Rheumatology

UChicago Medicine rheumatologists are at the forefront of understanding and treating rheumatic conditions, from the most common to the most complex.

Rheumatologists are internal medicine or pediatric specialists who have received special training to diagnose and treat rheumatic diseases, including injuries and disorders of the musculoskeletal system and systemic autoimmune conditions.

Autoimmune conditions occur when the immune system mistakenly attacks healthy cells in the body. This can cause damage to joints, muscles and almost all other organs in the body including the liver, heart, kidney, eyes and brain. Reflecting the widespread damage that autoimmunity can inflict, symptoms of autoimmune diseases range from fatigue, rash and joint pain to seizures and heart failure.

Rheumatic diseases may be treated with a combination of prescription medicine, joint surgery and/or physical and occupational therapy. When rheumatic diseases affect the heart or other organs, additional physician specialists may need to be consulted. One of the benefits of seeking care at an academic medical center like UChicago Medicine is that all the experts you need are available and regularly consult with one another. 

Signs and Symptoms of Rheumatic Disease

While rheumatic diseases have differing symptoms, many can affect the joints. Common symptoms in the joints may include:

• Pain
• Loss of motion
• Swelling, redness or warmth
• Stiffness
• Chronic pain

If symptoms do not get better over a short period of time, you should make an appointment with your primary care physician. They will refer you to a rheumatologist for evaluation if there is concern about a possible rheumatic condition. It is best to get a referral right away if symptoms are getting worse quickly, or if your relatives have autoimmune or rheumatic disease, because the disease can run in families. If a patient ignores symptoms of joint pain or does not seek treatment over a period of time, permanent joint damage can occur.

Causes of Rheumatic Disease

Experts don’t know what causes most types of rheumatic disease, but researchers believe these factors may have an influence:

• Genetics and family history
• Environmental triggers
• Lifestyle choices, such as diet, smoking, or drug and alcohol use
• Infection
• Trauma
• Metabolic problems
• Wear and tear or stress on a joint or joints

Diagnosing a Rheumatic Disease

Rheumatic diseases can be complex and difficult to diagnose. Rheumatologists gather a patient’s medical and family history, and complete a physical exam to look for signs and symptoms of inflammation throughout the entire body. They look at the results of prior testing, and order additional laboratory tests to determine if there is any inflammation and/or extra antibodies in the bloodstream. They also may use radiographic testing such as X-ray, ultrasound, CT scan or MRI to see if there are any musculoskeletal abnormalities.

This thorough evaluation is used to identify the source of a patient’s symptoms and to develop a personalized treatment plan. Several visits may be necessary for the rheumatologist to fully understand what is going on in the patient’s body.

The patient’s prognosis may vary with the type of rheumatic disease. Some require ongoing medical attention and/or limit activities of daily living, while others last for a much shorter period, especially if treated properly and promptly.

Treatment and Medical Options

Treatment recommendations may include:

• Medications to treat the disease, such as corticosteroids, disease-modifying anti-rheumatic drugs, biologics and janus kinase inhibitors
• Medications that help with pain and discomfort, such as oral and topical analgesics, and nonsteroidal anti-inflammatory drugs (NSAIDs)
• Injections in the affected joints/tendons
• Referral to physical therapists or other specialists
• Lifestyle modifications such as regular exercise, a healthy diet, stress management and rest

During follow-up appointments, rheumatologists may talk with patients about coping mechanisms, techniques for preventing disability or regaining function and ways to improve their quality of life.

Second Opinions for Rheumatic and Autoimmune Diseases

We welcome the opportunity to provide a second opinion on your diagnosis or treatment plan. Our specialists can offer solutions not widely available at most hospitals and are dedicated to helping you understand your options so you can select the best care plan for your needs.

If you live outside of Chicago, you can access the expertise of our specialists without having to leave home through our remote second opinions program.

Research

We are committed to providing the most advanced care for our patients and to developing new knowledge concerning diagnosis and treatment. Our rheumatologists are involved in a wide array of clinical research projects, giving our patients the chance to participate in studies of new treatments. Their scientific advances are readily and regularly incorporated into patient care.

Our research activities extend from laboratory-based, basic science investigations to patient care initiatives aimed at improving diagnosis and treatment.

Our rheumatology research laboratories are supported by federal agencies (such as the National Institutes of Health) and private foundations (such as the Arthritis Foundation). The Gwen Knapp Center for Lupus and Immunology Research at the University of Chicago provides important support for the study of autoimmune disease.

Current and recent testing of therapies developed at UChicago Medicine include studies aimed at modifying the course of diseases such as rheumatoid arthritis, psoriatic arthritis and scleroderma. Patients also are involved in studies on systemic lupus, osteoarthritis, gout and inflammatory muscle disease.