Category Archives: Arthritis

Rheumatology Associates of Houston

Welcome and thank you for visiting the Rheumatology Associates of Houston website. Our dedicated physicians, professional and friendly manager and staff make it possible for us to provide the best care and environment for comprehensive treatment of your arthritis.

Arthritis can be a painful, oftentimes debilitating disease, which can greatly impact your quality of life. This condition currently affects over 2.5 million people in the United States roughly 1% of the population. Recent developments in research have helped provide earlier and more accurate diagnosis and effective treatment options. It is now possible to return to a normal life again, with minimal discomfort.

Rheumatology Associates of Houston remains dedicated to using the latest and most effective diagnostic and treatment options for our patients. Each of our physicians has been in practice for more than 10 years. They play an important role in monitoring and assessing the activity of your rheumatoid arthritis. Therefore, it is valuable to develop a doctor/patient partnership by keeping your appointments and utilizing our on-site services offered for your convenience and safety.

If you are experiencing pain and swelling in your joints, it is time to find help. We are experienced and dedicated to treating those suffering from arthritis or related illnesses. Furthermore, we strive to educate our patients and their families on the symptoms, treatments, and complications of rheumatic diseases. Our specially trained, board-certified physicians will work with you to improve your quality of life.

Our physicians have helped alleviate the pain of many people throughout Houston. We specialize in the treatment of:

Within our website, you will find recent comprehensive information about rheumatoid arthritis and other autoimmune disorders, including different treatment methods and answers to common questions related to these diseases.

Please call our office at (713) 667-8292 to find out more about our services or to schedule an appointment. We offer flexibility in scheduling your appointments and we work with your insurance carriers to minimize your out of pocket expense. Our physicians will provide you with a comprehensive evaluation and will offer treatment options tailored to the individual patient.

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Houston Arthritis Treatment | Rheumatology Associates of Houston

Arthritis facts Arthritis is inflammation of one or more joints. Symptoms of arthritis include pain and limited function of joints. Arthritis sufferers include men and women, children and adults. A rheumatologist is a medical arthritis expert. Earlier and accurate diagnosis can help to prevent irreversible damage and disability. What is arthritis? What causes arthritis?

Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where two different bones meet. A joint functions to move the body parts connected by its bones. Arthritis literally means inflammation of one or more joints.

Arthritis is frequently accompanied by joint pain. Joint pain is referred to as arthralgia.

There are many types of arthritis (over 100 identified, and the number is growing). The types of arthritis range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation resulting from an overactive immune system (such as rheumatoid arthritis). Together, the many types of arthritis make up the most common chronic illness in the United States.

The causes of arthritis depend on the form of arthritis. Causes include injury (leading to osteoarthritis), metabolic abnormalities (such as gout and pseudogout), hereditary factors, the direct and indirect effect of infections (bacterial and viral), and a misdirected immune system with autoimmunity (such as in rheumatoid arthritis and systemic lupus erythematosus).

Arthritis is classified as one of the rheumatic diseases. These are conditions that are different individual illnesses, with differing features, treatments, complications, and prognoses. They are similar in that they have a tendency to affect the joints, muscles, ligaments, cartilage, and tendons, and many have the potential to affect other internal body areas.

Medically Reviewed by a Doctor on 5/7/2015

Arthritis - Effective Treatments Question: What kinds of treatments have been effective for your arthritis?

Arthritis - Symptoms Question: What symptoms did you experience with arthritis?

Arthritis - Diet and Fish Oil Question: Do you follow a special diet for arthritis? Does it involve fish oils? Please discuss your diet.

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Arthritis: Facts on Diet, Treatment and Symptoms

Rheumatoid arthritis (RA) causes premature mortality, disability and compromised quality of life in the industrialized and developing world (1). Rheumatoid arthritis is a systemic inflammatory disease which manifests itself in multiple joints of the body. The inflammatory process primarily affects the lining of the joints (synovial membrane), but can also affect other organs. The inflamed synovium leads to erosions of the cartilage and bone and sometimes joint deformity. Pain, swelling, and redness are common joint manifestations. Although the causes are unknown, RA is believed to be the result of a faulty immune response. RA can begin at any age and is associated with fatigue and prolonged stiffness after rest. There is no cure for RA, but new effective drugs are increasingly available to treat the disease and prevent deformed joints. In addition to medications and surgery, good self-management, including exercise, are known to reduce pain and disability.

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The etiology, or cause, of RA is unknown. Many cases are believed to result from an interaction between genetic factors and environmental exposures.

Socio-demographics: The incidence of RA is typically two to three times higher in women than men. The onset of RA, in both women and men, is highest among those in their sixties(2)

Genetics: There is longstanding evidence that specific HLA class II genotypes are associated with increased risk. Most attention has been given to the DR4 and DRB1 molecules of the major histocompatability complex HLA class II genes. The strongest associations have been found between RA and the DRB1*0401 and DRB1*0404 alleles (12). More recent investigations indicate that of the more than 30 genes studied, the strongest candidate gene is PTPN22, a gene that has been linked to several autoimmune conditions(12).

Modifiable: Several modifiable risk factors have been studied in association with RA including reproductive hormonal exposures, tobacco use, dietary factors, and microbial exposures.

Smoking Among these risk factors, the strongest and most consistent evidence is for an association between smoking and RA. A history of smoking is associated with a modest to moderate (1.3 to 2.4 times) increased risk of RA onset (2). This relationship between smoking and RA is strongest among people who are ACPA-positive (anti-citrullinated protein/peptide antibodies), a marker of auto-immune activity (12).

Reproductive and breastfeeding history Hormones related to reproduction have been studied extensively as potential risk factors for RA:

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CDC - Arthritis - Basics - Definition - Rheumatoid Arthritis

Note: There are different data sources for some of the arthritis-related statistics therefore; case definitions and terminology will also vary. Read more.

Nearly 1 in 2 people may develop symptomatic knee OA by age 85 years.

Two in three people who are obese may develop symptomatic knee OA in their lifetime.

1 in 4 people may develop painful hip arthritis in their lifetime.

Note: There are different data sources for some of the arthritis-related statistics therefore; case definitions and terminology will also vary. Read more.

An estimated 52.5 million adults in the United States reported being told by a doctor that they have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia.

One in five (22.7%) adults in the United States report having doctor diagnosed arthritis.

In 2010-2012, 49.7% of adults 65 years or older reported an arthritis diagnosis.

By 2030, an estimated 67 million Americans ages 18 years or older are projected to have doctor-diagnosed arthritis.

Arthritis & Rheumatism 2006;54(1):226-229 [Data Source: 2003 NHIS]

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CDC - Arthritis - Data and Statistics - Arthritis Related ...

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that primarily affects joints.[1] It may result in deformed and painful joints, which can lead to loss of function. The disease may also have signs and symptoms in organs other than joints.

The cause of rheumatoid arthritis is not completely understood. The process involves inflammation and fibrosis of the capsule around the joints. It also affects the underlying bone and cartilage.[1] RA can produce diffuse inflammation in the lungs, the membrane around the heart, the membranes of the lung, and whites of the eye. It can also produce nodular lesions, most common within the skin. It is a clinical diagnosis made mostly on the basis of symptoms and physical examination. X-rays, laboratory testing, and synovial fluid analysis might help support a diagnosis or exclude other diseases with similar symptoms.[2]

Treatments include both medication and non-pharmacological measures - the goal being to control joint inflammation and prevent joint damage and disability. Non-pharmacological treatment includes physical therapy, splints and braces, occupational therapy and dietary changes but these do not stop the progression of joint destruction. Painkillers and anti-inflammatory drugs, including steroids, suppress symptoms, but do not stop the progression either. Disease-modifying antirheumatic drugs (DMARDs) may slow or halt the progress of the disease.[2] Biological DMARDS like anti-TNF agents are effective but usually avoided in persons with active disease or hypersensitivity to these agents.[3] They have been shown to decrease the number of tender or swollen joints and the pain and disability due to the disease but there is little data about side effects.[4]Alternative medicine is not supported by evidence.[5][6][7]

RA affects between 0.5 and 1% of adults in the developed world with between 5 and 50 per 100,000 people newly developing the condition each year.[8] Onset is most frequent during middle age, but people of any age can be affected.[9] In 2013 it resulted in 38,000 deaths up from 28,000 deaths in 1990.[10] The name is based on the term "rheumatic fever", an illness which includes joint pain and is derived from the Greek word -rheuma (nom.), -rheumatos (gen.) ("flow, current"). The suffix -oid ("resembling") gives the translation as joint inflammation that resembles rheumatic fever. The first recognized description of RA was made in 1800 by Dr. Augustin Jacob Landr-Beauvais (17721840) of Paris.[11]

RA primarily affects joints, however it also affects other organs in more than 1525% of individuals.[12]

Arthritis of joints involves inflammation of the synovial membrane. Joints become swollen, tender and warm, and stiffness limits their movement. With time, multiple joints are affected (it is a polyarthritis). Most commonly involved are the small joints of the hands, feet and cervical spine, but larger joints like the shoulder and knee can also be involved.[13]:1089 Synovitis can lead to tethering of tissue with loss of movement and erosion of the joint surface causing deformity and loss of function.[2]

RA typically manifests with signs of inflammation, with the affected joints being swollen, warm, painful and stiff, particularly early in the morning on waking or following prolonged inactivity. Increased stiffness early in the morning is often a prominent feature of the disease and typically lasts for more than an hour. Gentle movements may relieve symptoms in early stages of the disease. These signs help distinguish rheumatoid from non-inflammatory problems of the joints, often referred to as osteoarthritis or "wear-and-tear" arthritis. In arthritis of non-inflammatory causes, signs of inflammation and early morning stiffness are less prominent with stiffness typically less than one hour, and movements induce pain caused by mechanical arthritis.[14] The pain associated with RA is induced at the site of inflammation and classified as nociceptive as opposed to neuropathic.[15] The joints are often affected in a fairly symmetrical fashion, although this is not specific, and the initial presentation may be asymmetrical.[13]:1089

As the pathology progresses the inflammatory activity leads to tendon tethering and erosion and destruction of the joint surface, which impairs range of movement and leads to deformity. The fingers may suffer from almost any deformity depending on which joints are most involved. Specific deformities, which also occur in osteoarthritis, include ulnar deviation, boutonniere deformity, swan neck deformity and "Z-thumb." "Z-thumb" or "Z-deformity" consists of hyperextension of the interphalangeal joint, fixed flexion and subluxation of the metacarpophalangeal joint and gives a "Z" appearance to the thumb.[13]:1089 The hammer toe deformity may be seen. In the worst case, joints are known as arthritis mutilans due to the mutilating nature of the deformities.[1]

The rheumatoid nodule, which is sometimes cutaneous, is the feature most characteristic of RA. It is a type of inflammatory reaction known to pathologists as a "necrotizing granuloma". The initial pathologic process in nodule formation is unknown but may be essentially the same as the synovitis, since similar structural features occur in both. The nodule has a central area of fibrinoid necrosis that may be fissured and which corresponds to the fibrin-rich necrotic material found in and around an affected synovial space. Surrounding the necrosis is a layer of palisading macrophages and fibroblasts, corresponding to the intimal layer in synovium and a cuff of connective tissue containing clusters of lymphocytes and plasma cells, corresponding to the subintimal zone in synovitis. The typical rheumatoid nodule may be a few millimetres to a few centimetres in diameter and is usually found over bony prominences, such as the elbow, the heel, the knuckles, or other areas that sustain repeated mechanical stress. Nodules are associated with a positive RF (rheumatoid factor) titer and severe erosive arthritis. Rarely, these can occur in internal organs or at diverse sites on the body.[citation needed].

Several forms of vasculitis occur in RA. A benign form occurs as microinfarcts around the nailfolds. More severe forms include livedo reticularis, which is a network (reticulum) of erythematous to purplish discoloration of the skin caused by the presence of an obliterative cutaneous capillaropathy.[citation needed].

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Rheumatoid arthritis - Wikipedia, the free encyclopedia

Managing arthritis: Young people share their tips and advice
Young people share their advice on coping with arthritis. They discuss where to find information and help, and share their experiences of growing up with the condition. For information on...

By: Arthritis Research UK

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Managing arthritis: Young people share their tips and advice - Video