Rheumatology

Bursa are small, fluid-filled sacs that cushion the bones, tendons and muscles near your joints. When they swell, it can cause pain and limit movement. Bursitis often happens in the shoulders, elbows and hips. It also can affect the knees, heels and big toes. 

Symptoms can include:

• Pain 
• Tenderness
• Limited joint movement

Diagnosis

Your doctor will do a physical exam and may order an ultrasound or MRI. Blood samples and fluid from the bursa may also be checked.

Care

Bursitis often gets better with rest, ice packs and over-the-counter pain relievers. If these don’t help, your doctor may prescribe:

• Medicine
• Physical therapy
• Shots
• A walking cane
• Surgery 

Gout is a common type of arthritis. It causes intense pain in one or more joints. Gout affects men more often than women.

Symptoms can include:

• Sudden and severe pain, often in the big toe
• Redness, swelling and tenderness
• Skin feels hot to the touch
• Limited motion

Diagnosis 

A physical exam, X-rays, ultrasound, blood work and testing a sample of joint fluid can help determine if you have gout.

Care

Your doctor may suggest prescription medication to: 

• Lower pain and swelling
• Lower uric acid, a waste product found in the blood

Myositis is a group of rare conditions that cause weak, swollen and painful muscles. Symptoms often get worse over time. Sufferers may trip or fall a lot. 

Symptoms include chronic (long-term) swelling that makes it hard to:

• Stand after sitting
• Climb stairs
• Lift the arms
• Swallow or breathe

Other symptoms include:

• A red or purple rash on the eyelids, elbows, knees and knuckles
• Muscle pain that doesn’t go away after a few weeks
• Difficulty walking and standing for long periods of time 

Diagnosis

Blood tests are used to check for high levels of certain muscle enzymes. A small sample of muscle tissue and skin may also be tested.

Care

Your doctor will create a care plan that may include:

• Medicine to lower the body’s attack on the skin, muscles and organs
• Physical therapy to improve movement and quality of life

Polymyalgia rheumatica causes muscle pain and stiffness, usually in the shoulders and hips. Most people who get this disorder are ages 65 and older. 

Symptoms include:

• Aches and pains in the shoulder, neck, upper arms, buttocks, hips or thighs 
• Morning stiffness
• Limited range of motion
• Pain or stiffness in the wrists, elbows or knees

Other symptoms include:

• Fever
• Feeling tired
• Depression
• Loss of appetite
• Weight loss

Diagnosis

Your doctor will do an exam that includes checking your joints and nervous system. Blood and imaging tests may be needed. Your doctor may also want to check you regularly for headaches, jaw pain, vision problems and a tender scalp.

Care may include:

• Medicine to ease symptoms
• Vitamin D
• Calcium

This type of arthritis often affects people who have psoriasis — a skin disease that causes red, scaly patches on the body.   

Joint pain, stiffness and swelling are common symptoms. Specific symptoms include:

• Swollen fingers and toes
• Pain in the back of the heel and soles of the feet
• Lower back pain
• Changes to fingernails and toenails
• Eye pain, redness and blurry vision

Diagnosis

Your doctor will look for signs of swelling and tenderness in your joints. They may also check your fingernails and press on the soles of your feet. If needed, imaging and lab tests will be ordered.

Care

Right now, there is no cure for psoriatic arthritis. But certain medications and care can ease the pain and swelling. Depending on your condition, your doctor may recommend:

• Over-the-counter medicines like aspirin, ibuprofen and naproxen
• Prescription medicines 
• Biologics (drugs made from living organisms) to slow the disease
• Steroid shots to reduce swelling 
• Joint replacement surgery

Rheumatoid arthritis (RA) is a disorder that affects the lining of the joints. But it can also damage the skin, eyes, lungs, heart and blood vessels. RA is an autoimmune disease, which means your body attacks healthy tissue.

Talk to your doctor if you notice:

• Tender, warm or swollen joints
• Joint stiffness, especially in the morning or after exercising 
• Fatigue 
• Fever
• Loss of appetite

Diagnosis

RA can be hard to identify in the early stages. Its symptoms can look like those of other conditions. There is no single blood test or physical finding to confirm it. 

Your doctor will check your joints for swelling, redness and warmth. Your reflexes and muscle strength may also be checked, and blood and imaging tests may be ordered.

Care

There is no cure for rheumatoid arthritis. But early and proper care with the right prescription medicine may reduce symptoms. Your doctor will create a care plan that may include: 

• Over-the-counter drugs for pain and swelling, such as aspirin, ibuprofen and naproxen
• Prescription medicine 
• Biologics (drugs made from living organisms) to help the immune system and slow the disease
• Steroid shots to reduce swelling, pain and joint damage 
• Occupational therapy
• Surgery

Scleroderma is a group of rare diseases that make the skin grow tight and uncomfortable. It can also damage blood vessels and organs, including the heart and lungs. 

If scarring happens in the heart or lungs, it can cause shortness of breath. Damage to the heart can lead to an irregular heartbeat and even heart failure.  

Symptoms

There are several types of scleroderma. Symptoms depend on the type you have and which part of the body is affected. Talk to your doctor if you have: 

• Tight, itchy, swollen areas of skin on your face, hands, feet, arms or chest 
• Heartburn 
• Trouble swallowing 
• Shortness of breath
• Dizziness
• High blood pressure
• Excess fluid in the legs, feet and around the heart
• Irregular heartbeat 

Diagnosis

Because there are many types of scleroderma, it can be hard to identify. Your doctor will do a physical exam and may order blood tests. Also, imaging and organ-function tests can help detect heart, lung and kidney damage.  

Care

There is no cure for scleroderma. But proper care can ease symptoms, slow the disease and improve quality of life. Your doctor will create a plan that may include:

• Medicine to ease pain and improve blood flow 
• Immunosuppressants to slow the disease
• Physical and occupational therapy
• Surgery 

Sjogren’s syndrome harms the body’s immune system. People with it often have related issues, including rheumatoid arthritis and lupus. Sjogren’s syndrome can happen at any age, but most people are 40 or older when diagnosed. Women are more likely to get it than men.

The two most common symptoms are dry eyes and a dry mouth. Others include:

• Joint pain, swelling and stiffness
• Swollen salivary glands (glands on each side of the face that create saliva)
• Dry skin and rashes 
• Dry cough that doesn’t go away
• Fatigue

Diagnosis

Signs of Sjogren’s syndrome can be similar to those caused by other diseases. Also, side effects of many common medicines can look like Sjogren’s syndrome. Tests that can help identify Sjogren's syndrome include:

• Blood tests
• Eye tests 
• Imaging tests
• Biopsies of tissue samples

Care

Care depends on the part of the body affected and may include: 

• Over-the-counter or prescription eye drops
• Medicine to increase saliva (the fluid in the mouth)
• Medicines for arthritis
• Immunosuppressants, which calm the immune system

Spondyloarthropathies are forms of arthritis. They usually affect bones in the spine and nearby joints, but other parts of the body can be affected as well. There are several types of the disease:

• Ankylosing spondylitis is the most common. It attacks joints between the bones in the spine (vertebrae).
• Reactive arthritis attacks joints in the legs and is often caused by an infection.
• Psoriatic arthritis affects people who have psoriasis, a skin disease. It can affect large and small joints, including the joints in the fingers and toes. 
• Enteropathic spondyloarthropathy is common in people who have digestive illnesses, like Crohn’s disease and ulcerative colitis. It can affect the arms, legs and, in some cases, the entire spine. 

Symptoms

Back pain is the most common symptom. Others include: 

• Pain and swelling in the hips, shoulders, knees and possibly elsewhere 
• Swollen, sausage-like fingers and toes
• Pain and redness in the eyes
• Psoriasis or a skin rash 

Diagnosis

Your doctor will examine your joints during a physical exam. If needed, the following tests made be ordered:  

• Blood tests
• Eye tests  
• Imaging tests
• Biopsies of tissue samples

Care

There are no known cures for any type of spondyloarthropathy at this time. Care focuses on easing pain and swelling, and may include: 

• Over-the-counter drugs like aspirin, ibuprofen and naproxen
• Prescription medicine
• Steroid shots to ease joint pain 
• Antibiotics 

Systemic lupus erythematosus (also known as SLE or lupus) is triggered when your immune system starts to attack the body’s tissues and organs. Lupus can damage the joints, skin, kidneys, blood cells, brain, heart and lungs.   

Symptoms

The clearest sign of lupus is a facial rash. It looks like the wings of a butterfly spread across both cheeks. But not everyone gets this rash. Other symptoms can include:

• Fatigue 
• Fever  
• Joint pain, stiffness and swelling  
• Sores on the skin after time in the sun 
• Shortness of breath
• Chest pain 
• Dry eyes 
• Headaches, confusion and memory loss 
• Fingers and toes that turn blue when stressed or cold

Diagnosis

Lupus can be hard to identify. Signs and symptoms vary from person to person. They can also change over time and look like symptoms of other illnesses. Your doctor will use a combination of tests to check for lupus, including:

• Blood tests 
• Urine tests
• Imaging tests
• Biopsies of tissue samples

Care

Every patient who has lupus has an individualized care plan. It may include:

• Over-the-counter drugs like aspirin, ibuprofen and naproxen
• Prescription medicine 
• Anti-malarial drugs  
• Steroids  
• Immunosuppressants, which calm the immune system 
• Biologics (drugs made from living organisms) 

Vasculitis causes blood vessels to swell. This means there’s less room for blood to flow, which can harm organs and tissues. Vasculitis may damage just one organ or several. It can last for a long time or be temporary.

Symptoms

There are several types of vasculitis. All share a common set of symptoms:

• Fever  
• Headache
• Weight loss 
• General aches and pains

Other symptoms are related to the part of the body affected by vasculitis, including: 

• Digestive system — Stomach pain, ulcers and tears in the digestive system 
• Ears — Ringing in the ears, sudden hearing loss 
• Eyes — Double vision, temporary blindness, red and itchy eyes  
• Hands or feet — Swelling, numbness or weakness 
• Lungs — Shortness of breath or a bloody cough 
• Skin — Open sores and bleeding under the skin that looks like red spots 

Diagnosis

Your doctor will do a physical exam and go over your medical history. Tests may include: 

• Blood tests 
• Imaging tests of blood vessels and organs
• Biopsies of tissue samples

Care

Some types of vasculitis may get better on their own. But most need medications to control swelling and keep flare-ups from happening. Surgery may also be needed to fix blood vessels and keep them from bursting.