Care of Arthritis & Rheumatism

Dr Aniruddha Tembe, at ‘Pune Rheumatology clinic’, is committed to providing state-of-the-art diagnosis, treatment and rehabilitation for adults and children with rheumatic and immunologic diseases. These diseases vary from the simple to complex and mild to life-threatening.


Who is a Rheumatologist?

A Rheumatologist is an internist who is qualified by additional training and experience in the diagnosis and treatment of arthritis and other diseases of the joints, muscles and bones.


What do Rheumatologists treat?

Rheumatologists treat arthritis, certain autoimmune diseases, musculoskeletal pain disorders and osteoporosis. All in all there are about 200 different musculoskeletal conditions. Arthritis is a term used by doctors to describe inflammation within a joint, while rheumatism is a more general term that is used to describe aches and pains in or around the joints. Because there are many possible causes of these pains doctors don't often use the term rheumatism and will usually refer to these problems either by a specific diagnosis or according to the part of the body affected. Doctors sometimes use the term 'musculoskeletal conditions' or 'the rheumatic diseases' to refer to a whole range of conditions that affect the joints.Some of these are very serious diseases that can be difficult to diagnose and treat.

The rheumatic diseases fall into two major categories:

I. Disorders of immune- mediated injury- Our immune system normally protects against infections, but in these illnesses, it attacks the body's own tissues, causing inflammation. The effects vary depending on which areas of the body are attacked - if the skin is attacked it results in a rash; if it's the joints then the main symptom is joint pain. The common ones in this category are:

            -Rheumatoid Arthritis                                         -Systemic Lupus Erythematosus            -Sjogren’s syndrome                                         -Systemic Sclerosis (Scleroderma)

            -The Spondyloarthritides (SpA) – This group includes: Ankylosing Spondylitis, Reactive Arthritis, Psoriatic Arthritis, Spondyloarthritis associated with Inflammatory Bowel diseases, & undifferentiated SpA

            -The Vasculitis syndromes: includes large (Takayasu’s arteritis, temporal arteritis, isolated angiitis of the CNS), medium vessel (Polyarteritis nodosa, Kawasaki disease), and small vessel- ANCA associated (Wegener’s granulomatosis, Churg Strauss vasculitis, Microscopic polyangiitis and leucocytoclastic vasculitis (Henoch Schonlein purpura, essential mixed cryoglobulinemia, cutaneous leucocytoclastic angiitis)

            -Behcet’s syndrome                                                       -Relapsing Polychondritis

            -Sarcoidosis                                                                 -Familial Mediterranean fever

`           -Amyloidosis

II. Disorders of the joints and adjacent tissues:

            -Osteoarthritis                                                   -Gout & other crystal arthropathies

            -Fibromyalgia                                                    -Infectious arthritis

            -Arthritis associated with systemic diseases like: Acromegaly, Hemochromatosis, Sickle cell disease, Thalassemia, Hypertrophic pulmonary osteoarthropathy, Reflex Sympathetic Dystrophy Syndrome, Tietze syndrome and costochondritis, Myofascial pain syndrome

            -Periarticular disorders of the extremities: bursitis, rotator cuff tendinitis & impingement syndrome, calcific tendinitis, bicipital tendinitis, De Quervain’s tenosynovitis, patellar tendinitis (jumper’s knee), adhesive capsulitis, lateral epicondylitis, medial epicondylitis, plantar fasciitis.

            -Disorders of bone and mineral metabolism- Osteomalacia, Osteoporosis, Paget’s disease and other dysplasias of bone

When should you see a Rheumatologist?

If musculoskeletal pains are not severe or disabling and last just a few days, it makes sense to give the problem a reasonable chance to be resolved. But sometimes, pain in the joints, muscles or bones is severe or persists for more than a few days. At that point, you should see a Rheumatologist.

Many types of rheumatic diseases are not easily identified in the early stages. Rheumatologists are specially trained to do the detective work necessary to discover the cause of swelling and pain. It’s important to determine a correct diagnosis early so that appropriate treatment can begin early. Some musculoskeletal disorders respond best to treatment in the early stages of the disease.

Because some rheumatic diseases are complex, one visit to a Rheumatologist may not be enough to determine a diagnosis and course of treatment. These diseases often change or evolve over time. Rheumatologists work closely with patients to identify the problem and design an individualized treatment program. Some of the common presenting symptoms of rheumatic illnesses are:


  • Pain, swelling, and/ or stiffness in/ around joints, muscles, bones
  • Neck and back pain associated with stiffness
  • Systemic symptoms like prolonged fever, skin rashes, tiredness, recurrent oral ulcers, hair loss, photosensitivity
  • Tightening of skin over hands, legs, face, chest and/ or  abdomen
  • Dryness of eyes and mouth
  • Fingers/ toes turning blue or white in cold conditions
  • Weakness of muscles with difficulty climbing stairs, getting up from a low position, combing hair etc.


Is specialty care more expensive?

You may be surprised to learn that specialized care may save time and money and reduce the severity of disease. A Rheumatologist is specially trained to spot clues in the medical history and physical examination. The proper tests done early may save money in the long run. Prompt diagnosis and specially tailored treatment often save money and buy time in treating the disease.


What are the procedures done?

Joint and soft tissue aspiration and injections