What is rheumatology?
Rheumatology is a subspecialty of medicine that deals with several conditions that cause chronic inflammatory pain affecting the joints, muscle, bone or ligament. These are known as rheumatic diseases and they are often autoimmune in nature – that is, the result of an overactive immune system that leads to the body attacking itself.
What are the most common rheumatic diseases?
Rheumatoid arthritis (RA)
is commonly found in Thailand, closely followed by lupus (SLE) and ankylosing spondylitis (AS).
Rheumatoid arthritis causes symmetrical joint pain, and is different from other conditions in that the pain is often worse in the morning just after getting out of bed.
Lupus is one of the more concerning conditions as it can affect every part of the body – kidneys, heart, brain, eyes, joints, skin and even hair. Lupus can range from mild to severe, but if detected and treated early, will usually remain mild.
Ankylosing spondylitis is a disease that causes chronic back pain, and over time the possible fusion of vertebrae, which may result in a hunched posture.
Then there is gout, which is not in fact an autoimmune disease, but the result of too much uric acid in the body. When urate crystals accumulate over a period of time, they can cause problems such as joint pain and kidney stones.
Who is at risk for rheumatic diseases?
Anyone with a family history of autoimmune disease or thyroid problems is at risk – at any age. Patients with unexplained symptoms such as joint pain in the morning, especially if these symptoms worsen over time, should immediately consult with a physician.
Diagnosis and treatment
Preliminary testing can show whether a patient has elevated inflammatory markers, low hemoglobin or abnormal kidney function. Further investigation will then take place for a diagnosis and treatment plan.
The Rheumatology Division at Bumrungrad International Hospital has a world-class team of specialists, timely laboratory results and the latest diagnostic equipment, including an MRI
machine with a specific spondyloarthritis protocol to look for inflammation in the back. For unexplained inflammation, PET scans are always available.
With such advanced capabilities, the Rheumatology Division is often called upon to diagnose challenging cases throughout Southeast Asia.
Bumrungrad also offers the latest treatment for RA and AS, which consists of biologic injections which some patients find more convenient than the standard treatment of pills.
Preventive measures and lifestyle modifications
The root causes of rheumatic diseases are multifactorial. They could be genetic or environmental. A flare-up could be triggered by a previous infection or stress.
Especially for gout, diet is important, and patients should avoid red meat, seafood, alcohol and sweet drinks to reduce the level of uric acid in the body.
In general, patients are advised to exercise every day. Swimming is especially effective for strengthening the joints, without gravity weighing down on the joints. Swimming also helps the spine and core muscles.
*Based on an interview of Dr. Supat Thongpooswan
by Masala in April 2022.
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