Professor Robert John Moots

Professor Robert John Moots
Rheumatology
Liverpool


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Professor Robert John Moots

Rheumatologist in
Liverpool

BSc (Hons) MBBS PhD FRCP

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Professional statement

Professor Robert John Moots is an award-winning consultant rheumatologist who specialises in inflammatory rheumatic diseases. He is Professor of Rheumatology at the University of Liverpool, where he leads cutting edge research into rheumatic diseases, and practices at Aintree University Hospital, Liverpool. Professor Moots has an international reputation for excellence in rheumatology care and is an expert in treating Behçet's syndrome. He is director of the National Centre for Behçet's Syndrome in Liverpool, and the European League Against Rheumatism (EULAR) Centre for Excellence in Rheumatology Research, Liverpool and provides regular consultancy advice to the UK National Institute for Health and Care Excellence (NICE) and the pharmaceutical Industry at a global level. 

After training in medicine in London, Professor Moots gained his PhD at the University of Oxford. Following this, he was lecturer in Rheumatology at the University of Birmingham, before moving to Harvard Medical School, USA to focus on research. He moved back to the UK to establish a new academic rheumatology unit in Liverpool. Whilst much of his time is dedicated to research, providing the highest quality of care for patients remains a priority, with regular referrals from the UK and other parts of the world. Professor Moots has been editor-in-chief of Rheumatology,  and a trustee of the British Society for Rheumatology.

 Videos of doctor

Behcet’s syndrome and its treatment

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 Credentials

GMC: ‍3068395

 Professional experience

• More than 35 years of experience
• Consultant Rheumatologist, University Hospital Aintree, Liverpool (1997 - present)
• Consultant Rheumatologist, private practice (present)

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 Sub-specialties

• Arthritis
• Behçet's syndrome
• Vasculitis
• Rheumatoid arthritis
• Ankylosing spondylitis
• Psoriatic arthritis
• Inflammatory arthritis
• Ankylosing spondylitis
• Seronegative spondyloarthropathies

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 Positions in public associations

• Director, National Centre for Behçet's Syndrome, Liverpool (2012 - present)
• Chair, NICE Quality Standards for RA (2014 - present)
• Trustee, British Society for Rheumatology (2009 - 2014)
• Editor-in-Chief, Rheumatology (2009 - 2015)
• Director: European League Against Rheumatism (EULAR) Centre of Excellence for Rheumatology Research, Liverpool 2015-2020
• Director: Rheumatology for All (USA)

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 Teaching posts

• Professor of Rheumatology, University of Liverpool (2002 - present)
• Visiting Professor: various major universities in South East Asia and Africa

 Education

• BSc (Hons), University of London (1983)
• MB BS (Dual Honours), University of London (1985)
• MRCP, Royal College of Physicians, London (1988)
• PhD, University of Oxford/CNAA (1992)
• FRCP, Royal College of Physicians, London (2000)

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 Publications and conferences

• More than 200 publications in renowned international journals and author of several book chapters for textbooks on rheumatological diseases.
• Invited keynote speaker at major international rheumatology meetings, on each continent (except Antarctica), each year, for more than 10 years.

 Prizes and awards

• Michael Mason prize for Rheumatology
• Heberden Round Medal 2018
• NHS National Clinical Excellence Award: Gold (awarded 2014, renewed 2019)

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 Professional membership

• British Society for Rheumatology
• Association of Physicians
• Fellow: American College of Rheumatology
• Christian Medical Fellowship

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Languages spoken

  • English

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Prof. moots is warm and welcoming, he immediately puts you at ease. his knowledge of his specialty is hugely reassuring. i was very happy to have found him.

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Thank you for your kind rating. I'm glad to have been of help and hope that all will be well for you

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Diseases, Medical Tests and Treatments

Arthritis

What is arthritis? Arthritis is a disease that causes inflammation of the membrane that covers the joints. There are more than 100 different types ...

Autoimmune diseases

What are autoimmune diseases? Autoimmune diseases are a group of conditions where healthy cells in the body are mistakenly attacked by the immune s ...

Behçet disease

Behçet's syndrome is an inflammatory disease that affects the blood vessels. It is a disease of unknown origin, defined as autoimmune, chronic, and sy ...

Inflammatory arthritis

What is inflammatory arthritis? Inflammatory arthritis is one of the two major sub-categories of arthritis (the other being osteoarthritis), an ...

Rheumatoid arthritis

Rheumatoid arthritis is a chronic, degenerative disease that causes inflammation in the joints. The areas most affected by this type of rheumatism are the wrists, fingers and toes, elbows, shoulders, hips, knees and ankles. The inflammation of the joint causes pain, deformity, and difficulty moving, as the cartilage wears away and the separated bones rub against each other. The cause of this disease is unknown and currently has no possible cure. The damage to bone and cartilage is irreparable, so the treatment of this condition seeks to relieve the pain and disability of patients, in addition to preventing permanent damage from occuring in the affected joints. ...

Vasculitis

What is vasculitis? Vasculitis is an inflammation of the blood vessels. It occurs when the immune system mistakenly attacks the blood vessels, whether because of an infection, medication, or another disease. This can limit blood flow and cause damage to organs and tissues. It can affect veins, arteries, and capillaries. When a blood vessel becomes inflamed it can: Make it difficult for blood to flow through, since the vessel becomes narrower Close completely, preventing the blood from flowing through Stretch and weaken so much that it bulges. This is known as an aneurysm, and if it bursts it can cause dangerous bleeding into the body. There are many types of vasculitis, but most are rare. However, vasculitis may affect one or more organs and may be long-lasting (chronic) or short-lived (acute). This condition can affect anyone, although some types of vasculitis are more common in certain groups of people and among those who suffer from particular diseases. Types of vasculitis include: Larger arteries (aorta and main branches): giant cell arteritis, Takayasu arteritis, spondyloarthropathy-associated aortitis, isolated aortitis and aortitis associated with Cogan syndrome Medium-sized arteries: polyarteritis nodosa and Kawasaki disease Small- and medium-sized arteries: ANCA-associated vasculitis, granulomatosis with polyangiitis, microscopic polyangiitis, primary vasculitis of the central nervous system and eosinophilic granulomatosis with polyangiitis Small arteries: lgA vasculitis (Henoch-Schönlein purpura), vasculitis associated with rheumatoid arthritis, vasculitis associated with systemic lupus erythematosus and Sjögren’s syndrome, anti-GBM disease (Goodpasture’s syndrome), cryoglobulinaemic vasculitis and drug-induced vasculitis Arteries and veins of different sizes: relapsing polychondritis and Behçet's disease.   Prognosis of the disease Vasculitis can be short-term or can last a lifetime. The principal aim of the specialists is to prevent the death or disability of the sufferer, as well as to prevent irreparable damage to vital organs and nerves. The symptoms of vasculitis can severely impair a person’s life (fatigue, pain, arthritis, etc.). In addition, the side effects of certain drugs can make the person more vulnerable to certain infections.   Symptoms of vasculitis The symptoms of vasculitis usually include fever, tiredness, headache, rash, night sweats, weight loss and local clinical manifestations in some parts of the body, as blood flow decreases. This leads to ischemia or visceral infarction due to blood vessel occlusion, causing abdominal pain, renal failure and neurological symptoms, among others.   Medical tests for vasculitis Diagnosis of the disease will be made with a tissue biopsy, blood tests and angiograms to detect abnormalities in the blood vessels. These tests will enable a diagnosis of the type of vasculitis based on blood vessel size and the organs affected.   What causes vasculitis? The exact cause of most types of vasculitis is unknown. It may be influenced by genetic factors and is also considered to be an autoimmune disease (the immune system attacks the body, in this case the blood vessels). It can also be caused by a reaction to certain drugs. Additionally, it can sometimes be associated with rheumatic diseases, such as systemic lupus erythematosus, rheumatoid arthritis and Sjögren's syndrome. Vasculitis can occur at any age and affect people of any race or gender. However, some factors can increase the risk of vasculitis, including: Having chronic hepatitis B or C Having an autoimmune disease such as scleroderma, lupus or rheumatoid arthritis Smoking   Treatments for vasculitis Vasculitis should be treated mainly with glucocorticoids (steroids). These are drugs that help reduce inflammation but may also have side effects. Immunosuppressive treatments, which are normally used to treat rheumatic diseases, are sometimes recommended, since they have less serious side effects. Vasculitis can cause serious damage to some parts of the body. In such cases, surgery may be recommended. The intervention will depend on the location and severity of the damage. A revascularisation graft (surgery to bypass the affected area of the blood vessel) may be helpful, as may sinus surgery or a kidney transplant.   Which specialist treats it? It is usually rheumatologists who treat vasculitis, focusing on people with chronic diseases affecting the joints and connective tissues. However, anyone who has vasculitis should also consult specialists who treat the specific organs affected. They can also be seen by specialists in vascular surgery, internal medicine, dermatology, neurology, ophthalmology, otorhinolaryngology, or nephrology.   ...

Fibromyalgia

What is fibromyalgia? Fibromyalgia is a chronic disease that causes pain throughout the body and sensitivity in joints, muscles, tendons and other soft tissues. It is more common in women between the age of 20 and 50. What are the symptoms? Fibromyalgia causes fatigue and muscle pain throughout the body, headaches, IBS (irritable bowel syndrome), increased pain sensitivity, problems with memory and concentration, and can affect sleep patterns and overall amount of sleep. There are different conditions related to fibromyalgia or those which have the same symptoms. Sleep disorder, Lyme disease, chronic fatigue syndrome, and hypothyroidism, among others, may cause similar symptoms. It is important to visit your doctor and if necessary, get specialist referral in order to correctly confirm a diagnosis after assessment. Causes of fibromyalgia The origin of fibromyalgia is unknown, but several factors can trigger its appearance, such as a physical or emotional trauma, a bacterial or viral infection or a disease such as rheumatoid arthritis. Can it be prevented? There is no known way to prevent fibromyalgia. What is the treatment? The treatment of fibromyalgia is aimed at relieving pain and combatting sleep disorder with drugs and relaxation techniques. Therapy, counselling and support is also beneficial in those with fibromyalgia, as talking about the condition and receiving therapy can help to counter depression, sometimes experienced in those with fibromyalgia. Exercise has been shown to be beneficial for those with the condition, and it can also help to reduce pain. Speak to your GP or specialist about recommendations for exercise, and referral for therapy if necessary. Many also find it beneficial to speak to a psychologist as part of their ongoing treatment. ...

Gout

What is it?     Gout is a type of arthritis that appears when there is a build-up of uric acid in the blood which causes joint swelling. If urate serum levels exceeds the physiological zone of saturation (around 7.6 mg/dl), monosodium urate crystals form and are stored in the cartilage and periarticular tissues of the peripheral joints. From a clinical perspective, the continued deposit is silent and almost 10% of patients have hyperuricemia, which will more than likely lead to clinical gout. Acute gout is a very painful condition that affects just one joint. Chronic gout involves multiple attacks and quite often more than one joint is affected.    Disease prognosis If the disease is diagnosed at the onset of symptoms then the affected person can lead a normal life if they follow the prescribed treatment correctly. For older people affected by gout, reducing uric acid levels in the blood could help the tophi disappear and improve joint movement. Broadly speaking gout has more complications when symptoms develop before the age of 30. Metabolic syndrome and heart disease contribute to early death in people with gout. Some treatments are less effective for patients, sometimes the reason is due to lack of monitoring the treatment, low doses of medications, or alcoholism. What are the symptoms? Acute gout symptoms include: Only some joints are affected. The joints that tend to be affected are the big toe, the knee, or the ankle.  In many cases the pain come on suddenly at night. It is an intense pain and has been described as throbbing and unbearable. The joint is hot and red. It tends to be quite sensitive and swollen (pain can be felt even by putting a bed sheet or cushion on it). A fever may develop. The attack may subside after a few days, but it can intermittently return. Additional attacks tend to last longer. After the first attack, gout patients don’t normally have any symptoms. However, many people will have another attack in the following 6 to 12 months. Some patients may develop chronic gout, also known as gouty arthritis. This type of gout can cause joint damage and loss of joint movement. People with this kind of gout quite often have joint pain and other symptoms most of the time. Tests for gout There are several medical tests to diagnose gout, including: Synovial fluid analysis Uric acid in the blood Joint X-ray Synovial biopsy Tetsing for uric acid in the urine    A level of uric acid higher than 7ml/dl in the blood is deemed high.  However, not everyone with high levels of uric acid has gout.   What causes it? Gout is caused by higher than normal levels of uric acid. This happened when the body produces too much uric acid or when the body is unable to get rid of the uric acid. When there is too much uric acid in the fluid around the joints, that’s when uric acid crystals form. These cause joint swelling and pain as well as an increase in temperature in the surrounding area.  The cause of gout remains unknown. The disease is thought to be hereditary and men, postmenopausal women, and alcoholics are more susceptible to it. As a person ages, their chances of developing gout increases. People with the following diseases have a higher chance of developing gout: Diabetes Kidney disease Obesity Sickle cell anaemia and other types of anaemia Leukaemia and other blood cancers.   Gout may also develop after taking medications that prevent the elimination of uric acid. People who take medications such as hydrochlorothiazide and other diuretics are more likely to have higher levels of uric acid in the blood. How can it be prevented? It is thought that gout can’t be prevented, however there are certain risk factors that can make symptoms appear. Taking medications to reduce levels of uric acid can prevent gout from progressing. What is the treatment?   It is recommended that the patient see a specialist and start taking the medication for gout as soon as possible to lessen symptoms if having an attack. Anti-inflammatory medications such as ibuprofen and indometacin are also recommended. If symptoms worsen, the dose should be increased. The patient will need different types of medication if they have: Several attacks the same year or high intensity attacks Joint damage Tophi Kidney disease or kidney stones Another effective treatment is to make diet and lifestyle changes to avoid gout attacks: Reduce alcohol consumption, especially beer Lose weight Exercise regularly Reduce consumption of red meat and sugary drinks Eat healthily, for example dairy products, vegetables, nuts, pulses, fruits, and whole grains (ones with less sugar)  Drinking coffee and taking vitamin supplements can help some people. What specialist should I see? The specialist who treats gout is a rheumatologist. They are often also the specialist responsible for correctly diagnosing the patient and starting them on a treatment which could reduce uric acid levels in the blood so that the urate crystals dissolve. Rheumatologists believe that gout can be cured, and to achieve this the levels of uric acid in your blood should be enough to dissolve the crystals. The symptoms should disappear and there shouldn’t be any long term damage to joints.        ...

Hand arthritis

What is osteoarthritis of the hand? Osteoarthritis is a degenerative joint condition, resulting in join pain, stiffness, and swelling. It can affect any joint in the body, including those in the hand. It most commonly occurs in the wrist, fingertips (DIP joint), middle knuckle (PIP joint), and the basilar joint (which connects the thumb and wrist). Osteoarthritis is where the cartilage that cushions the bones at the joints wears away, which causes the bones to rub against one another, leading to inflammation, stiffness and pain.   What are the symptoms of hand arthritis? The symptoms of osteoarthritis include: Pain – located around a joint or part of the hand, e.g. thumb, wrist, knuckle Stiffness – this can make it difficult to perform tasks such as using a phone or buttoning a shirt. Weakness – the patient may find it difficult to grip or pinch. It may hinder tasks like opening jars or turning the key in a car’s ignition. Nodes – bony growths that can develop where the bones have been rubbing. Heberden’s nodes develop on the end knuckle (the DIP joint), while Bouchard’s nodes develop on the middle knuckle (PIP joint). Bone spur   What causes hand arthritis? Osteoarthritis of the hand occurs due to gradual wear and tear of the joint, which results in the cartilage wearing away. The cartilage is responsible for cushioning the bones and allowing smooth movement. Without it, the bones rub together, and movement becomes stiff. The exact cause of the initial deterioration is unknown.   Risk factors More women develop osteoarthritis than men. Patients born with defective cartilage or malformed joints are also at increased risk. Other risk factors include: Old age Hand injuries Jobs requiring a lot of hand work, e.g. manufacturing jobs A family history of osteoarthritis   What is the treatment? Osteoarthritis is a progressive disease, meaning there is no cure, and it will continue to get worse over time. However, it can be managed and its symptoms can be treated with a number of different methods: Pain medication – this is directed at relieving the symptoms of pain and inflammation. Over-the-counter anti-inflammatories are usually sufficient, but in extreme cases your doctor might prescribe something stronger. Exercises – simple exercises, such as touching your thumb to each fingertip, making a fist and then unfurling the fingers, or walking your fingers up and down a wall can help maintain flexibility in the hands Hot and cold compresses Splints for support on the digits or wrist Using tools designed to help people with arthritis Surgery – if osteoarthritis doesn’t respond to other treatments, there are surgical options. This could mean fusing the bones on either side of the arthritic joint together, limiting movement, but also limiting pain and inflammation. The other option is to reconstruct the joint, transplanting soft tissue from other parts of the body to replace the lost cartilage.  ...

Joint injections

Joint injections are a treatment against joint pain that involves the injection of anti-inflammatory drugs and analgesics to improve joint mobility. It is a quick and simple technique, is minimally invasive, and produces longer-lasting effects compared to those obtained through a drug administered orally or intramuscularly.  ...

Knee osteoarthritis

What is osteoarthritis of the knee? Osteoarthritis of the knee is a disease which mainly consists of a tearing of the articular cartilage, and it can be progressive. The disease is not exclusive to old age, however, the frequency of affliction increases with age. It is also more common in women than in men, and in people who are genetically predisposed to it. Although many of these factors are not preventable, it is possible to slow down its progression or to reduce the chances of it developing. There are two types of knee osteoarthritis: primary knee osteoarthritis, which is related to age, and secondary knee osteoarthritis, which occurs after a previous injury, such as a fracture and affects people with high levels of strenuous physical activity or those who are obese. Prognosis of knee osteoarthritis Although osteoarthritis is generally not a serious disease, it can gradually undermine the quality of life of those affected. Prognosis of the disease depends greatly on the pathology and its evolution. Early diagnosis and joint protection measures are key in helping to slow the progression and development of the disease. Pain and a lack of mobility are the main factors that have an impact on the person’s quality of life, causing it to decrease. The disease mainly affects people over the age of 50. It can make them more sedentary, which can result in obesity and the appearance of risk factors for conditions such as cholesterol, hypertension and diabetes, among others. Symptoms of knee osteoarthritis: The symptoms and manifestations of osteoarthritis are diverse, progressive and appear gradually over time. The most common symptom is joint pain with limited joint movement, accompanied by cracking sounds and sometimes knee joint effusion (also known as ‘water on the knee’). Some people may experience stiffness or joint deformity. The worst symptom is pain. In the early stage of the disease, pain occurs when you move or try to force the affected joint, and it subsides when you rest. As the disease progresses, pain can occur not only when you move the joint but also when it is being rested. However, joint pain is not constant, so you can go for long periods of time without any pain, although the disease continues to progress. How is knee osteoarthritis diagnosed? Osteoarthritis can be difficult to diagnose. Firstly, it should be noted that it cannot be diagnosed by X-ray, so a thorough medical history must be taken and a physical examination performed. If there is swelling in the knee, the specialist may decide to remove fluid from the joint to test it and to confirm the diagnosis. In addition to X-rays, a CT or MRI scan may also be used to diagnose knee osteoarthritis. What causes knee osteoarthritis? The cause of osteoarthritis is still unknown. However, there are a number of risk factors associated with its occurrence: Gender: osteoarthritis affects women between the ages of 50 and 55 in particular. Age: the risk of osteoarthritis increases after the age of 50 Genetics: it may be an inherited disease Strenuous physical activity: constant repetition of joint movements can lead to joint overload Menopause: decreased oestrogen levels are a risk factor for the development of the disease Obesity: this can aggravate osteoarthritis in joints such as the knees Trauma: fractures and injuries can trigger osteoarthritis. Can knee osteoarthritis be prevented? The main measures for preventing the onset of osteoarthritis are simple: eat a healthy, balanced diet and take regular, moderate physical exercise according to your age and physical condition. You should limit strenuous physical exertion, such as lifting or carrying heavy objects. Contact sports such as football and rugby are not recommended for people with osteoarthritis, as they can exacerbate the disease. Footballers are one of the groups most affected by this disease due to frequent meniscus injuries. Treatment for knee osteoarthritis The main objective of treatment for osteoarthritis is to improve pain and functional disability. The first step is awareness, as avoiding risk factors is essential for preventing or minimising the disabling effects of the disease. You will also have a personalised and adapted exercise regimen which you need to follow with the physiotherapist to help improve your condition. Anti-inflammatories: sometimes pain is severe due to inflammation of the area. In this case, anti-inflammatory drugs may be prescribed to reduce inflammation and relieve pain. Chondroprotective drugs: these are specifically indicated for the long-term treatment of osteoarthritis, as they act directly on the joint. They relieve pain and improve mobility, as well as attack the disease at the root by slowing its progression. Chondroprotectors include glucosamine and hyaluronic acid. Surgery: implant surgery will be recommended if the disease is very advanced; in this case, a partial or total knee implant. Which specialist treats knee osteoarthritis? There are several specialists that can treat knee osteoarthritis, including orthopaedic surgeons, rheumatologists and physiotherapists. ...

Lupus

What is lupus? Lupus is a disease that damages the immune system; that is, your own immune system mistakenly attacks healthy cells and tissues. This can cause damage to many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain. There are different types of lupus: Systemic lupus erythematosus: This is the most common type and it may be mild or acute and can damage many parts of the body. Discoid lupus: This type of lupus causes a rash on the skin that won't go away. Subacute cutaneous lupus: Causes blisters after exposure to the sun. Drug-induced lupus: This is caused by some medications. The disease usually disappears when you stop taking the medication in question. Neonatal lupus: This affects newborns, but it is not common. It may be caused by certain antibodies in the mother’s body. Prognosis of the disease: We have not yet found a cure for lupus; a disease that can still be fatal for some. However, if treatment is successful it is rare for a person to die from lupus. Around 80-90% of people diagnosed with lupus live for more than 10 years after learning they have the disease. In addition, people who have some organs affected by the disease, but whose life is not at risk, usually live a completely normal life if they follow the advice of their specialist, which is to take prescription medications and to seek help if there are undesirable side-effects, or if new symptoms of the disease appear. Symptoms of lupus: Lupus can have a variety of symptoms depending on the individual. The most common symptoms are: Pain or swelling in the joints Muscle pain Fever Red rashes on the skin, mostly on the face and in the form of a butterfly Chest pain when breathing deeply Hair loss White or purple fingers or toes Sunlight sensitivity Swelling in the legs or eye area Sores in the mouth Swollen glands Feeling of tiredness. These symptoms can be intermittent and are referred to as “outbreaks”. These outbreaks may be mild or severe and new symptoms may appear at any time. Medical tests for lupus: As with the symptoms, there is no single test to diagnose lupus, because it can sometimes be confused with other diseases. It can take months or years for a specialist to diagnose lupus. Some of the medical tests that the specialist may use to diagnose lupus include: A detailed evaluation of someone’s medical history Full physical examination Blood tests Skin biopsy Kidney biopsy What causes lupus? The cause of lupus and its risk factors are currently unknown. Anyone can get lupus, but women are at a higher risk for the disease. Lupus is two to three times more common in African-American women than in white women. Hispanic, Asian and Native American women are also more likely to develop lupus. African-American and Hispanic women are more susceptible to the most severe types of lupus. Can lupus be prevented? Lupus can occur without any symptoms, so it is difficult to know if it can be completely prevented during a person's lifetime. The best thing you can do to reduce the chances of developing lupus is to follow a balanced diet and to exercise regularly, i.e. have a healthy lifestyle. Taking care of your diet: By eating the right foods and eating a healthy diet you can prevent inflammation of the organs, which is one of the main symptoms of lupus. Exercise: Staying active and avoiding a sedentary lifestyle can help you build strength, control your weight and even improve your mood. Check with your specialist about the type of exercise you can do, because the organs affected by lupus could complicate the practice of some exercises. Take supplements: These can add nutritional value to your diet and can also help reduce inflammation throughout your body. Krill oil, for example, contains nutrients that can improve your cardiovascular health if taken regularly. Treatments for lupus: There is no treatment to cure lupus, but medication and lifestyle changes can help control the disease. The aims of each treatment are to: Prevent outbreaks Treat symptoms as soon as they appear Reduce organ damage and other problems. Treatments may be accompanied by medication for: Reducing inflammation and pain Preventing or reducing outbreaks Boosting the immune system Preventing or reducing joint damage Balancing hormones. In addition to taking medicine for lupus, you may need to take medicine for other problems related to lupus, such as high cholesterol levels, high blood pressure, or infections. There are alternative treatments that take a completely different path to conventional treatments. However, there is currently no medical research regarding current, useful alternative therapies to combat lupus. Some alternative or complementary approaches may help improve the quality of life of those with a chronic illness like this. Before undertaking any alternative treatment, you should consult a specialist. Which specialist treats lupus? People with lupus will see several different doctors. Including, a primary care doctor, dermatologists, cardiologists, pain specialists, to name a few. ...

Osteoarthritis

What is osteoarthritis? Osteoarthritis is a degenerative conditions that affects the joints, causing them to become stiff and causing pain. Any of the joints in the body can be affected, but it more commonly affects the hips, knees, and small joints in the hands. It affects women more commonly than it does men, and is the commonest form of arthritis in the UK.   What are the symptoms of osteoarthritis? The most common symptoms of osteoarthritis are joint pain, difficulty in mobility, and stiffness or deformity in the joints. These symptoms vary depending on the patient and intensify in a progressive manner. Joint pain, the most common symptom, appears first with movement and ceases with rest, but as osteoarthritis progresses, the pain may also be present while resting. What are the causes of osteoarthritis? The causes of the onset of osteoarthritis are not currently known but there are a number of risk factors associated with it: Genetics: In more than 60% of cases, genetic inheritance influences the appearance of osteoarthritis. Physical activity: athletes and people who maintain high physical activity have a higher risk of suffering from osteoarthritis. Working day: those who perform repetitive joint movements in their working day can wear down the joints and overload them, which can trigger osteoarthritis. Menopause: osteoarthritis more commonly affects women who have reached menopause due to the decrease in oestrogen that occurs during this stage of life. Injuries: fractures and traumas in the joints can influence osteoarthritis. Obesity: although it does not directly cause the onset of osteoarthritis, obesity influences wear and tear of the joints and therefore the progression of the condition. Prevention of osteoarthritis To avoid risk factors and therefore prevent osteoarthritis, it is very important to eat a balanced diet, such as the Mediterranean diet, and perform regular moderate exercise, thus avoiding wear and tear of the joints. Avoiding obesity is important as carrying too much weight can be detrimental. Treatment of osteoarthritis The objective of the treatment is to avoid or reduce pain and improve mobility. To treat osteoarthritis, the medical specialist will recommend the patient a series of exercises to be performed which are adapted to their situation and abilities, often with the help of a physiotherapist. Pharmacological treatment: In most cases anti-inflammatories or analgesics are prescribed to reduce swelling and therefore pain. Chondroprotective medications may also be prescribed which may slow the progression of the disease. Surgical treatment: osteoarthritis in very advanced stages may require prosthetic surgery. ...

Polymyalgia rheumatica (PMR)

Polymyalgia rheumatica, often called PMR, is a disease that causes pain, stiffness and limitation of mobility in the neck, nape of the neck, shoulders, arms, hip, torso, pelvic girdle and thighs. This condition, of unknown origin, is only suffered by people over 50 years of age. The pain, which does not cause swelling, appears after resting, usually at night. Inactivity, such as a long drive or sitting in the same position for a long time can cause the stiffness to come back. In addition, it is very common for patients to have problems lifting the upper arms above the shoulders. Today the most effective treatment for PMR is low doses of corticosteroids. ...

Psoriatic arthritis

Psoriatic arthritis is a rheumatic disease that causes inflammation in the joints. This pathology is associated with a chronic condition of the skin called psoriasis and it usually appears after cutaneous lesions do. It rarely manifests simultaneously or precedes the dermatological lesions. In addition, this pathology usually affects the joints of the fingers and toes, which become inflamed and lose functionality. The evolution of the disease can deform and destroy the aforementioned joints. Treatment consists of alleviating symptoms with nonsteroidal anti-inflammatory drugs and modifying and stopping the disease with immunosuppressants. It is also important to rest during the periods of inflammation and do some physical rehabilitation. When psoriatic arthritis affects children, the disease is included in the category of juvenile arthritis, which presents various clinical modalities such as juvenile idiopathic arthritis or rheumatoid arthritis in children, and reactive arthritis in children, among others. ...

Rheumatism

What is rheumatism?   Rheumatism was the common name given to musculoskeletal disorders that affect one or more structures such as ligaments, tendons, muscles and bones. The term is no longer used by medical professionals, yet words similar to rheumatism such as rheumatoid and rheumatology are still in use. Today, doctors are much more specific in their diagnoses regarding rheumatic diseases and do not use the term rheumatism as a diagnosis but as a category of conditions, such as rheumatoid arthritis.   Rheumatism is a general term, which describes a number of different conditions that produce similar symptoms. Overall, rheumatic conditions are caused by the wear of articular cartilage, inflammation of a joint or bone decalcification. Rheumatic pain may occur from the same joint or from structures around it, such as muscles, tendons, etc. It can also appear solely in the joints or produce pain so persistent that it can affect the quality of sleep.   What are the rheumatic symptoms? Rheumatism is a broad category but there are several fundamental symptoms among all conditions, which include: • Pain in hands, fingers, shoulders or knees • Stiffness, swelling and tenderness in joints and muscles • Redness and warmth in muscles • Lack of mobility in specific joints and muscles   What are the different types of rheumatic diseases? There are over 100 types of rheumatism and each has varying symptoms and treatment options. Overall, rheumatic conditions affect the musculoskeletal system. Some of the most common conditions are: • Rheumatoid arthritis • Osteoarthritis • Rheumatic fever • Juvenile Rheumatoid Arthritis • Rheumatic heart disease • Gout • Fibromyalgia • Lupus   How is rheumatism diagnosed? It is difficult to diagnose rheumatic conditions because the symptoms tend to crossover between the different types. The patient will have a physical examination and be asked specific questions about their symptoms. There may also be blood tests and imaging scans too.   How is rheumatism treated? Treatment is much more effective of the condition if it is diagnosed as early as possible. A specialist doctor called a rheumatologist, will advise of the best treatment option. Treatment options may include non-steroidal anti-inflammatories to reduce inflammation and pain. Patients should continue with exercise to maintain mobility and a healthy diet is recommended.   ...

Scleroderma

Scleroderma is an autoimmune disease that causes hardening of the skin and changes in blood vessels, muscles and internal organs. The origin of the disease is unknown, but infected patients show the accumulation of a fibrous protein (collagen) in the skin and other organs. The main symptom of scleroderma is swelling and hardening of the skin, and inflammation and scarring in many parts of the body that cause problems in other organs. The disease can be severe and even cause death, or mild in which case it affects just certain parts of the body. Therefore, we differentiate between two types of scleroderma. One is localized scleroderma, which only affects parts of the skin, usually the hands and face. The other is the systemic scleroderma, which can affect the whole body (skin, oesophagus, lungs, and heart). The systemic scleroderma is subdivided into two types: diffuse scleroderma and limited scleroderma or CREST syndrome, which presents five typical features: calcinosis, Raynaud’s syndrome, oesophageal dysfunction, sclerodactyly and dilation of small vessels. Treatment of the disease depends on the type and severity of symptoms. ...

Second medical opinion

What is a second medical opinion? A second medical opinion is when you consult with a doctor that is not your regular doctor about a potential diagnosis and/or treatment plan. There is no legal right to a second opinion, however, it is rare for a doctor to refuse. Why would you get a second medical opinion? Patients may consider a second medical opinion if they are facing a new diagnosis or recommended treatment because sometimes this can feel confusing and a second opinion can put their mind at ease. In addition, there are certain situations where a second medical opinion is sought after: Potential treatment is risky and could be life-changing or the diagnosis is possibly life-threatening The diagnosis is not clear-cut If you are considering a new treatment approach that is experimental The aims of obtaining a second medical opinion are: To confirm whether a diagnosis is correct and/or appropriate. To confirm whether a suggested treatment is correct and/or appropriate. To compare information received from each doctor so that you can make an informed decision – sometimes a second medical opinion can rule out the need for a potentially unnecessary invasive procedure. Possible disadvantages of seeking a second medical opinion include: The process can delay the start of treatment. Logistically, seeing another specialist might be difficult and possibly time-consuming. It might be stressful to hear the same diagnosis again. How would you seek a second medical opinion? You can request a second medical opinion from your GP or consultant, but before doing so it is recommended that you ask for as much clarification and explanation about the initial diagnosis and treatment, before seeking a second opinion. Obtaining a second medical opinion does not mean that the second doctor will then take over – if that is what the patient decides, then this needs to be agreed formally between doctors and hospitals.  ...

Septic arthritis

Septic arthritis, also known as infectious arthritis or bacterial arthritis is characterized by a bacterial infection in the joint space. This causes pain and swelling. ...

Sjogren's syndrome

What is Sjögren’s syndrome? Sjögren’s syndrome is a disease that affects moisture-producing glands of the body. Specifically, it is an autoimmune disorder (meaning the immune system attacks the cells of its own body) in which the tear- and saliva-producing glands are destroyed, leading to dry mouth and eyes. The syndrome can also affect other parts of the body, including the joints, blood vessels, digestive organs, nerves, kidneys and lungs. Very often, it dries out other parts of the body that need to remain moist, such as the nose, the skin and the throat. It is classified as a rheumatic disease affecting joints, tendons, ligaments, bones and muscles. The syndrome generally affects people aged over 40 years. Sometimes, it is linked to diseases such as rheumatoid arthritis and lupus. Prognosis Dental and ophthalmic damage can be prevented and symptoms can also be treated. Serious problems affecting internal organs are rare; if they do occur, the physician can change the treatment to control inflammation and prevent damage. Patients with Sjögren’s syndrome have a higher probability of developing cancer of the lymph glands; nevertheless, if detected in time, this cancer can be treated effectively. Symptoms Sjögren’s syndrome can cause many different symptoms. The main symptom is dry eyes; the patient may feel a burning, stinging or gritty sensation in their eyes. Other possible symptoms are blurred vision or sensitivity to intense light, specifically fluorescent light. Dry mouth; the patient may feel like they have chalk in their mouth or that it is full of cotton. The patient may also experience difficulties swallowing, talking or distinguishing the flavour of foods. The syndrome may also affect other parts of the body such as: the skin; joints; lungs; kidneys; blood vessels; organs of the digestive system; nerves. Some of the possible symptoms are: dry skin; rash; chronic dry cough; thyroid problems; muscle and joint pain; vaginal dryness; numbness and tingling sensation in the arms and legs; fatigue. Medical tests The specialist will begin with a full physical examination to detect dry eyes and mouth, and possible presence of mouth ulcers, deterioration of teeth and inflammation of gums, due to dry mouth. The specialist will also examine your mouth looking for a possible fungal infection. Similarly, the specialist will look out for an allergic reaction on the skin; the pulmonary examination may present abnormal results; abdominal palpation may be performed to detect possible liver enlargement. Joints may be examined to detect possible arthritis and examination of the nerves may reveal abnormalities. Here are some of the tests that the specialist may perform: Full blood chemistry with liver enzymes Complete blood count Urinalysis Examination of antinuclear antibodies (ANAs) Rheumatoid factor Cryoglobulin test Complement levels Protein electrophoresis Hepatitis C test Thyroid function tests Schirmer test to evaluate tear production Biopsy of salivary glands Skin biopsy if a skin allergy is present Examination of the eyes Chest X-ray What are the causes of Sjögren’s syndrome? Currently, the cause of Sjögren’s syndrome is unknown. As previously mentioned, it is an autoimmune disorder in which the body attacks itself. The disease is rare in children and occurs most commonly in women aged 40 to 50 years. The primary form is defined as dryness of the eyes and mouth without any other autoimmune disorder. The secondary form is the form that occurs in association with another autoimmune disorder, specifically: Rheumatoid arthritis (RA) Systemic lupus erythematosus Scleroderma Polymyositis Hepatitis C may affect the salivary glands and resemble Sjögren’s syndrome Treatments The primary aim of treatment is to relieve symptoms. Eye dryness can be treated with artificial tears, eye creams or liquid ciclosporin. If a Candida infection occurs, it can be treated with sugar-free nystatin or miconazole. In addition, tiny plugs may be placed in the tear drainage ducts so that tears remain in the eye longer. Other measures you may take to relieve symptoms are: Take sips of water throughout the day Instead of regular chewing gum, make sure you chew sugar free versions Avoid medications that may cause mouth dryness, such as antihistamines or decongestants Avoid alcohol Mouthwashes to replenish mineral salts in the teeth Saliva substitutes Drugs that help the salivary glands produce more saliva Brush your teeth and use dental floss frequently, to prevent tooth decay due to dry mouth Visit your dentist regularly for check-ups and cleaning Which specialist treats it? The rheumatologist is the specialist that diagnoses and treats musculoskeletal diseases and systemic autoimmune diseases. Rheumatologists treat a wide range of complex diseases affecting the locomotor apparatus and also possibly affecting other organs and tissues such as the skin, eyes, and nervous system. ...

Spondylitis

Spondylitis, also known as ankylosing spondylitis, rheumatoid spondylitis and morbus Bechterew, is an inflammatory joint disease of the spine and sacroiliac (at the junction of the pelvis to the spine). The first symptoms of the disease are back pain and stiffness, which can also affect the cervical and dorsal spine, pain or swelling in the buttocks. The consequences are loss of mobility and progressive joint deformity, and some patients have eye inflammation and abnormal heart valves. Besides, sometimes spondylitis precedes another inflammatory bowel disease. Currently there is no cure but there are treatments that combine medication and physical therapy to alleviate the symptoms and slow down the progression of the disease. Spondylarthropathies ...

Systemic sclerosis

  Systemic sclerosis or scleroderma is a mixed connective tissue disease affecting skin, internal organs, joints and blood vessels. The main symptom of systemic sclerosis is swelling and hardening of the skin, and inflammation and scarring in many parts of the body that cause problems in organs like the heart, lungs, or kidneys, among others. The disease can occur in severe form resulting in death, or mild form in which it manifests itself only in a localized way. Thus, there are two main types of MS. The first is localized scleroderma, which affects only the skin, causing discolored areas, thick grooves or slots, and the second is systemic scleroderma which affects the skin, blood vessels and internal organs. In localized scleroderma there is a variety called linear morphea that occurs most often in children and can cause functional impairment, joint contractures, deformity and neurological manifestations. Treatment of the disease depends on the type and severity of symptoms. ...

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