Rheumatology
Featured Rheumatology
All Rheumatology
Amplified Musculoskeletal Pain Syndrome
Rheumatology
Amplified musculoskeletal pain syndrome, sometimes called juvenile fibromyalgia or chronic widespread pain, is an umbrella term for ongoing pain in the muscles, joints and bones that isn't caused by inflammation or actual tissue damage. It shows up mostly in childhood and the teenage years, most often in preteen and teen girls roughly between ages 11 and 15. Researchers believe it happens when the nervous system's pain-processing signals become disordered and amplify pain sensations even though nothing is actually being damaged. The pain is real and can be disabling day to day, but it isn't a sign of a dangerous underlying disease. What tests are you running to rule out other causes of this pain before settling on this diagnosis? Why does gradually increasing exercise help this condition instead of making the pain worse? How do we find a cognitive behavioral therapist or counselor experienced with chronic pain in kids and teens? Should we expect sleep trouble, headaches or dizziness to improve as the pain itself improves? How do we build a physical or occupational therapy plan that doesn't feel overwhelming at first? A pediatric rheumatologist can diagnose amplified musculoskeletal pain syndrome and coordinate care with physical or occupational therapists and mental health providers trained in chronic pain. Seek care sooner if the pain pattern changes suddenly or comes with swelling, redness or fever, since those can point to a different cause that needs its own evaluation. Source: https://rheumatology.org/patients/amplified-musculoskeletal-pain-syndrome-amps
Antinuclear Antibodies (ANA)
Rheumatology
Antinuclear antibodies, or ANA, are antibodies your immune system mistakenly makes against proteins inside your own cells, and testing for them is one way doctors look for signs of autoimmune activity. A negative result means none were detected, while a positive result means they were found but doesn't by itself prove you have an autoimmune disease — as many as 15% of healthy people test positive, and the rate climbs with age, illness or certain medications. Because of this, a positive ANA is treated as one clue among several, most useful when paired with your symptoms and other test results. What titer and staining pattern did my ANA test show, and how do those numbers change what it means? Given my result, what other blood tests, exam findings, or symptoms are you looking at before considering an autoimmune diagnosis? Could my age, a medication I'm taking, or a recent illness explain this result? If my ANA is positive but I have no symptoms right now, do I need to be retested later, and how soon? What new symptoms, like joint pain, rashes or fatigue, should prompt me to come back sooner? A primary care provider often orders the first ANA test, and a positive result is usually reviewed by a rheumatologist, who weighs it alongside your symptoms, physical exam and additional bloodwork before considering any autoimmune diagnosis. Seek follow-up sooner if you develop new or worsening symptoms alongside a positive result, rather than waiting for a routine check-in. Source: https://rheumatology.org/patients/antinuclear-antibodies-ana
Antiphospholipid Syndrome
Rheumatology
Antiphospholipid syndrome is an autoimmune disease, most often diagnosed in women between about ages 30 and 40, in which abnormal antibodies make the blood more likely to clot. It can occur on its own or alongside another autoimmune disease — roughly 40% of people with lupus also carry these antibodies, though not all of them go on to develop clots. Because clots can form in blood vessels throughout the body, the condition can lead to serious problems like miscarriage, pulmonary embolism, heart attack, stroke or kidney damage, and it's sometimes discovered only after one of these events occurs. Which of the antiphospholipid antibody blood tests came back positive, and was the result confirmed on a repeat test months later? Given my risk factors, like smoking, blood pressure or birth control use, what can I change to lower my clotting risk? Will I need long-term anticoagulant medication, and how will you monitor whether the dose is working? If I'm pregnant or planning to be, how does this diagnosis change my prenatal care and medications? Besides blood thinners, are there other medications, like hydroxychloroquine, that could help manage my risk? A rheumatologist typically manages antiphospholipid syndrome, often together with a hematologist and, during pregnancy, a high-risk obstetrician. Seek emergency care right away if you develop symptoms that could signal a blood clot, stroke or heart attack. Source: https://rheumatology.org/patients/antiphospholipid-syndrome
Axial Spondyloarthritis
Rheumatology
Axial spondyloarthritis is a form of inflammatory arthritis that mainly affects the spine, including the sacroiliac joints where the pelvis meets the lower back. It most often begins in males in their teens or twenties and is closely linked to a gene called HLA-B27, though carrying the gene doesn't mean someone will develop the disease. Left untreated, the inflammation can cause ongoing low back pain, stiffness and fatigue, along with tendon pain or eye inflammation in some people, but with today's treatments most people go on to live full, active lives. Do my X-rays or other imaging show signs of sacroiliitis, and what does that mean for my diagnosis? Should I be tested for the HLA-B27 gene, and how would that result change my treatment plan? Is physical therapy or an NSAID a reasonable place to start for me, and when would you consider a medication like methotrexate or an anti-TNF drug? How can I tell whether new pain or swelling, like in my heel or a tendon, is part of this disease? What can I do day to day to protect my spine's flexibility and posture over the long term? A rheumatologist diagnoses and manages axial spondyloarthritis and can coordinate physical therapy and, when needed, advanced medications. Seek care sooner if you notice sudden eye pain or light sensitivity, since that can signal eye inflammation linked to the disease. Source: https://rheumatology.org/patients/axial-spondyloarthritis
Behcet's Disease
Rheumatology
Behcet's disease is a rare condition that causes inflammation of blood vessels throughout the body, which can affect the mouth, genitals, skin, eyes, joints, digestive tract and nervous system. It tends to appear in a person's 20s or 30s and is seen more often in people with roots in the Middle East, Turkey, Iran and parts of East Asia such as China and Japan. The exact cause isn't known, but certain genes — including one called HLA-B*51 — appear to play a role, even though testing positive for that gene alone can't confirm the diagnosis. Based on my mouth sores, genital sores and other symptoms, do I meet the pattern you use to diagnose Behcet's disease? Which other organs, like my eyes or digestive tract, need to be checked for involvement? Would a topical treatment be enough for my sores, or do you recommend a medication like colchicine or apremilast? Under what circumstances would you consider a stronger immune-suppressing medication or a biologic like infliximab? What symptoms mean I should be seen urgently rather than waiting for my next scheduled visit? A rheumatologist typically coordinates care for Behcet's disease, working with other specialists as needed depending on which organs are affected. Seek care promptly for new eye pain, redness or vision changes, since eye involvement is one of the ways this disease can affect the body and is worth assessing quickly. Source: https://rheumatology.org/patients/behcets-disease
Calcium Pyrophosphate Deposition (CPPD)
Rheumatology
Calcium pyrophosphate deposition disease, sometimes called pseudogout, is a form of inflammatory arthritis that develops when calcium pyrophosphate crystals build up in joint cartilage and trigger inflammation. It's most common in adults over 60, though it can appear earlier, and it's often linked to other issues such as parathyroid problems, low magnesium, certain inherited metabolic conditions, or existing osteoarthritis or gout. Flares typically bring on sudden, severe pain, warmth and swelling, most often in the knee, and repeated flares can gradually damage cartilage if they go untreated. Did joint fluid testing confirm calcium pyrophosphate crystals, or are we going by symptoms and imaging alone? Could an underlying condition, like a parathyroid problem or low magnesium, be contributing to this, and should I be tested for it? What's the fastest way to calm down a flare — joint drainage, a steroid injection, or an oral medication? Since there's no treatment that dissolves the crystals themselves, what does long-term management look like for me? If I keep having frequent flares, would a preventive medication like colchicine make sense? A rheumatologist can confirm CPPD, often by analyzing joint fluid or reviewing X-rays and ultrasound, and guide both flare treatment and long-term management. Seek care sooner if a joint becomes suddenly hot, swollen and very painful, since that can also point to a joint infection that needs urgent evaluation. Source: https://rheumatology.org/patients/calcium-pyrophosphate-deposition-cppd
Carpal Tunnel Syndrome
Rheumatology
Carpal tunnel syndrome is a common nerve condition that occurs when the median nerve, which runs through the wrist, becomes compressed, leading to numbness, tingling and sometimes weakness in the hand. It's more common in women and in middle-aged or older adults, and it usually affects one hand, though it can occur in both. Pregnancy, being overweight, diabetes, an underactive thyroid, rheumatoid arthritis and repetitive hand use can all raise the risk or make symptoms worse. Did the Phalen test, Tinel sign, or nerve conduction testing confirm carpal tunnel syndrome, or could my symptoms have another cause? Is an underlying condition, like diabetes, thyroid disease or arthritis, contributing to this, and should that be treated too? Would a wrist splint, activity changes, or a cortisone injection be reasonable to try before anything more invasive? At what point would you recommend carpal tunnel release surgery, and what does recovery involve? What hand positions or activities should I avoid at work or at home to keep this from getting worse? A rheumatologist or hand specialist can evaluate carpal tunnel syndrome, especially when it's connected to an underlying condition like arthritis, and discuss whether nonsurgical treatment or carpal tunnel release surgery is the right next step. Seek care sooner if you notice worsening weakness, dropping objects more often, or numbness that isn't improving, since delaying care can allow nerve damage to progress. Source: https://rheumatology.org/patients/carpal-tunnel-syndrome
Chronic Recurrent Multifocal Osteomyelitis (CRMO)
Rheumatology
Chronic recurrent multifocal osteomyelitis, also known as chronic nonbacterial osteomyelitis, is an autoinflammatory condition that causes bone pain from inflammation rather than from an actual infection. It typically begins around ages 9 to 10 and is diagnosed more often in girls than boys, and in some cases it can run in families. Along with bone tenderness and pain that can make a child avoid using a limb, it can also cause joint swelling and fatigue. What imaging or tests, such as X-rays, MRI, or a bone biopsy, confirmed this is CRMO rather than a bone infection? Why does treatment usually start with NSAIDs, and how will we know if we need to move on to methotrexate or a biologic medication? If a biologic medication is recommended, what screening, like a TB test, and ongoing monitoring will my child need? How will we track whether the bone inflammation is improving, and how often will follow-up imaging be needed? What's the outlook for my child — is remission possible, or should we plan for this as a long-term condition to manage? A pediatric rheumatologist typically diagnoses and manages CRMO, coordinating imaging and, when needed, biologic therapy. Seek care sooner if bone pain suddenly worsens, comes with fever, or your child starts refusing to bear weight on a limb, since these can also be signs of an actual bone infection that needs prompt evaluation. Source: https://rheumatology.org/patients/chronic-recurrent-multifocal-osteomyelitis-crmo
Cryopyrin-Associated Autoinflammatory Syndromes (CAPS)
Rheumatology
CAPS is a group of rare, inherited inflammatory conditions caused by a change in the cryopyrin protein that keeps the body's inflammation switch stuck in the "on" position. It usually begins in infancy or early childhood and ranges from a mild form triggered by cold exposure to a severe, lifelong form that can cause chronic meningitis-like inflammation. It affects boys and girls from every ethnic background, and without treatment it can lead to hearing loss and organ damage over time. Which type of CAPS does my child have, and how does that affect the long-term outlook? What genetic testing was used to confirm this diagnosis, and should other family members be tested? How will we monitor for hearing loss, eye inflammation, or other organ involvement over time? Which medication do you recommend starting with, and how soon might we see improvement? What symptoms during a flare should prompt an urgent call to you rather than waiting for the next visit? A pediatric rheumatologist experienced in autoinflammatory diseases should guide diagnosis and treatment, since CAPS often needs input from specialists in hearing, eyes, and neurology as well. Seek care sooner if fever, rash, or headaches are accompanied by new confusion, severe headache, or a sudden change in hearing, since early treatment can help prevent damage that may not be reversible. Source: https://rheumatology.org/patients/cryopyrin-associated-autoinflammatory-syndromes-caps
Familial Mediterranean Fever
Rheumatology
Familial Mediterranean fever is an inherited condition, not an infection, caused by mutations in the MEFV gene that lead to repeated episodes of fever along with pain in the abdomen, joints, or chest. It's most common in people with Mediterranean or Middle Eastern ancestry, and it usually shows up early in life — most cases start before age 20, and many before age 10. A child can inherit the condition from one or both parents carrying the mutated gene. Does the genetic test confirm one mutated copy of the MEFV gene or two, and does that change what we should expect? How long and how often will these fever episodes typically last once the diagnosis is confirmed? Why is colchicine taken every day even between attacks, and what happens if a dose is missed? If colchicine doesn't fully control the episodes, what other treatment options are available? What symptoms during an abdominal attack would mean we need to rule out appendicitis or another emergency? A rheumatologist familiar with periodic fever syndromes should confirm the diagnosis and manage long-term treatment, and for children a pediatric rheumatologist is best suited to the condition. Seek care sooner if abdominal pain is severe or doesn't follow the usual pattern, since it can be difficult to tell apart from a surgical emergency like appendicitis. Source: https://rheumatology.org/patients/familial-mediterranean-fever
Glucocorticoid-Induced Osteoporosis
Rheumatology
Glucocorticoid-induced osteoporosis happens when steroid medicines like prednisone or methylprednisolone, often prescribed for autoimmune and inflammatory conditions, weaken the bones and raise the risk of fracture. Bone loss can start quickly, sometimes within the first six months of treatment, and the risk climbs for people taking more than a low daily dose for several months. It matters most for people already living with a chronic condition that requires ongoing steroid treatment, since the bone loss can continue for as long as the medication is needed. Based on my steroid dose and how long I'll need it, how much bone loss risk am I facing? When should I have a bone density (DXA) scan, and how often should it be repeated? Am I getting enough calcium and vitamin D, and do I need supplements? Is a bone-protecting medication appropriate for me now, or should we wait and monitor first? What lifestyle changes, like exercise or quitting smoking, would make the biggest difference for my bones? A rheumatologist can weigh the benefits of your steroid treatment against the risk to your bones and arrange monitoring and prevention, often coordinating with a primary care doctor. Seek care sooner if you experience a fall, new back pain, or a fracture from a minor injury, since that can be a sign of significant bone loss. Source: https://rheumatology.org/patients/glucocorticoid-induced-osteoporosis
Gout
Rheumatology
Gout is a form of arthritis caused by sharp uric acid crystals building up inside a joint, leading to sudden, severe pain and swelling. It develops when the level of uric acid in the blood rises higher than the kidneys can clear, often linked to diet, heavy alcohol use, or certain medications, and it affects men more often than women. Attacks tend to come and go, and over time untreated gout can lead to visible lumps called tophi and lasting joint damage. What is my current uric acid level, and how does that compare to the target you'd like me to reach? Should we test the fluid from my joint to confirm this is gout rather than another cause of joint pain? What's the best way to treat a flare quickly once it starts? Do I need a daily uric acid-lowering medication like allopurinol, and how long would I stay on it? Which foods, drinks, or habits should I change to reduce how often flares happen? A rheumatologist can confirm the diagnosis and help set up a long-term plan to keep uric acid levels controlled, which is the key to preventing future attacks and joint damage. Seek care sooner if a joint becomes suddenly hot, swollen, and severely painful, especially with fever, since that combination needs prompt evaluation. Source: https://rheumatology.org/patients/gout
Granulomatosis with Polyangiitis
Rheumatology
Granulomatosis with polyangiitis, formerly known as Wegener's granulomatosis, is a rare disease in which small and medium-sized blood vessels become inflamed, most often damaging the sinuses, lungs, and kidneys. It's uncommon, affecting only a few people out of every 100,000, and it usually appears in adults between about 40 and 65, striking men and women in roughly equal numbers. Early signs like nasal congestion or nosebleeds can look minor at first, but without treatment the disease can progress to serious kidney or lung failure. Which organs show signs of involvement so far, and how will we track whether that changes? Was my ANCA blood test positive, and if it wasn't, how does that affect the diagnosis? What treatment are you starting with, and why — steroids, another DMARD, or a biologic medication? How often will I need blood work, urine tests, or imaging to watch for relapse? What new symptoms, like blood in my urine or worsening breathing, mean I should contact you right away? A rheumatologist, often working with kidney and lung specialists, should manage diagnosis and long-term treatment, since relapses are common and ongoing monitoring matters even after symptoms improve. Seek care sooner if you develop worsening shortness of breath, coughing up blood, or a significant drop in urine output, as these can signal organ damage that needs urgent attention. Source: https://rheumatology.org/patients/granulomatosis-with-polyangiitis-wegeners
HCV and Rheumatic Disease
Rheumatology
Hepatitis C virus (HCV) infection keeps the immune system continuously switched on, and that ongoing activation can trigger a range of rheumatic problems, including joint pain and swelling, muscle aches, inflamed blood vessels, and cryoglobulinemia, a buildup of abnormal proteins that can clump together in cold temperatures and affect the kidneys. Some people have few or no symptoms from the virus itself and don't realize they're infected until joint or muscle symptoms bring them to a doctor, sometimes before HCV is ever diagnosed. Because a rheumatic complication can be the first clue to an HCV infection, and because some rheumatic medications can affect the liver, the two conditions are usually best managed together. Could my joint or muscle symptoms be connected to hepatitis C, and should I be tested for the virus? Now that hepatitis C is confirmed, will treating the virus with antiviral medication also improve my joint and muscle symptoms? Which of my symptoms are linked to cryoglobulinemia, and does that put my kidneys at risk? Are the medications you're considering for my joint pain safe for my liver, given the hepatitis C? Should my rheumatology care be coordinated with a liver specialist, and how often should we communicate? A rheumatologist can evaluate joint, muscle, and blood vessel symptoms linked to HCV, usually alongside a hepatologist, or liver specialist, who manages the virus itself and screens for liver damage. Seek care sooner if you notice new swelling in your legs, blood in your urine, or numbness and pain in your hands or feet, since these can point to kidney or nerve involvement that needs prompt attention. Source: https://rheumatology.org/patients/hcv-and-rheumatic-disease
Henoch Schonlein Purpura
Rheumatology
Henoch Schonlein Purpura (HSP) is a form of vasculitis, meaning inflammation of small blood vessels, that most often affects children. The immune system attacks blood vessels in the skin, joints, intestines, and kidneys, producing a distinctive purple-red rash along with joint pain and sometimes abdominal pain. It's the most common form of childhood vasculitis, tends to appear in the school-age years, and while most children recover fully, some go on to develop kidney problems that need to be watched closely afterward. Is this rash on my child's legs and buttocks consistent with HSP, or do we need more testing to be sure? How severe is my child's abdominal pain, and does it need treatment with steroids? Are my child's joints affected, and will that pain go away on its own? How often will we need to check urine and blood pressure to watch for kidney involvement, and for how long? What symptoms would mean we need to come back sooner rather than waiting for the next scheduled check? Many children with HSP can be managed by their primary care provider, with a rheumatologist brought in for more severe joint or blood vessel symptoms and a kidney specialist involved if urine or blood pressure tests show kidney involvement. Seek care sooner if abdominal pain becomes severe or you notice blood in your child's stool or urine, since these need prompt evaluation. Source: https://rheumatology.org/patients/henoch-schonlein-purpura-hsp
HIV and Rheumatic Disease
Rheumatology
People living with HIV can develop a range of joint, muscle, and bone problems, including inflammatory arthritis, muscle pain and weakness, and inflamed blood vessels. These symptoms sometimes appear before HIV itself is diagnosed, so unexplained joint or muscle symptoms can be a reason to test for the virus. Some of these problems come from HIV's effect on the immune system, while others can be side effects of the medications used to treat HIV, including gout and a reaction called immune reconstitution inflammatory syndrome that can occur after starting treatment. Could my joint or muscle pain be related to HIV, or to the medications I'm taking for it? Which specific rheumatic condition do you think is causing my symptoms, and how did you arrive at that diagnosis? Will starting or adjusting my antiretroviral therapy affect my joint symptoms one way or the other? Are anti-inflammatory medications or immunosuppressants safe for me to take given my HIV status? Would physical therapy help protect my joints and prevent them from becoming deformed over time? A rheumatologist can evaluate joint, muscle, and blood vessel symptoms in someone with HIV, working alongside the HIV specialist managing antiretroviral therapy. Seek care sooner if you develop a hot, swollen joint, new eye pain or redness, or muscle weakness that's getting worse, since these can need urgent evaluation. Source: https://rheumatology.org/patients/hiv-and-rheumatic-disease
Hyperimmunoglobulin D Syndrome / Mevalonate Kinase Deficiency
Rheumatology
Hyperimmunoglobulin D syndrome, also called mevalonate kinase deficiency, is a rare, inherited condition that causes children to have repeated episodes of fever along with symptoms such as abdominal pain, joint pain, mouth sores, and a body-wide rash. It's caused by a change in the gene responsible for an enzyme involved in normal cell function, and it can affect any child from infancy onward, though it's seen more often in children of European descent. The fever episodes come and go every few weeks, and while there's no cure, treatment can reduce how often and how severely they occur. What blood, urine, or genetic testing confirmed this is mevalonate kinase deficiency rather than another periodic fever syndrome? How long and how often should we expect these fever episodes to last? What can we give during a flare to manage the fever, mouth sores, and joint pain? If flares stay frequent or severe, would a medication that blocks inflammation, like anakinra or canakinumab, be appropriate? Is there any risk of long-term organ damage, and how will we monitor for it as my child grows? A pediatric rheumatologist experienced in periodic fever syndromes should confirm the diagnosis and guide treatment, since the condition needs specialized genetic and laboratory testing to distinguish it from other causes of recurrent fever. Seek care sooner if fever episodes become more frequent, more severe, or are accompanied by new symptoms that haven't occurred before. Source: https://rheumatology.org/patients/hyperimmunoglobulin-d-syndrome-hids-mevalonate-kinase-deficiency-mkd-juvenile
Hypermobility Syndrome
Rheumatology
Hypermobility syndrome describes joints that move beyond their normal range of motion without the inflammation seen in arthritis. It's more common in girls than boys, tends to run in families, and is seen more often in children with Down syndrome, though it can occur in any child. For most children it causes joint or muscle pain, especially after activity or at night, and while it's rarely a sign of a more serious connective tissue disorder, that possibility is worth ruling out. Is my child's joint pain caused by hypermobility, or could there be another cause we should look into? Should we test for a connective tissue disorder like Marfan or Ehlers-Danlos syndrome? What kind of physical therapy or exercises would help strengthen the joints and reduce pain? Would shoe inserts or other supports help with my child's flat feet or joint positioning? What activities or sports should we avoid or modify to prevent sprains and injuries? A pediatric rheumatologist can confirm the diagnosis through a physical exam and rule out other conditions with lab testing when needed, then guide a plan built around physical therapy, joint protection, and pain management. Seek care sooner if joint pain is accompanied by swelling, redness, or warmth, since those can point to inflammation rather than hypermobility alone. Source: https://rheumatology.org/patients/hypermobility-syndrome-juvenile
IgG4-Related Disease
Rheumatology
IgG4-related disease is a condition in which the immune system is abnormally regulated and causes inflammation and scarring in one or more organs, commonly the salivary and tear glands, thyroid, lungs, aorta, kidneys, pancreas, and bile ducts, among others. It typically affects middle-aged to older adults and is more common in men, though it can involve more than one organ at the same time and, rarely, occurs in children. Many people have few or no symptoms early on, so organ damage can build silently before the disease is caught, and in some organs it can look enough like cancer to complicate diagnosis. Which organs show signs of involvement, and how will we monitor them over time? Could this be something else, like cancer, and how did you rule that out? Why are you starting treatment with steroids, and what happens if the disease comes back after we taper the dose? Would rituximab be a better option for me than long-term steroids? Since this needs ongoing treatment, how often will I need follow-up visits and testing? A rheumatologist experienced in IgG4-related disease should coordinate diagnosis and treatment, often together with specialists for whichever organs are involved. Seek care sooner if you notice new swelling, jaundice, shortness of breath, or vision changes, since these can signal that another organ has become involved. Source: https://rheumatology.org/patients/igg4-related-disease-igg4-rd
Juvenile Arthritis
Rheumatology
Juvenile idiopathic arthritis is chronic arthritis that begins before age sixteen and can affect one joint or many. It's one of the more common chronic conditions in children, most often involving fewer than five joints and appearing somewhat more frequently in girls, though it takes several different forms with different patterns of joints, fevers, rashes, or eye inflammation involved. It generally isn't inherited, and with treatment many children with juvenile arthritis are able to go to school and stay active like their peers. Which type of juvenile arthritis does my child have, and how many joints are involved? Does this type put my child at higher risk for eye inflammation, and how often should we see an ophthalmologist? What treatment are you starting with, and would a biologic medication be appropriate if it isn't enough? How will physical or occupational therapy fit into my child's treatment plan? What accommodations should we request at school to help my child manage flares and joint pain? A pediatric rheumatologist should lead the diagnosis and treatment of juvenile arthritis, since the specific type shapes which medications and monitoring, like eye exams, are needed. Seek care sooner if your child develops a high fever with a rash that comes and goes, or sudden, severe joint swelling, since these need prompt evaluation. Source: https://rheumatology.org/patients/juvenile-arthritis