Rheumatology

Rheumatoid Arthritis: Much Beyond Joints…

Rheumatologist Dr Vivek R Mehta explains a condition which is often misunderstood

Rheumatoid arthritis is often thought to be a disease of joints. Rheumatoid arthritis does effect joints more commonly but it can affect almost any organ of the body. I like to tell my patients that rheumatoid arthritis is a disease of immune system that can affect almost any organ of the body, with most common manifestation being joint pains. Diptiben, pictured here, was very kind to share her picture and story to spread knowledge about rheumatoid arthritis. Diptiben had nonspecific pain for more than a few years but like many of us she ignored it initially. Eventually she needed a procedure on her knee to help reduce the swelling and pain, which eventually led to diagnosis of rheumatoid arthritis. However, her rheumatoid arthritis remained poorly controlled. She eventually presented to the Welcare Hospital with breathing difficulty, severe pain and swelling. She was diagnosed as having worsening of rheumatoid arthritis and started on treatment for the same which made remarkable difference in pain. She underwent a chest x-ray to look for the reason of shortness of breath, which showed me certain changes concerning lung involvement of rheumatoid arthritis. We decided on obtaining a specialized CT scan to evaluate these changes which could have otherwise been missed. CT scan showed nodules likely from rheumatoid arthritis and changes relating to a rare side effect of methotrexate. She was effectively treated and is closely being followed as an outpatient now. Diptiben’s story is a great reminder
about why rheumatoid arthritis needs close follow up and treatment by a rheumatologist. Rheumatologists treat
many immune system related disorders like rheumatoid arthritis, psoriatic arthritis, gouty arthritis, spondyloarthritis, vasculitis, lupus, scleroderma etc. Treatment of these diseases have completely changed in past 10-15 years and new treatments are coming out every year. It is important to stay ahead of these diseases so we can prevent development of complications and if someone already has complications further damage can be stopped with timely intervention.

When to see a Rheumatologist?

• Joint pain, back pain or other musculoskeletal pain that does not improve within 3-4 weeks, especially if its worst in the morning.
• Unusual sensitivity to sun, rash, oral ulcers, hair loss etc which can suggest lupus.
• Fevers for which other infection related reason cannot be found.
• Skin thickening, unusual sensitivity of fingers to cold and stress.
• Unusual and progressively worsening muscle weakness and/or rash.
• Other multi-system disorders which you or your doctor think could be immune system related disorders.