Rheumatology

Physical examination is one of the most important steps for initiating a personalized treatment protocol. It involves the evaluation of the patient’s overall physical health which involves checking of pulse, listening to the heartbeats and lungs and checking for swollen lymph nodes along with a detailed examination of the affected limb and joints for assessing the intensity of inflammation, range of motion and function.

This is extremely important for making an effective clinical decision as it helps the doctors to understand what is going on with your health as well as helps them to figure out what health issues you are genetically at a risk of.

These are very crucial for determining the root cause of the problem and the extent to which it has spread, both of which are important for figuring out a proper treatment protocol.
Blood test - CBC, ESR, CRP, Liver and renal function test, Urine examination.
Special immunological tests - Rheumatoid factor. Ant-CCP antibody, ANA(Anti Nuclear Antibody), ANCA, ANA Profile, C3, C4
Imaging tests- these help to give detailed images of the areas inside the body using different types of energy

• X-ray- high energy radiations
• Ultrasound- high energy sound waves
• MRI (Magnetic Resonance Imaging) scan- high intensity magnetic waves
• CT scan- high intensity radiations

Our team of specialists, which consists of renounced and well acclaimed rheumatologists,offers surgical as well as non-surgical treatments for a wide array of rheumatologic disorders, some of which are mentioned below:

Osteoarthritis-A progressive disease marked by the degeneration of the joints and the underlying bones, leading to stiffness, inflammation and unbearable pain.

• Diagnosis
  1. Imaging tests like X-rays and MRI
  2. Blood tests
  3. Joint fluid analysis

• Treatments offered
  1. Non-surgical - Prescribing oral or topical pain killers and anti-inflammatory drugs like Acetaminophen, Duloxetine and NSAIDs
  2. Surgical - Cortisone injections, lubrication injections, surgical realignment of bones, joint replacement (both conventional and arthroscopic), etc.
  3. Therapeutic -Physical as well as occupational therapy

Rheumatoid Arthritis (RA)-

• Diagnosis
  1. Erythrocyte sedimentation rate
  2. C-reactive protein
  3. Blood test for anti-cyclic citrullinated peptide (anti-CCP) antibodies
  4. Imaging tests like X-rays and MRI

• Treatments offered-
  1. Non-surgical-NSAIDs, steroids, DMARDs and biologic response modifiers.
  2. Surgical-Synovectomy, tendon repair, joint fusion, total joint replacement etc.
  3. Therapeutic-occupational therapies and use of assistive devices.

• Diagnosis
  1. Blood test for CBC
  2. Erythrocyte sedimentation rate
  3. Kidney and liver assessment
  4. Urinalysis
  5. Antinuclear antibody (ANA) test ANA Profile, C3, C4
  6. Chest X-ray
  7. Echocardiogram
  8. Biopsy of Kidney or Skin

• Treatments offered-
  1. Medicines- NSAIDs, Antimalarial drugs, Corticosteroids, Immunosuppressant drugs, Biologics.
  2. Lifestyle modification- Comprehensive assistance and guidance from our specialists

Takayasu Arteritis - Seen in young female mostaly, marked by narrowing of Blood vesseles of arms and brains.

• Diagnosis - Blood test - CBC, ESR, CRP etc.
•  Imaging - CT or MRI, angiography, PET CT Scan
• Treatment - corticosteroids, DMARD, Biologic theropy

Spondyloarthropathies- It is a collective term used for a family of chronic joint diseases that are likely to affect adults as well as children. For e.g. ankylosing spondylitis (AS) and psoriatic arthritis (PsA) Inflammatory bowel disease related arthiris.

• Diagnosis-
  1. Physical examination
  2. Imaging tests like X-ray and MRI
  3. Blood test for HLA-B27 gene

• Treatments offered-
  1. Medication- NSAIDs,Corticosteroid injections, DMARDs and Tumour necrosis alpha blockers. IL-17A blocker (BIologis)

Sjogren’s Syndrome-It is an auto immune disorder due to which a person’s immune system starts attacking the salivary and tear glands, leading to symptoms like dry mouth and dry eyes.

• Diagnosis-
  1. Blood tests to determine the presence of antibodies,
  2. Eye tests
  3. Sailogram
  4. Salivary scintigraphy

• Treatments offered-
  1. Medication and other options- artificial saliva, artificial tears, eye drops, moisture chamber spectacles, expectorants, throat medication, NSAIDs, DMARDs, antifungal medication, eye serums etc.
  2. Surgical- Punctual occlusion.

Gout-Coming from the family of arthritis, Gout is an inflammatory disease triggered by increased levels of uric acid in the blood.

• Diagnosis-
  1. Joint-fluid test
  2. Blood test
  3. X-ray imaging
  4. Ultrasound
  5. Dual energy CT scan

• Treatments offered-
  1. Medication-NSAIDs, Colchicine, corticosteroids etc.Uric acid lowerite therapies
  2. Healthy dietary and lifestyle modifications: personalised diet plans and counselling.

Scleroderma-Also known as systemic sclerosis, it is a rare Connective tissue disease marked by hardening and tightening of the skin can also affect other organs like lungs, heart, blood vessels, Kidneys

• Diagnosis-
  1. Physical examination
  2. Blood tests
  3. Imaging tests

• Treatments offered-
  1. Non-surgical-Oral medicines and ointments to supress immune system, dilate blood vessels, reduce symptoms, relieve pain and treat skin and other organ involvement.
  2. Surgical-Amputation and lung transplant.
  3. Therapeutic- Physical and occupational

Osteoporosis -Marked by weekenire of bones making them more prime to fracture. Usually found in Post - menopaused females or elderly men.

• Diagnosis - Blood tests- Calcium, phosporus, Alkalin phosphetes, Vit. D, TSH test
• Imaging - DEXA Scan
• Medication

1. Calcium and Vit. D supplements, Prisphosphanates, Lower druges like denosumab, teriperatide
2. Physical Theropy

Infectious Arthritis-Commonly referred to as septic arthritis, the condition is marked by severe bacterial or viral infection in the joints or the fluids surrounding it.

• Diagnosis-
  1. Joint fluid analysis
  2. Blood tests
  3. Imaging tests

• Treatments offered - IV and oral antibiotics
  1. Minimally invasive-joint drainage using a needle or using arthroscopy.
  2. Conventional-joint drainage via open surgery.

Juvenile Idiopathic Arthritis-Initially known as Juvenile rheumatoid arthritis, it is the most common type of arthritis found in children below 16 years of age and is marked by persistent joint pain and inflammation.

• Diagnosis-
  1. Blood tests for erythrocyte sedimentation rate (ESR), C-reactive protein, anti-nuclear antibody, rheumatoid factor and CCP.
  2. Image tests like X-rays and MRI.

• Treatments offered
  1. Medication-NSAIDs, DMARDs, biologic agents, corticosteroids etc.
  2. Surgical- Surgical relocation of joints
  3. Therapeutic- Physical and occupational therapies.

Polymyalgia Rheumatica-Most likely to affect people above 65 years of age, Polymyalgia rheumatica is an inflammatory disorder marked by muscle pain and stiffness especially in the shoulder and the surrounding areas.

• Diagnosis-
  1. Blood testsfor CBC count, erythrocyte sedimentation rate and C-reactive protein.
  2. Image tests like MRI

• Treatments offered
  1. Medication- Corticosteroids, Methotrexate and calcium and vitamin D supplements.
  2. Therapeutic-Physical therapy

Affects people above 65 years of age and, inflammatory disorder marked by headache, and sudden vision lost if not promptaly treded. Can be associated with polymyalogic rheumatice.

Diagnosis and Treatment - Same as polymyalogic rheumatice
Post Viral/Post-Chikungunya arthiritis - Can affect any age group, marked by chronic joint pains following dengue/Chikungunya fever Diagnosis - Blood test, CBC, ESR, CRP

Imaging
TLT : NMedications : NSALD, Corticosteroids, DMARB like Methotredexds, physical theropy