:
SELF HELP MEASURES
What is the outlook?
Attacks can vary from person to person. In time, though, attacks tend to happen more often and new joints are affected. A continued build-up of urate crystals and formation of hard tophi can damage your cartilage and bone, leading to long-term (chronic) arthritis.
What is lupus?
Lupus is a disorder that affects the skin and joints and often also involves the internal organs, including the heart or kidney. Lupus is an autoimmune disease, which means that your body’s defense system produces antibodies that attack the body’s own tissues.
What are the symptoms of lupus?
You will need REGULAR CHECK-UPS with your doctor for early signs of these complications.
What is the outlook?
It is a variable and unpredictable condition and may even be life-threatening for people whose vital organs are affected. It’s hard to predict exactly how lupus will affect you. Most people with lupus don’t have the more serious complications, but your doctor will be on the look-out for these so that early treatment can be given if necessary
How is it diagnosed?
Some of the symptoms of lupus are the same as other diseases, more common conditions, so beside the clinical manifestations, you’ll probably have a number of tests before the diagnosis is confirmed.
Who should treat me?
There’s no cure for lupus at present, but the disease is most often very treatable and usually responds well to a number of different types of drugs – especially when treatment is started in the early stages of the disease.
Too much ultraviolet light from sunlight can cause a red rash across the cheeks and the bridge of the nose, often known as the butterfly rash.
Keep your skin covered or use suncream of SPF 30 or greater
Raynaud’s phenomenon: blue/white/red discoloration of digits in cold: keep hands and chest warm and covered
A RHEUMATOLOGIST MAY ADVISE YOU SPECIALIZED TREATMENT WITH :
PREGNANCY AND LUPUS
Most women with lupus should be able to have a baby if they wish to, but it’s best to discuss your plans with your doctor before trying to get pregnant so that your treatments can be altered if need be.
A NORMAL JOINT:
A joint is formed by two bones.The end of each bone is covered with cartilage which has a smooth, slippery surface that allows the ends of the bones to move against each other almost without friction. When a joint develops osteoarthritis, some of the cartilage covering the ends of the bones gradually roughens and becomes thin and the knee develops swelling and pain.
What treatments are there?
If you still have pain after trying self-help measures, seek help from a
Bone is a living tissue, but as we get older it’s not able to renew itself as well and our bones start to thin. This happens to everybody to some degree, but when the bones become fragile it’s called osteoporosis.
Who is at risk ?
it’s more common in women, particularly after the menopause
You are at greater risk of developing osteoporosis if you:
How can I help myself ?
The following will help to reduce your risk of developing osteoporosis:
Your rheumatologist would advise you a special test “DEXA or DXA SCAN” (Dual Energy X-ray Absorptiometry )for diagnosis. This test measures bone density. The possible results are:
What treatments are there?
There are a number of treatments available, including:
How to take bisphosphonates?
Available as intravenous form or in an oral tablet:
Inform your doctor:
Gastritis(commonest),skin rashes, a sore mouth, flu-like symptoms, jaw pain, bone pain/muscle pain, headaches
Psoriatic arthritis is a condition that causes painful inflammation of the joints and is often linked with the scaly skin condition; psoriasis.
However, some people develop the arthritis symptoms before the psoriasis, while others will never develop the skin condition.
Psoriasis can affect people of any age, both male and female, but psoriatic arthritis tends to affect more adults than young people.
How is it diagnosed?
It’s important that psoriatic arthritis is diagnosed early so treatment can be started as soon as possible.
There’s no specific test for psoriatic arthritis, but the diagnosis is based on your symptoms and a physical examination. Your doctor will check for psoriasis and may ask if there’s a history of psoriasis or psoriatic arthritis in your family.
With history and appropriate blood tests and radiologic findings, your doctor should be able to reach the diagnosis. Once treatment is started, regular follow-up and monitoring is necessary. You may be given some of the following treatments, depending on your symptoms:
It is an autoimmune disease that causes inflammation in your joints. This means that your immune system starts attacking your body’s own tissues instead of germs and viruses. Rheumatoid arthritis causes inflammation in the joint lining. This results red, painful and swollen joints. The redness is caused by the increase of blood flow. As a result, the inflamed joint may feel warmer than usual.
Symptoms of rheumatoid arthritis (RA) tend to come and go. You may have flare-ups when your symptoms become worse than normal. Common symptoms of rheumatoid arthritis include:
Rheumatoid arthritis symptoms vary from one person to another but it usually starts quite slowly. A few joints – often your fingers, wrists or the balls of your feet – become uncomfortable and may swell, often intermittently. Your hand, fingersand other joints may also feel stiff when you wake up in the morning. The stiffness may last for more than half an hour.
Because rheumatoid arthritis can affect different people in different ways, we can’t predict how the condition might develop for you.
75% of people will continue having some joint pain, swelling and flare-ups.
20% will always have very mild rheumatoid arthritis.
5% will develop severe disease with extensive disability.
HOW IS RHEUMATOID ARTHRITIS DIAGNOSED?
No single test can give a definite diagnosis of rheumatoid arthritis in the early stages of the condition.
Doctors have to arrive at a diagnosis based on your symptoms, a physical examination and the results of blood tests. Sometimes x-rays, musculoskeletal USG or scans are needed.
Blood tests including:
Regular physiotherapy and foot wear are necessary
Four main groups of drugs are used to treat rheumatoid arthritis:
REMEMBER: Most people with rheumatoid arthritis need to take more than one drugs. This is because different drugs work in different ways.
Some shoulder problems may be part of a general condition such as
There are several other possible causes of shoulder pain, including:
SHOULD I SEE A DOCTOR:
SELF HELP MEASURES:
Reducing the strain
Each shoulder problem has its own pattern of symptoms.
Your doctor or physiotherapist will need to establish which movements produce the most pain, as this could indicate where the problem is.
Usually your symptoms and the doctor’s examination of your shoulder will give all the information needed to plan your treatment. However, your doctor may suggest tests if considered necessary
What tests are there?
If your shoulder pain doesn’t improve with simple medications, other treatments are available. Your doctor will be able to give more specific advice. Options include:
The word scleroderma means hard skin (sclero = hard, derma = skin).
Systemic sclerosis causes tightening of the skin. It is an autoimmune disease, which means the immune system attacks the body’s own tissues. It’s one of a number of conditions called connective tissue diseases.
Systemic sclerosis is rare, but women are 3–4 times more likely than men to develop it. It usually starts between the ages of 25–55 years.
Systemic sclerosis can cause a range of symptoms affecting many different parts of your body:
Sensitivity to the cold:
Your fingers or toes turn white then blue/red in the cold. This is called Raynaud phenomenon.
Changes in the skin
Pain stiffness swelling in joints
WHICH TESTS ARE DONE:
Usually include managing all the four salient symptoms with the use of pain killers,NSAIDS,stomach protection agent, skin moisturizing agents, measures to keep chest and peripheries warm.
Specific treatment includes