Rheumatology

This booklet provides information and answers to your questions about foot conditions and footwear.

Psoratic arthritis classification criteria: Moll and Wright, ESSG and CASPAR – a comparative study

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Questions  Answers About Osteoporosis and Osteopenia

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Foot Pain

Respiratory problems are one of the most common – and serious – extra-articular complications of rheumatoid arthritis.

Ankylosing spondylitis exercise guide

Postherpetic neuralgia (post-hur-PET-ik noo-RAL-juh) is the most common complication of shingles. The condition affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear.

An aortic aneurysm is a balloon-like bulge in the aorta, the large artery that carries blood from the heart through the chest and torso.

Anti­tumor necrosis factor (anti­TNF) drugs are a class of drugs that are used worldwide to treat inflammatoryconditions such as rheumatoid arthritis (RA), psoriatic arthritis, juvenile arthritis, inflammatory bowel disease (Crohn’sand ulcerative colitis), ankylosing spondylitis and psoriasis. These drugs are able to reduce inflammation and stopdisease progression.

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Frozen shoulder, also called adhesive capsulitis, causes pain and stiffness in theshoulder. Over time, the shoulder becomes very hard to move. Frozen shoulder occurs in about 2% of the general population. It most commonly affects people between the ages of 40 and 60, and occurs in women more o enthan men.

Cyclophosphamide (Cytoxan) belongs to a class of drugs known as alkylating agents, which have been used totreat some types of cancer. It is also considered an immunosuppressant—a medicine that can decrease theimmune response

Your heel pain is caused by a traction injury with some inflammation of the tissues of the heel and the underside of the foot. Usually patients have a flat foot, i.e. loss of the instep (long arch of the foot). The treatment is aimed at relieving your pain and restoring this arch.

If your knee is severely damaged by arthritis or injury, it may be hard for you to perform simple activities, such as walking or climbing stairs. You may even begin to feel pain while you are sitting or lying down.

Steroid Education Sheet Steroids are used to reduce or prevent inflammation and decrease immune responses.They also can be used to treat some cancers.How to take steroids:*Take with food to avoid stomach upset.*Take in the morning to coincide with the body’s natural cortisol secretion cycle.POTENTIAL SIDE EFFECTS Additional Information about Potential Psychological Effects • Emotional and social side effects of steroids can be unpredictable. Research estimates varywidely, but suggest that between 2 – 57% of people experience these side effects.• Up to 6% of patients experience severe psychiatric side-effects including mania, depression,psychosis, delirium, and obsessive-compulsive syndrome.• These psychological difficulties, even if

What is cutaneous polyarteritis nodosa? Cutaneous polyarteritis nodosa (PAN) is a rare form of vasculitis(in ammation of blood vessels) that involves smalland medium-sized arteries of the dermis and subcutaneous tissue i.e. the deeper layers of the skin. It is sometimes called periarteritis nodosa. How does it relate to systemic polyarteritis nodosa? Although identical skin lesions are common in systemic PAN, cutaneous PAN should be considered a separate disease and distinguished from systemic PAN, as the clinical course and management of these conditions di er from each other. PAN is a vasculitis that causes destructive in ammation of medium-sized muscular arteries

Carpal Tunnel Syndrome Carpal tunnel syndrome is possibly the most common nerve disorder experienced today. It affects 4 – 10 million Americans and is usually very treatable. Middle­aged to older individuals are more likely to develop the syndrome than younger persons, and females three times more frequently than males. Carpal tunnel syndrome disables a key nerve, resulting in symptoms ranging from mild occasional numbness to hand weakness, loss of feeling and loss of hand function. The main symptom is numbness of the fingers. Given this widespread familiarity, people often attribute any discomfort or pain in the hand or wrist to

BPPV is a common cause of dizziness. It occurs in people of all ages but is more common in middle-aged and elderly people. It causes short bursts of intense dizziness when the body or head is placed in certain positions such as lying on one side in bed or looking upwards. People can feel sick and are sometimes unsteady for a few hours after the dizziness has gone away. Benign – this means the cause of dizziness is not a threat to your health. Paroxysmal – the dizziness comes in short bursts. Positional – the dizziness is provoked by certain

Bariatric surgery Overview Gastric bypass and other weight-loss surgeries make changes to your digestive system to help you lose weight by limiting how much you can eat or by reducing the absorption of nutrients, or both. Gastric bypass and other weight-loss surgeries are done when diet and exercise haven’t worked or when you have serious health problems because of your weight. There are many types of weight-loss surgery, known collectively as bariatric surgery. Gastric bypass is one of the most common types of bariatric surgery in the United States. Many surgeons prefer gastric bypass surgery because it generally has fewer

Baker’s cyst Overview A Baker’s cyst is a fluid-filled cyst that causes a bulge and a feeling of tightness behind your knee. The pain can get worse when you fully flex or extend your knee or when you’re active. A Baker’s cyst, also called a popliteal (pop-luh-TEE-ul) cyst, is usually the result of a problem with your knee joint, such as arthritis or a cartilage tear. Both conditions can cause your knee to produce too much fluid, which can lead to a Baker’s cyst. Although a Baker’s cyst may cause swelling and make you uncomfortable, treating the probable underlying problem

ARTHRITIS AND JOINT PAIN Arthritis, or inflammation (pain with swelling) of the joints, is the most common extraintestinal complication of IBD. It may affect as many as 30% of people with Crohn’s disease or ulcerative colitis. Although arthritis is typically associated with advancing age, in IBD it often strikes younger patients as well. In addition to joint pain, arthritis also causes swelling of the joints and a reduction in flexibility. It is important to point out that people with arthritis may experience arthralgia, but many people with arthralgia may not have arthritis. Types of Arthritis Peripheral Arthritis. Peripheral arthritis usually

Arthritis and Infection Risk People with inflammatory forms of arthritis have an increased risk of infections, which can range from mild to life threating. This increased risk can be caused by the disease itself, medications you take to treat the disease, and a variety of other health and lifestyle factors. Doctors have long known that people with inflammatory forms of arthritis have an increased risk of infections, which can range from mild to life threating. This increased risk can be caused by the disease itself, medications you take to treat the disease, and a variety of other health and lifestyle

Overview An ACL injury is a tear or sprain of the anterior cruciate (KROO-she-ate) ligament (ACL) — one of the major ligaments in your knee. ACL injuries most commonly occur during sports that involve sudden stops or changes in direction, jumping and landing — such as soccer, basketball, football and downhill skiing. Many people hear or feel a “pop” in the knee when an ACL injury occurs. Your knee may swell, feel unstable and become too painful to bear weight. Depending on the severity of your ACL injury, treatment may include rest and rehabilitation exercises to help you regain strength

What is osteonecrosis? Osteonecrosis is a bone disease. It results from the loss of blood supply to the bone. Without blood, the bone tissue dies. This causes the bone to collapse. It may also cause the joints that surround the bone to collapse. If you have osteonecrosis, you may have pain or be limited in your physical activity. Osteonecrosis can develop in any bone, most often in the: Thigh bone (femur). Upper arm bone (humerus). Knees. Shoulders. Ankles. It is also called: Avascular necrosis. Aseptic necrosis. Ischemic necrosis. Who gets osteonecrosis? Anyone can get osteonecrosis, but it is most common

Osteoporosis is a common condition where bones become weak that affects both men and women, mainly as they grow older. Bone is living tissue that is in a constant state of regeneration. That is, the body removes old bone (called bone resorption) and replaces it with new bone (bone formation). By their mid­30s, most people begin to slowly lose more bone than can be replaced. As a result, bones become thinner and weaker in structure. Osteoporosis is silent because there are no symptoms (what you feel). It may come to your attention only after you break a bone. When you

Between 400,000 and 3.1 million adults have Sjögren’s syndrome. This condition can affect people of any age, but symptoms usually appear between the ages of 45 and 55. It affects 10 times as many women as men. About half of patients also have rheumatoid arthritis or other connective tissue diseases, such as lupus. In the early 1900s, Swedish physician Henrik Sjögren (SHOW­gren) first described a group of women whose chronic arthritis was accompanied by dry eyes and dry mouth. Today, rheumatologists (/I­Am­A/Patient­ Caregiver/Health­Care­Team/What­is­a­Rheumatologist) know more about the syndrome that is named for Sjögren and—most significantly for patients—can offer advice about

This material will help you understand scleritis, its causes, symptoms, and how it is treated. What is scleritis? Scleritis is inflammation of the sclera. Most often, there is an infection. The sclera is the white tissue that forms the outside wall of the eye. There are two main types of scleritis: Anterior scleritis: affects the front part of the eye. This is the more common type. Posterior scleritis: affects the back part of the eye. What causes scleritis? Scleritis is usually associated with autoimmune diseases. Your immune system normally protects your body from infection and keeps you from getting sick.

Gout is a painful and potentially disabling form of arthritis that has been around since ancient times. It is sometimes referred to as the “disease of kings,” because people long have incorrectly linked it to the kind of overindulgence in food and wine only the rich and powerful could afford. In fact, gout can affect anyone, and its risk factors vary. The first symptoms usually are intense episodes of painful swelling in single joints, most often in the feet, especially the big toe. The swollen site may be red and warm. Fifty percent of first episodes occur in the big

Your doctor has prescribed the medicine warfarin (brand names Coumadin and Jantoven) for you. It is an anticoagulant (blood thinner) that makes your blood clot more slowly to prevent dangerous problems, such as a stroke. Your doctor can tell how well warfarin is working from a blood test, called international normalized ratio (INR). The test shows how quickly your blood clots. There are some foods, including those rich in vitamin K, alcohol, some dietary and herbal supplements, as well as some medicines, that can affect the way warfarin works in your body. Foods rich in vitamin K To help warfarin

The prospect of a muscle disease worries some people because they are afraid of not being able to walk. Yet in many cases, treatment exists for myopathy (muscle disease). Proper diagnosis and treatment raise the chance of living life fully despite this illness. Fast Facts Myopathy almost always causes loss of muscle strength. Some patients also have rashes or breathing problems, or both. While there is no cure for myopathies, treatment is most often effective. Following your doctor’s treatment plan is key to having a good outcome. What are myopathies? Myopathy is the medical term for muscle disease. Some muscle

What is done during a joint aspiration/injection? Joint injections or aspirations (taking fluid out of a joint) usually are performed with a cold spray or other local anesthesia in the office or hospital setting. After the skin surface is thoroughly cleaned, the joint is entered with a needle attached to a syringe. At this point, either joint fluid can be obtained (aspirated) and used for appropriate laboratory testing or medications can be injected into the joint space. This technique also applies to injections into a bursa or tendon sheath to treat bursitis and tendonitis, respectively. What benefit is derived from

Overview Diffuse idiopathic skeletal hyperostosis (DISH) is a bony hardening of ligaments in areas where they attach to your spine. Also known as Forestier’s disease, this condition might not cause symptoms or require treatment. If it does cause symptoms, the most common are mild to moderate pain and stiffness in your upper back. DISH can also affect your neck and lower back, and some people have DISH in other areas, such as shoulders, elbows, knees and heels. DISH can be progressive. As it worsens, it can cause serious complications. Symptoms You might have no signs or symptoms with DISH. For

Type 2 Diabetes WHAT IS DIABETES? Diabetes is a problem with your body that causes blood glucose (sugar) levels to rise higher than normal. This is also called hyperglycemia. When you eat your body breaks food down into glucose and sends it into the blood. Insulin then helps move the glucose from the blood into your cells. When glucose enters your cells, it is either used as fuel for energy right away or stored for later use. In a person with diabetes, there is a problem with insulin. But, not all people with diabetes have the same problem. The types

What is Sleep Hygiene? ‘Sleep hygiene’ is the term used to describe good sleep habits. Considerable research has gone into developing a set of guidelines and tips which are designed to enhance good sleeping, and there is much evidence to suggest that these strategies can provide long-term solutions to sleep difficulties. There are many medications which are used to treat insomnia, but these tend to be only effective in the short-term. Ongoing use of sleeping pills may lead to dependence and interfere with developing good sleep habits independent of medication, thereby prolonging sleep difficulties. Talk to your health professional about

People have long feared rheumatoid arthritis (commonly called RA) as one of the most disabling types of arthritis. The good news is that the outlook has greatly improved for many people with newly diagnosed (detected) RA. Of course, RA remains a serious disease, and one that can vary widely in symptoms (what you feel) and outcomes. Even so, treatment advances have made it possible to stop or at least slow the progression (worsening) of joint damage. Rheumatologists (/IAmA/ PatientCaregiver/HealthCareTeam /WhatisaRheumatologist) now have many new treatments that target the inflammation that RA causes. They also understand better when and how to

Osteoarthritis (also known as OA) is a common joint disease that most often affects middle­age to elderly people. It is commonly referred to as “wear and tear” of the joints, but we now know that OA is a disease of the entire joint, involving the cartilage, joint lining, ligaments, and bone. Although it is more common in older people, it is not really accurate to say that the joints are just “wearing out.” It is characterized by breakdown of the cartilage (the tissue that cushions the ends of the bones between joints), bony changes of the joints, deterioration of tendons

Simple exercises Leg stretch Sit on the floor with your legs stretched out in front. Keeping your foot to the floor, slowly bend one knee until you feel it being comfortably stretched. Hold for 5 seconds. Straighten your leg as far as you can and hold for 5 seconds. Repeat 10 times with each leg. Leg cross Sit on the edge of a table or bed. Cross your ankles over. Push your front leg backwards and back leg forwards against each other until the thigh muscles become tense. Hold for 10 seconds, then relax. Switch legs and repeat. Do 4

Fibromyalgia is a common health problem that causes widespread pain and tenderness (sensitivity to touch). The pain and tenderness tend to come and go, and move about the body. Most often, people with this chronic (long­term) illness are fatigued (very tired) and have sleep problems. The diagnosis can be made with a careful examination. Fibromyalgia is most common in women, though it can occur in men. It most often starts in middle adulthood, but can occur in the teen years and in old age. You are at higher risk for fibromyalgia if you have a rheumatic disease (health problem that

The following exercises should be started gently and increased gradually, and you should not try to push hard to get rid of pain. A little discomfort is common when starting a new activity or exercise, especially if you have not been active for some time, as your joints and muscles get used to working again. Try each exercise in turn and find out how many times you can repeat it without feeling extra discomfort the following day. If you are not sure, try each one 5–10 times to start with. As your back gets used to the new exercise, you

‘Sleep hygiene’ is the term used to describe good sleep habits. Considerable research has gone into developing a set of guidelines and tips which are designed to enhance good sleeping, and there is much evidence to suggest that these strategies can provide long-term solutions to sleep difficulties. DOWNLOAD FULL ARTICLE  

People have long feared rheumatoid arthritis (commonly called RA) as one of the most disabling types of arthritis. The good news is that the outlook has greatly improved for many people with newly diagnosed (detected) RA. Of course, RA remains a serious disease, and one that can vary widely in symptoms (what you feel) and outcomes. Even so, treatment advances have made it possible to stop or at least slow the progression (worsening) of joint damage. Rheumatologists (/I­Am­A/Patient­Caregiver/Health­Care­Team/What­is­a­Rheumatologist) now have many new treatments that target the inflammation that RA causes. They also understand better when and how to use treatments