OVERVIEW

The Department of Rheumatology and Clinical Immunology of Sri Ramakrishna Hospital has over the years treated thousands of patients suffering from disorders like rheumatoid arthritis, osteoarthritis, autoimmune connective tissue diseases, vasculitis, interstitial lung disease and many others. Here people who suffer from debilitating pain experience relief through treatments ranging from corticosteroid injections to biologics to viscosupplementation. Our team of experts utilises top flight technology for both diagnostics and treatment. If you or somebody you know suffers from any of these conditions, do visit us and spend some time discussing it with one of our physicians. You may get a new lease on life.


MEDICAL CONDITIONS

Rheumatoid Arthritis (RA):

Rheumatoid arthritis is commonly thought to affect joints but it can affect much more. A chronic inflammatory autoimmune disorder, rheumatoid arthritis may cause damage to a whole host of body systems such as the skin, heart, eyes, blood vessels and lungs. Like any other autoimmune disease, the body’s natural defences mistake healthy tissue for invaders and attacks. Rheumatoid arthritis affects the lining of the joints which results in swelling. This can cause pain and, in the long run, erode bone and deform joints.

Psoriatic Arthritis (PsA):

This is an autoimmune disorder caused by psoriasis - a skin disease where the immune system attacks the skin causing scaly patches on it. About 15% of psoriasis patients contract psoriatic arthritis. It varies from patient to patient but psoriatic arthritis may affect any part of the body.

Ankylosing Spondylitis (AS):

This is a kind of arthritis which attacks the spine. The bones of the spine might fuse together causing a rigid spine. Depending on the case, it can be a mild or severe condition.

Juvenile Idiopathic Arthritis (JIA):

JIA is a type of autoimmune inflammatory arthritis affecting children <16 years of age. There are different sub types and it can affect any part of the body, particularly eyes other than joints. It can be effectively treated with modern treatment. However, there are many effective treatments for it.

The connective tissue is a particular kind of connective tissue of the body. It binds, supports and protects organs. Made up of the proteins collagen and elastin, connective tissue makes up a framework for the body. There are a number of autoimmune diseases of the connective tissue and they be caused by both environmental and genetic factors. Lupus is one such. Capable of afflicting any organ system, it is an inflammation of connective tissue. Sjogren’s syndrome is another. Most commonly affecting tear and salivary glands, patients are at risk of eye infection and cornea damage. It may also cause dental decay, oral yeast infections and gingivitis. Scleroderma is yet another autoimmune connective tissue disease. It leads to thickening of the skin and scarring of body parts. This leads to trouble in the heart, lungs, intestines and so on.

This is a group of disease which share one thing in common - the inflammation of the blood vessels including arteries and veins. They are many in number and rare. Vasculitis results in reduced flow of blood to tissue across the body. Types of vasculitis have a great range of symptoms, vary in intensity and differ in duration. For the most part their causes remain unknown, they affect both sexes and people of all ages. Different types of vasculitis may affect specific groups of people. They might be mild but can even cause death, may be one-off or repeated over a great many years.

There are a host of connective tissue disorders involving collagen which are hereditary. Osteogenesis imperfecta, also known as brittle bone disease, is the result of insufficient levels of normal collagen which is a necessity for strong, healthy bones. Stickler syndrome presents with abnormalities of the eye, joint trouble, loss of hearing and facial characterises which are distinctive.

Sometimes the immune system may suddenly attack the normal proteins in the blood by error. This is known as antiphopholipid syndrome and it can result in blood clots in the arteries and veins. When it forms in the veins of the legs it causes deep vein thrombosis (DVT). Clots may also form in the lungs or kidneys or brain causing a whole host of conditions. Antiphospholipid syndrome can also result in pregnancy complications. Unfortunately there is no cure for it but there are treatments which can reduce risk from it.

One of the conditions caused by autoimmune and rheumatological diseases is interstitial lung disease. This is a broad term which covers a host of disorders which progressively cause scarring of the lung tissue that lies between and supports the air sacs. Over time, scarring causes stiffness of the lungs. In time this severely reduces the lungs efficiency make it harder and harder to breathe. This reduces the amount of oxygen introduced into the blood stream thereby affecting the whole body. Scarring is irreversible but there are treatments to slow the rate at which it occurs. Another alternative is a lung transplant.

This is a general group of autoinflammatory diseases which have symptoms which are similar. The main symptom of these is recurring fever which has no infectious cause. The fevers are often accompanies by a host of other symptoms. The fevers may be cyclical in nature - sometimes erratic and sometimes more predictable. What is worse however is that they are accompanied by systemic inflammation which affects a host of tissues and organs. Some of the periodic fever syndromes include Aphthous Stomatitis, Pharyngitis, & Cervical Adenitis (PFAPA syndrome), Familial Cold Autoinflammatory Syndrome (FCAS), Muckle-Wells Syndrome (MWS), and Neonatal-Onset Multisystem Inflammatory Disease (NOMID or CINCA).

Bones is living tissue. It is in a constant state of regeneration wherein old bone is replaced with new bone. The rate at which bone is replaced begins to slow for people in their mid-thirties. Which means that by default bone steadily becomes weaker and more brittle. However this might be greater in some individuals than others. Osteoporosis affects older people of both sexes. It is almost always undetected until a bone is broken. Typically, a person with osteoporosis will break a bone when doing something which an ordinary person would come away from unscathed. The bone snaps under far less duress than for the average person. The greatest threats to long-term health is caused by hip and spinal fractures where the loss of quality of life is so great that death within a short period of time of the injury is common. Subcutaneous and intravenous injections can limit and even treat osteoporosis.


TREATMENTS & PROCEDURES

Entrapment neuropathy is the pain caused by the trapping or pinching of a nerve. It typically occurs at the elbow, shoulder, wrist, neck, foot or lower leg. One such example is carpal tunnel syndrome. Here at Sri Ramakrishna Hospital we provide treatment for it in a number of ways. The Department of Rheumatology can deliver medication to the location through corticosteroid injections. Many patients suffering from entrapment neuropathies have finally found relief using this treatment.
Arthritis does not require surgery in the early stages. There are other treatments which can bring patients relief. One such option is called viscosupplementation. Viscosupplementation is a non-surgical treatment which involves injecting a fluid which resembles a gel into the knee joint. The fluid is called hyaluronic acid. Hyaluronic acid occurs naturally in the synovial fluid - the fluid which surrounds the joints, and acts as a lubricant. It allows bones to move over each other without friction. People with arthritis have lower levels of hyaluronic acid than normal in their knees. Replacing it through injections improves joint function. A large number of patients have benefited from this treatment at Sri Ramakrishna Hospital.
To modify the behaviour or reactions of the immune system, immunomodulators are prescribed. These also reduce the natural inflammatory response in autoimmune conditions. Typically it takes a few months to see a response so it is used along with corticosteroids. They are of great benefit to patients suffering from autoimmune diseases, vasculitis and inflammatory arthritis. The Department of Rheumatology has extensive experience using immunomodulators to provide relief to many patients.
Antibodies can today be grown in a laboratory. These are called biologics and they are designed to prevent the proteins which cause inflammation in the body. Biologics can exactly target what they were designed for. Thus, their use reduces side effects of things like corticosteroids which usually affect the whole body. Here at Sri Ramakrishna Hospital, biologics are delivered to specific parts of the body through injections to target inflammatory arthritis, autoimmune diseases and vasculitis.
As the name indicates these are injections which are made to the joints and to the soft tissue. A needle is inserted into a joint like the knee or a soft tissue space like the space between bone and muscle. It can then be used to either inject medication or remove fluid. Pain relievers and corticosteroids are used to relieve the pain caused by a host of conditions such as rheumatism, carpal tunnel syndrome, tendonitis and bursitis. They can be effectively used to diagnose conditions too. At the Department of Rheumatology, thousands of patients have found relief in our joint and soft tissue injections.
Osteoporosis and a host of metabolic diseases can be limited and even treated through medications. The most effect are delivered via injection subcutaneously or intravenously. This might be the result of either just age or menopause or even cancer of the prostate or breast.

SPECIALITY DOCTORS

Dr. K. S. Jayakumar
MRCP, MD, CCT (Rheum & GIM), FRCP.,
Consultant Rheumatology & Immunology

MON- SAT | 08:00 AM – 4.00PM