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CAREPLUS
There’s more to ‘rayuma’ than meets the eye

By Angelo B. Palmones
Philippine Daily Inquirer
First Posted 20:57:00 05/23/2008

Filed Under: Health

MANILA, Philippines?Often jokingly associated with advancing age, arthritis or rayuma and the joint pain it causes is the most common reason a person consults a rheumatologist. Pain can also originate from tendons, muscles or nerves and may be a symptom of a more serious disease such as an infection or malignancy.

Properly diagnosing this common symptom is the key in providing appropriate medical care. A rheumatologist is a physician who specializes in the treatment of arthritis and other rheumatic diseases that may affect joints, muscles, bones, skin and other tissues.

Unfortunately, many patients with arthritic conditions often self-medicate with over-the-counter pain relievers, reveals Dr. Juan Javier T. Lichauco, assistant head of the Rheumatology, Allergy and Immunology (RAI) Center at St. Luke?s Medical Center.

?This is dangerous. Such patients may end up with stomach ulcers and liver and kidney damage.? He stresses that consulting a rheumatologist is the first vital step in ensuring that patients with rheumatic diseases are educated about their condition and treated appropriately.

Most common types

There are actually many kinds of arthritis. A rheumatologist is trained to diagnose the type of arthritis an individual has and administer the appropriate treatment. Dr. Lichauco gives an overview of the most common types of arthritis in the country:

Osteoarthritis is the most common type of arthritis. It is usually seen with age and in patients who are overweight. The hands and weight bearing joints, such as the hips and knees are commonly involved. Maintaining an ideal body weight, engaging in muscle strengthening exercises and using pain relievers that is supervised by a physician are key components in managing patients with this type of arthritis.

Gout is a kind of arthritis associated with an elevated blood uric acid level. Patients initially present with an arthritis that comes and goes. As the arthritis progresses, the attacks become more frequent and disabling. Some patients with long-standing gout can develop deposits of uric acid along bony surfaces (?tophi?).

Arthritis can be a symptom of a more serious illness, such as systemic lupus erythematosus (SLE). Commonly seen among women of reproductive age, SLE is considered the prototypical autoimmune disease, a strange malady in which the immune system attacks the person?s own body causing widespread inflammation. Symptoms include fever, hair loss, rash aggravated by sunlight exposure, oral or nasal sores, and arthritis. In more severe cases, SLE can involve the brain, lungs, heart and kidneys.

Rheumatoid arthritis is another autoimmune disease more commonly seen among women. It presents as arthritis involving multiple body joints, especially the wrists, hands, hips, knees and ankles. It is an aggressive form of arthritis that can cause permanent disability if not treated with appropriate medications.

Psoriasis is a skin condition that presents as a widespread scaly red rash. Some patients with psoriasis can develop a destructive and aggressive form of arthritis called psoriatic arthritis. Similar to rheumatoid arthritis, psoriatic arthritis can lead to permanent joint damage and disability if not treated with proper medications.

More commonly seen among young men, ankylosing spondylitis is a form of arthritis that attacks the spine, causing it to spontaneously fuse. Back pain with progressive stiffness of the spine is a common feature. Some patients may also present with arthritis of the hips and knees.

?Diagnosing arthritic and autoimmune conditions requires a comprehensive history, physical examination and the use of special blood tests,? Dr. Lichauco stresses. Advancements in molecular medicine have produced a growing number of intravenous medications that are effective in treating several conditions such as SLE, rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis, he adds.

Choosing a hospital

Dr. Lichauco underscores the importance of choosing a hospital with a comprehensive diagnostic and therapeutic center for rheumatic and immunologic conditions. The St. Luke?s RAI Center is staffed by well-trained rheumatologists and allergologists supported by an efficient nursing staff, he explains. It is well-equipped to meet the needs of patients with various arthritic conditions. At the center, intravenous medications are infused in a strictly monitored and patient-friendly setting, thereby ensuring safe and high-standard drug administration.

?The center?s synergy of state-of-the-art equipment and topnotch expertise ensures patients with arthritic conditions receive accurate diagnosis and safe, targeted treatments,? Dr. Lichauco says.

* * *

Angelo Palmones is a science and technology broadcaster. For feedback, please e-mail the Healthcare Technology and Outcomes Information Bureau at inquire@htoib.com. The RAI Center is located at the Ground Floor, Annex II Building of St. Luke's Medical Center. For inquiries, please call 723-0101 ext. 4725.



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