Pregnancy May Give You A Reprieve
RA is primarily diagnosed in women during their childbearing years, so its natural to have many questions and concerns about how the disease will affect your fertility, pregnancy, and postpartum health.
The good news is that for many patients with inflammatory arthritis, pregnancy temporarily suppresses the immune system. This causes an overall decrease in inflammation throughout the body, giving many patients a nine-month window of some relief. On the other hand, some women may still experience flares during pregnancy, so its important to work together with both your ob-gyn and rheumatologist closely to manage all your arthritis and pregnancy symptoms.
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How Can A Rheumatologist Help
Unlike your primary care doctor, a rheumatologist specializes in different types of arthritis, including osteoarthritis and other musculoskeletal conditions. If your OA diagnosis is unclear or requires specialist attention, it would be helpful to get the opinion of a rheumatologist.
The rheumatologist can help you with the following:
Comprehensive history and physical examination
A rheumatologist will examine your medical history of arthritis and any other symptoms you are experiencing . They will also look at your family history and any medications you have taken in the past.
They will also perform a complete physical exam on the affected joints. During a physical exam, your rheumatologist may check your skin for nodules which could indicate another type of arthritis rheumatoid arthritis.
Diagnostic testing
A rheumatologist might perform some diagnostic testing that can help rule out other problems that may be causing your symptoms, such as infections, autoimmune disorders, genetics, and abnormal uric acid metabolism.
Diagnostic testing may also focus on conditions that result in cartilage loss within the joint, or wider problems with your muscles and bones.
Imaging testing
A rheumatologist can perform different imaging tests to your doctor if required. These include CT scans, MRI scans, x-rays, and ultrasounds which can help the rheumatologist to provide an accurate diagnosis.
Lab testing
Treating joint inflammation and pain
Prescribing effective medication
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How Is Osteoarthritis Of The Spine Diagnosed
The best way to confirm a diagnosis of osteoarthritis is by X-ray. The doctor will take a medical history and perform a physical exam to see if the person has pain, tenderness, loss of motion involving the neck or lower back, or if symptoms are suggestive, signs of nerve involvement such as weakness, reflex changes, or loss of sensation.
The doctor may order certain tests to aid in the diagnosis of osteoarthritis of the spine. These tests include:
- X-rays to look for bone damage, bone spurs, and loss of cartilage or disc however, X-rays are not able to show early damage to cartilage.
- Blood tests to exclude other diseases
- Magnetic resonance imaging to show possible damage to discs or narrowing of areas where spinal nerves exit
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Coping With Low Mood And Sleeping Difficulties
Arthritis can take a mental toll on a person, leading to anxiety and depression related to the condition. Depression and anxiety can lead to sleep issues.
A person may benefit from psychotherapy, such as cognitive behavioral therapy or traditional talk therapy.
RA and PsA can both cause fatigue, which can make a person feel extremely tired even after rest.
A person the following steps help improve sleep quality:
- making the bedroom dark, quiet, and cool
- removing electronic devices from the bedroom, such as TVs and computers
- going to bed at the same time each night
- avoiding alcohol, caffeine, and large meals before bed
- participating in regular exercise
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Orthopedic Doctor Near You In San Antonio Tx
It is in your best interest to get your arthritis checked out to lessen the pain and the likelihood of needing surgery. Intervention at an early stage can prevent it from getting worse. If you observe symptoms of arthritis, see an orthopedic doctor near you.
The Center for Orthopaedic Surgery and Sports Medicine in San Antonio, Texas, is committed to delivering patient-centered quality care. Our board-certified doctors are experts in various surgical and rehabilitative techniques.
If you have any questions or would like to schedule a consultation, contact our staff today at 692-7400. You can also fill out our online appointment form now. We look forward to helping you enjoy a pain-free life!
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Delays In Getting Diagnosed With Psoriatic Arthritis Are All Too Common Knowing What To Expect May Help Speed Up The Process
If your shoes are feeling tighter than usual or youre having difficulty or pain opening jars, a type of autoimmune disorder called psoriatic arthritis could be to blame. PsA is an inflammatory arthritis linked to psoriasis . It is characterized by pain, stiffness, and swelling in the joints although these general arthritis symptoms can take on specific characteristics when they are caused by psoriatic arthritis
As with many conditions, early diagnosis and prompt treatment are important. If you put off seeing the doctor, there are two major concerns with a delayed psoriatic arthritis diagnosis, says Bharat Kumar, MD, Associate Rheumatology Fellowship Program Director at University of Iowa Health Care and member of the American College of Rheumatology.
First, he explains, disease activity may worsen and cause lasting joint damage. Second, PsA is linked to a higher rate of heart disease, so the sooner youre diagnosed the quicker you can address cardiovascular factors like high cholesterol and hypertension. Rheumatologists are eager to see anyone with psoriasis who is also experiencing joint pain, Dr. Kumar says.
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Other Specialists For Psoriatic Arthritis
If you have other health conditions related to PsA, you might need the help of a few other specialists. If you do not have these conditions, you can leave them off the roster. Preemptive screening visits arent needed, either.
You may need the expertise of a cardiologist if you have severe heart disease. While a primary care provider can manage blood pressure and other risk factors for heart disease, a cardiologist is needed for multiple risk factors or when you have severe heart disease.
Seeing an ophthalmologist is important if your PsA causes eye inflammation . Eye inflammation is an uncommon complication of PsA. Symptoms include eye pain, redness, and vision changes.
A gastroenterologist may be an important member of your care team if you have inflammatory bowel disease. PsA can increase the risk of inflammation in the gut. Symptoms of inflammatory bowel disease include chronic abdominal pain, diarrhea, and bloody stools.
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Rheumatologist Vs Orthopedist: What Kind Of Doctor For Joint Pain Is Right For You
Youve been dealing with joint pain all over for as long as you can remember.
You suddenly started feeling a sharp pain in one of your joints.
Your joints ache when it rains or the weather changes.
Your joint never felt quite the same after that one injury now you live with constant, nagging pain.
Your joint pain is so severe, it keeps you up at night.
Any of these sound familiar?
If so, its probably time to see a joint specialist. Before you book an appointment with a rheumatologist or orthopedic specialist, though, you should first see your primary care physician for a general diagnosis. Even though some insurance providers dont require a referral from a PCP to see a joint specialist, your PCP may recommend a completely different type of joint specialist than you might have consulted otherwise. Your PCP should be able to point you in the right direction based on your symptoms.
That said, its understandable that you want to be as informed as possible about your choice of doctor. The following information will give you a better idea about joint paint, its causes and what kind of doctor for joint pain may be right for you.
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Where Can I See Allied Health Professionals And How Much Will It Cost
If your GP refers you to a health professional as part of a care plan, you may be able to have five sessions per year funded by Medicare. Ask your GP for more information.
- The public system: Most health professionals are available in the public health system . There is often a waiting list, and you will usually need a referral from your GP. Their services are usually free or low cost.
- The private system: You can consult any of these health professionals at private clinics without a referral from your GP. The cost of a private consultation varies with the type of health professional and may cost from $30 to $100. These costs may be covered in part by private health insurance.
How Does A Rheumatologist Treat Arthritis And Other Autoimmune Conditions
If you’re diagnosed with a rheumatic condition, the primary goal of treatment is to modify the activity of your immune system in order to reduce the inflammation it’s causing.
“Immunomodulatory medications and steroids are the mainstay for managing these conditions,” says Dr. Ganti. “Lastly, we add in symptomatic treatment with over-the-counter anti-inflammatory medications, such as ibuprofen and acetaminophen, and topical analgesics.”
For treatment of advanced or severe conditions, medications that suppress your medications may be needed.
“Your immune system plays otherwise important roles, such as preventing infection so we don’t suppress it unless your condition warrants it,” says Dr. Ganti.
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What Is The Difference Between A Rheumatologist Vs An Orthopaedist
Orthopaedists and rheumatologists specialize in conditions affecting the joints, bones, muscles, ligaments and tendons. They treat many of the same conditions, including joint pain and tendinitis. But there are a few differences between these medical specialties.
Rheumatologists consider every organ system when looking for the cause of your symptoms. An orthopaedist focuses on injuries, congenital disease and wear and tear . Also, orthopaedists perform surgery, but rheumatologists do not. While both rheumatologists and orthopaedists help diagnose and treat musculoskeletal conditions, rheumatologists have specialized training in musculoskeletal conditions of an inflammatory and autoimmune etiology.
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How Is Psoriatic Arthritis Diagnosed
A single medical test is not available to diagnose psoriatic arthritis. To find out whether you have psoriatic arthritis, your doctor will do the following:
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Look at your medical records.
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Ask you specific questions. This usually includes questions such as whether any of your blood relatives have psoriasis or psoriatic arthritis.
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Examine your joints. This examination includes looking at your body to see whether you have swollen joints. Your doctor will gently press on the skin around certain joints to find out whether the area is tender.
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Send you for medical testing. This may include x-rays and a blood test.
Before giving you a diagnosis, your doctor considers your test results and everything he or she learned while meeting with you. In case youre wondering, the result from your blood test cannot tell whether you have psoriatic arthritis. It tells your doctor whether you have inflammation throughout your body. People who have psoriatic arthritis have body-wide inflammation. Many other diseases also cause body-wide inflammation. Inflammation is a piece of the puzzle.
Because psoriatic arthritis can look like other types of arthritis, patients often see a dermatologist or rheumatologist for a diagnosis. A rheumatologist is a medical doctor who specializes in diagnosing and treating arthritis and other diseases of the joints, muscles, and bones. Rheumatologists and dermatologists generally have the most experience diagnosing and treating psoriatic arthritis.
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Are There Other Ways To Diagnose Arthritis
Examination of your joints by your doctor is the first, and one of the most important, ways of diagnosing arthritis. Your doctor will use blood tests to help confirm what they find on examination and from listening to your symptoms. Your doctor may also use a variety of other tests to help diagnose arthritis, including testing other body fluids and x-rays and scans . However it is possible to make a diagnosis of arthritis without any blood tests or imaging.
Do Dermatologists And Rheumatologists Ever Work Together
- Combined rheumatology-dermatology clinics are a newer frontier in the treatment of psoriatic arthritis, with just over 20 clinics in the United States
- Depending on the clinic, some rheumatologists and dermatologists may see a patient at the same time in the same room. Sometimes, separate back-to-back visits are required
- Studies show this combined care approach could achieve better outcomes for both skin and musculoskeletal symptoms
- A survey from the Psoriasis and Psoriatic Arthritis Clinic Multicenter Advancement Network found over 80% of doctors thought a combined clinic accelerated an accurate diagnosis
- Challenges are largely related to scheduling and billing
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What Does A Rheumatologist Do
Rheumatology studies the causes, impact, and treatments of inflammatory autoimmune disorders on the human body. In an autoimmune disorder, a patients own immune system malfunctions and turns its attack on his own healthy body tissue, rather than on invading or external disease agents.
Rheumatologists can be internists or pediatricians who have additional training and qualifications. They have the experience to diagnose and treat many of the over 100 systemic forms of adult, juvenile, and temporal arthritis. They treat mechanical joint, bone, muscle, and soft and connective tissue diseases.
Often referred to as arthritis doctors, rheumatologists treat many other diseases too.
Complete Medical History For Diagnosing Psoriatic Arthritis
Your road to a psoriatic arthritis diagnosis starts with talking to your rheumatologist in order to share symptoms and identify risk factors. While symptoms like joint pain could suggest a number of conditions, in psoriatic arthritis, joint pain often has specific characteristics, including the following:
- Joint pain that gets better with use
- Joint redness and swelling
- Swelling of an entire finger or toe as opposed to just one joint, called dactylitis or sausage digits
- Morning stiffness that lasts more than 30 minutes
- Changes in the nails of your fingers or toes, such as holes, pitting, discoloration or softness, which occurs in 80 to 90 percent of PsA cases
When patients talk about these psoriatic arthritis symptoms, rheumatologists like Dr. Kumar hear a number of common concerns, such as My shoes dont fit, I feel stiff all over in the mornings, and I have trouble opening jars or door knobs.
Along with listening to your symptoms, your rheumatologist will want to hear about any possible risk factors for psoriatic arthritis. While this condition can affect patients of both genders at a range of ages, the following can increase your risk:
- Having psoriasis
- Having a family history of PsA, psoriasis, or associated conditions, including ankylosing spondylitis, Crohns disease, ulcerative colitis, autoimmune uveitis, and reactive arthritis
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How Might Doctors Treat Arthritis In Hands
Doctors generally start with treatments that dont involve surgery to treat arthritis in the hand, reports the American Society for Surgery of the Hand . Temporarily resting the joint, and using a splint to help keep it in place might help. Exercising the joint is important, so your doctor might prescribe physical therapy.
Doctors might treat rheumatoid arthritis in the hand with medications. Steroid injections from time to time may provide relief from either osteoarthritis or rheumatoid arthritis in the hand, according to the ASSH.
In some cases, you might need surgery to treat the arthritis in your hands, notes the American Academy of Orthopaedic Surgeons. There are various types of surgery, such as fusion and joint replacement with an artificial joint. Fusion involves removing damaged joint surfaces and cartilage, and attaching one bone to another. You will no longer be able to move the fused joint, but your pain should be gone, according to the ASSH.
What Did You Look For In Your Rheumatologist
I looked for a gentle, confident, wise, reassuring bedside manner, says Seth D. Ginsberg, cofounder and president of the Global Healthy Living Foundation, an advocacy group for people living with chronic illnesses.
I was interested in someone I could relate to, have a conversation with, and explain my situation to in broader terms than just my aching joints. My wife came with me during the first visit and joined us in the exam room. Her opinion mattered, too, says Ginsberg.
Udell agrees that one of the first things to consider is the doctors personality and how well it meshes with yours especially if your disease is a serious, chronic one such as rheumatoid arthritis.Thats because your relationship with the rheumatologist could be a very long one, which is one reason I went into this specialty, Udell says.
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And, he notes, the doctor-patient relationship should be nurtured as time goes on. If thereâs an issue that the patient and physician donât see eye-to-eye on, for example, they need to discuss it.
Or you might want to be more aggressive about treatment options while your doctor wants to be less aggressive this is also something you two must discuss, he says.
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