Initiating a personalised treatment protocol begins with a physical examination, one of the most crucial stages. It entails evaluating the patient's overall physical health, which includes taking the patient's pulse, listening to the heart and lungs, and checking for swollen lymph nodes, as well as performing a thorough examination of the affected limb and joints to determine the severity of inflammation, range of motion, and function.

This is crucial for making an effective clinical decision because it helps physicians understand what is happening with your health and determine your genetic susceptibility to certain health conditions.

These are critical for understanding the fundamental source of the disease as well as the extent to which it has spread, all of which are required for developing a good treatment strategy.
CBC, ESR, CRP, liver and renal function tests, and urine examination are all blood tests. Rheumatoid factor is a special immunological test. Anti-CCP antibody, ANA (AntiNuclear Antibody), ANCA (AntiNuclear Antibody Profile), C3, C4
Imaging tests- they provide detailed images of internal organs utilising various sources 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 renowned and highly regarded rheumatologists offers surgical and non-surgical remedies for a wide range of rheumatologic disorders, including those listed below:

Osteoarthritis-is a progressive disease characterised by the degeneration of the joints and the underlying bones, which results in rigidity, inflammation, and excruciating 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 - Mostly seen in young females, this condition is characterised by constriction of blood arteries in the arms and brain.

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

Spondyloarthropathies- It is the collective term for a group of chronic joint diseases that can affect both adults and infants. For example, ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are associated with inflammatory bowel disease.

• 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 autoimmune illness in which the immune system attacks the salivary and tear glands, causing symptoms such as 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-Gout is an inflammatory disease caused by elevated levels of uric acid in the blood; it is a form of arthritis.

• 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-It is a rare Connective tissue disease characterised by hardening and tightening of the skin that can potentially affect other organs such as the lungs, heart, blood vessels, and 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 -Weakening of bones makes them more susceptible to fracture. Typically found in postmenopausal women and 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-Septic arthritis is a disorder characterised by severe bacterial or viral infection in the joints or the fluids around them.

• 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-Originally referred to as Juvenile rheumatoid arthritis, it is the most prevalent form of arthritis in children younger than 16 years old, characterised 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-Polymyalgia rheumatica, which primarily affects persons over the age of 65, is an inflammatory illness characterised by muscle pain and stiffness, particularly in the shoulder and adjacent 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

If not promptly treated, this inflammatory disorder characterised by headaches and sudden vision loss affects persons older than 65. Linked to polymyalgia rheumatica.

Diagnosis and Treatment - Same as polymyalgia rheumatica Post Viral/Post-Chikungunya arthritis - 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 therapy