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Arthritis is pain, swelling with early morning stiffness of the joints. It is not a single disease but the symptom of more than 40 rheumatology related diseases. Two most common diseases are Rheumatoid arthritis and Spondyloarthritis. Lower back and buttock pain with early morning stiffness in a young man for more than 3 months is the characteristic feature of Ankylosing spondylitis. Rheumatoid arthritis presents with pain swelling and stiffness of both wrists and hands. Psoriasis is a skin disease that is associated with various forms of arthritis.
Arthritis being a long duration disease need specialized care from a rheumatologist for diagnosis, prognosis, and prevent the joints from the damage. It takes time to get complete relief from the symptoms usually 2 to 4 months.
Steroid use is very frequent in public for relief from arthritis. Use of steroid leads to prompt relief of symptoms followed by recurrence of symptoms even if the steroid is stopped for a day or two. Steroid is increasingly misused in form of muddy colored powder preparation or unlabeled medicines given by many quacks and is even rampant in city as well as villages. White colored intramuscular injections of steroid is often given to patients by quacks causing prompt relief of symptoms. Steroids has many side effects including marked weight gain, puffy cheeks, early cataract, bone fractures, diabetes mellitus, hypertension, ulcers in stomach, increased rate of all infections including frequent skin boils, pneumonia etc.
Osteoarthritis is a misnomer and is not a disease but an age related degenerative process of joints most commonly knee characterized by pain on walking, stiffness on changing positions for example standing from sitting position that improves after walking few steps. They have difficulty on sitting crossed leg on floor.
Autoimmune diseases are usually suspected when multiple organs like skin, joints, kidney, lungs are involved and autoantibodies tests are positive.
Various autoimmune diseases are
Vasculitis is inflammation of blood vessels. This leads to loss of blood supply to different organs or tissues. This causes blackening of digits, ulcer in legs, skin rash, kidney and lung problems along with fever, weight loss, myalgia and arthralgia.
Different types of systemic vasculitis are
Myositis is inflamation of muscle causing weakness in standing from squatting position or raise arms above shoulders. Its diagnosis can be confirmed clinically, blood tests and muscle biopsy.
Various types of myositis are:
Primary Immunodeficiencies are the group of rare childhood diseases that happen due to the defect in components of body’s immune system. It is suspected when infections occurs again and again.
Some Primary immunodeficiencies seen in children diagnosed at our clinic are:
Auto-inflammatory diseases are the rare hereditary diseases that occur due to defects in innate immune system. They lead to recurrent episodes of fever, joint pains and skin rash.
Various forms of auto-inflammatory disease are:
Intra-articular injections of steroid are given when arthritis is involving one or two joints for prolonged period. It gives prompt relief of pain and prevents damage to the joint. There are many misconcepts regarding joint injection in society. This injection is not much helpful for joint problems due to aging that is osteoarthritis of knee. They are very helpful in inflammatory arthritis of joints. Injections are also given around tendons in synovial sheaths. They are not harmful and are better to treat when few sites are involved.
Muskulo-skeletal ultrasound helps in diagnosing the tear, sprains or inflammation at the muscles, ligaments, tendons and joints of the body. This is a safe technique that does not involve radiations. We are planning to start Ultrasound for joints and ligaments in future.