Rheumatology is a branch of Medicine which deals with diagnosis and management of diseases which primarily affect joints, bones and muscles. It also includes managing autoimmune diseases which initially may present with musculoskeletal symptoms but can involve internal organs like kidneys, lungs and brain. Rheumatic diseases are one of the major reasons for long term disability all over the world and can make simple daily tasks of life like eating and walking a struggle.
Rheumatology is a well established sub-specialty abroad for decades but it is relatively unknown and neglected branch of medicine in Pakistan. There is little awareness in public about this and only a few Rheumatology centers exist in the whole country, centered in big cities to cater for around 200 million population of Pakistan. This has led to suboptimal care of rheumatic diseases in Pakistan and there is huge need of more specialist Rheumatology Centers.
Shifa has played its role by establishing Rheumatology service many years ago and the department is growing to cater for increasing number of patients and is served by a young team of Rheumatologists trained in UK. Spectrum of Rheumatology is quite vast and Rheumatologists see from simple knee and back pain to arthritis of various kinds, to complex autoimmune diseases like Lupus and Vacuities.
Outlook of Rheumatologic disorders has improved dramatically over last 2 decades and many diseases previously thought untreatable can now be managed very effectively. This is largely due to early diagnosis and timely introduction of Disease Modifying Anti-Rheumatic Drugs (DMARDs) and more recently due to availability of targeted treatments called Biologics. Steroids have been mainstay of treatment for autoimmune rheumatic diseases in past but these are now used as bridging therapy while more specific DMARDs are taking effect. This approach avoids long term side effects associated with steroids. Autoimmune Rheumatic conditions can be multi system and often quite complex and hence are best managed under supervision of an expert Rheumatologist.
Rheumatology is a multi disciplinary specialty involving close collaboration with most other specialties and variety of other health care professionals including physiotherapists, occupational therapists and podiatrists.
The most common joint problem dealt by Rheumatologists is Rheumatoid Arthritis which affects around 1% of population. It affects small joints of hands and feet and leads to pain, swelling and stiffness in the joints. If not treated properly it can lead to joint deformities and long term disability. Early diagnosis hence is paramount as standard treatment earlier on results in better results and remission of disease. Therefore it is very important to consult a Rheumatologist if you have got pain, swelling or stiffness in the joints which does not seem to improve. The earlier, the better.
- Up to date and evidence based management of all rheumatic conditions;
- Painful joints (both small as well as large joints like hands, feet, knees, shoulders)
- Spinal pain (neck and back pain)
- Elbow pain (Tennis and Golfer’s Elbow)
- Plantar Fasciitis (Heel Pain)
- Frozen Shoulder and Shoulder Impingement
- Rheumatoid Arthritis
- Psoriatic Arthritis
- Reactive Arthritis
- Enteropathic Arthritis
- Juvenile Idiopathic Arthritis (Arthritis affecting children)
- Osteoarthritis of Knees
- Joint Hyper mobility
- Ankylosing Spondylitis
- Systemic Lupus Erythematosus (SLE)
- Antiphospholipid Antibody syndrome
- Sjogren’s Syndrome
- Systemic Sclerosis
- Vasculitis (e.g; Takayasu’s and Wegner’s)
- Fibromyalgia Syndrome
- Behcet’s Disease
- Joint and soft tissue injections
- Administration of Biologics for arthritis and autoimmune diseases
- Administration of IV therapies for Osteoporosis