Conditions Treated

Arthritis / Joint Pain

Joint pain can result from wear and tear in the joints, which is known as osteoarthritis, or inflammation in joints due to an autoimmune disease. The commonest forms of inflammatory arthritis are rheumatoid arthritis and psoriatic arthritis which are associated with a risk of progressive joint damage and an increased risk of cardiovascular disease. These conditions often require treatment with disease modifying agents.

Crystal deposition in joints can also cause severe pain and swelling – the commonest crystal deposition disease is gout which can affect all people of all ages and is not solely caused by diet. A full understanding of uric acid physiology is needed to ensure successful gout treatment.

Pain in joints is not always related to arthritis and may be related to tendonitis such as tennis elbow or rotator cuff tendonopathy at the shoulder. These are often treated with steroid injections.

It is important that the correct diagnosis is made to guide appropriate treatment strategies. This is crucial not only in helping with debilitating symptoms, but also in optimising joint health and preventing progression of arthritis.

Polymyalgia Rheumatica

Polymyalgia Rheumatica (PMR) is a common inflammatory condition affecting older patients and is characterised by early morning stiffness, often lasting several hours, in the shoulders and hips. It is treated with low dose steroids and sometimes other steroid sparing medication. PMR can be associated with vasculitis – blood vessel inflammation – which requires more aggressive treatment.

Osteoporosis

Osteoporosis refers to thinning of the bones leading to an increase risk of fractures – often at the hip, wrist and spine.  Anyone who is concerned about their risk of osteoporosis or who has a diagnosis can benefit from a full risk factor assessment, review of DEXA scans and  investigations for associated underlying conditions if indicated.

The approach to the prevention and treatment of osteoporosis is based on diet, exercise and medication and is tailored to each individual.

Systemic Lupus Erythematosus 

Systemic Lupus Erythematosus (SLE) is commonly referred to as Lupus. It is an autoimmune condition which can present with a skin rash which is worse in the sun, kidney involvement, low cell counts, mouth ulcers, hair loss, joint pain and fatigue. Patients affected often do not have all of these symptoms.

A full clinical assessment and special blood tests are required for accurate diagnosis and treatment.

Sjogren’s Syndrome

Sjogren’s syndrome is an autoimmune condition which attacks the tear and salivary glands resulting in dry eyes and a dry mouth. It is often associated with other autoimmune conditions such as rheumatoid arthritis and lupus. History and lab investigations are used to confirm the diagnosis and guide treatment.

Raynaud’s Phenomenon and Scleroderma

Raynaud’s phenomenon refers to a condition in which the fingers, and sometimes toes, turn pure white on exposure to cold temperatures due to decreased blood flow. As the blood returns fingers often turn a deep red or purplish colour and become painful.

Raynaud’s phenomenon can be primary or secondary. Secondary Raynaud’s can be associated with connective tissue diseases such as scleroderma and may result in digital ulceration if not treated.

As assessment of clinical history, blood testing and examination of the nailfolds all help in confirming the diagnosis. Treatment options included may be medication based depending on severity.

Fibromyalgia

Fibromyalgia is characterised to varying degrees by chronic pain, fatigue, poor sleep and memory problems. It is important that the diagnosis is correct to optimise management of this common condition. Treatment is based on lifestyle changes, exercise and sleep hygiene. There are several medications which may be helpful if used appropriately.