Category Archives: Treatment

when to go to the emergency room

Know When to Go to the Emergency Room

You’re feeling sick but your doctor is booked and the nearest urgent care center is 45 minutes away. There’s always the hospital emergency room, but your symptoms aren’t that bad. Should you just tough it out?

Figuring out how and where to handle an illness isn’t easy. It’s even harder for people with inflammatory types of arthritis, because complications related to the disease and its treatment can be serious, says Uzma Haque, MD, assistant professor of medicine at Johns Hopkins University School of Medicine in Baltimore. Here’s what she suggests:

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integrated medicine for arthritis

Integrative Medicine Approach for Arthritis

Some people with arthritis feel that doctor-patient communication can sometimes seems narrow and impersonal. Integrative medicine aims to be different.

“Patients are at the center of integrated medicine; our goal is to partner with them to address the physical, emotional, social, environmental and spiritual factors that affect health,” says internist Adam Perlman, MD, executive director of Duke Integrative Medicine in Durham, N.C. “This approach is very inclusive. We practice and believe in Western medicine, but we also have an openness to complementary modalities that help address the whole person.”

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arthritis misdiagnosis

Arthritis Misdiagnosis

For 20 years, Frances Muller’s rheumatoid arthritis (RA) was misdiagnosed. A neurologist told her the pain in her hands was carpal tunnel syndrome. An internist told her the all-over aches were the flu. An orthopaedic surgeon said she had bursitis in both shoulders. “None of my symptoms made any sense,” and none of the treatments helped, says Muller, who lives in Scottsdale, Ariz. After she’d seen 13 other doctors, an orthopaedic surgeon who ordered an X-ray of her pelvis finally figured it out: there was no way she could have so much damage to her hips and not have RA.

Misdiagnosis is one of the most common medical errors, occurring in about 10 to 20 percent of cases, according to the National Center for Policy Analysis. It can lead to unnecessary or delayed treatments and physical and emotional suffering.

In rheumatology, where symptoms and diseases frequently overlap, even experienced and well-intentioned physicians can miss important clues. “For many rheumatic diseases, there’s no gold standard [for diagnosis],” says Don L. Goldenberg, MD, chief of rheumatology at Newton-Wellesley Hospital in Massachusetts. “You don’t biopsy it. There aren’t a lot of laboratory tests.” If patients are concerned, they should get a second opinion, he adds.

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medical imaging arthritis diagnosis

Medical Imaging for Arthritis Diagnosis

Whether it’s magnetic resonance imaging (MRI), an ultrasound or a good old-fashioned X-ray, your doctor is likely to order some type of medical imaging to see what’s going on below the surface with your arthritis.

“The most important thing rheumatologists can do to assess patients is still a good history and clinical exam. The role of imaging is to assist in assessing the degree of severity,” says Orrin Troum, MD, professor of medicine at University of Southern California and spokesperson for the International Society for Musculoskeletal Imaging in Rheumatology. Understanding its severity helps a doctor decide how aggressively to treat the disease.

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Aging and Arthritis Pain

Aging and Arthritis Pain: Should Treatment Plans Change as We Age?

Pain and aging—it’s an unfortunate fact of life. As we increase in age, so does our risk for painful health conditions. Research also suggests the experience of pain changes as we age; the treatments for it must often change as well.

More Painful Problems

“As we get older we are more likely to experience pain because of the kinds of health problems that go with getting older,” says Patricia A. Parmelee, PhD, director of the Alabama Research Institute on Aging at the University of Alabama in Tuscaloosa. “There are a number of disorders linked with the aging body that are painful,” she says. Of these, one of the most common is osteoarthritis (OA).

The likelihood of developing arthritis increases with age. The CDC reports that 7% of people between the ages of 18 and 44 say they have doctor-diagnosed arthritis. Among people 65 and older, that number is 50%.
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