Areas of Specialty

Areas of Specialty
Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic type of inflammatory arthritis. Early symptoms of RA include fatigue, joint pain, and joint stiffness. As it progresses, rheumatoid arthritis symptoms may feel like the flu with muscle aches, severe fatigue and loss of appetite. Early and effective rheumatoid arthritis treatment can not only improve the prognosis but can prevent joint destruction and deformity associated with the disease.


Osteoarthritis (OA) is extremely common affecting over 80% of those over 65 years of age. Typical causes of OA can include age, obesity, previous injury and overuse of joints. Pain, stiffness and swelling can occur as a result of changes to the cartilage and bone. Patients commonly complain of creaking and locking of joints. OA may affect any joint, including the hand, wrist, neck, back, knee and hip. As the disease progresses, associated muscles atrophy and ligaments become weak and lax. Sometimes underlying medical illnesses can cause OA and treatment of the underlying disorder can frequently help ease pain and suffering.


The Spondyloarthropathies are a group of inflammatory arthritic disorders that typically do not make antibodies like some other autoimmune diseases. They can occur spontaneously, in reaction to recent or previous infection and affect people of all ages. The classic disease described is Anklyosing Spondylitis that primarily affects young men but there are many different subtypes. Even though the name of these disorders suggests it affects the spine, “spondy” = spine, “arthro” = joint, “itis” = inflammation, many peripheral joints are frequently involved. Very commonly the tendons and their attachments to bone are involved forming a hallmark in the diseases called “enthesopathy”.

Psoriatic Arthritis

Psoriatic arthritis is one of the spondyloarthropathies that affects about one-third of people who have psoriasis. Psoriasis is an inherited skin disease that causes a red, scaly rash most commonly over the elbows, knees, ankles, feet, hands, and other areas. There are five subtypes of psoriatic arthritis and it is not uncommon for patients to have more than one subtype affecting them. It can affect most joints in someone’s body and cause severe debility.


Osteoporosis, or thinning bones, is a serious condition that can result in tremendous pain with fractures. Noted mostly as a disease of women it is important to note men can suffer from the disease as well in many different circumstances. Risk factors for osteoporosis include aging, female gender, low body weight, hormonal disorders, menopause or andropause, smoking, and many medications. It is important that once any woman reaches menopause she have a baseline bone density scan, as prevention is the key to the treatment of Osteoporosis and can dramatically affect irreversible deformity, height loss and potential complications if caught early.


Lupus is an autoimmune disease that develops when the immune system recognizes our own body as foreign and attacks its tissues causing inflammation, swelling, pain and a host of other symptoms. Lupus symptoms vary, and has been known throughout the annals of medicine as “the great imitator” as it can mimick many other diseases. Early Lupus symptoms include fatigue, joint pain, fever, and butterfly rash on the face, especially if worsening after being in the sun. The disease can develop at any age but predominantly affects young women and in these cases can be severe and aggressive.


Fibromyalgia is often a misdiagnosed and misunderstood syndrome. Recent research has suggested that the underlying problem is with alteration in the way the body receives pain messaging from the brain resulting in pain to gentle touch, otherwise known as allodynia. Its characteristics include widespread musculoskeletal pain, fatigue, difficulty sleeping, chronic headaches, irritable bowl syndrome, interstitial cystitis, restless leg syndrome, anxiety and depression. Although not much is definitively known about this syndrome ongoing research leads to new discovery every day.


Gout was initially described as, “A Disease of Kings” or “The Rich Man’s Disease” yet any afflicted patient never felt this lucky. It brings on sudden burning pain, stiffness, and swelling in a joint, about half of the time in the largest toe called podagra. These attacks can happen over and over unless gout is treated. Over time, they harm your joints, tendons, and other tissues and the pain settles in every day rather than intermittently causing flares of the disease. Gout is caused by persistent high levels of uric acid in the blood. When the blood cannot handle the volume by filtering it through the kidneys the uric acid deposits in crystals into the joints. These crystals cause chronic pain, swelling and eventually deformity.


Vasculitis is a general term that refers to inflammation of blood vessels. When blood vessels become inflamed, they may become weakened, stretch and either increase in size or become narrow — even to the point of closing entirely. An enormous number of symptoms are possible because any organ system may be involved. There many acute and chronic causes of Vasculitis and treatment depends entirely upon diagnosis and the affected organs.

Sjögren’s Syndrome

Sjögren’s syndrome is a condition where the immune system attacks the body’s moisture-producing glands, such as the tear glands and the saliva glands. These glands may become scarred and damaged causing extreme dryness in the eyes and mouth to develop. Sjögren’s syndrome may also cause fatigue, pain in the joints, and, in rare cases, problems with the function of vital organs, such as the lungs, kidneys, and nerves.

Bursitis and Tendinitis

Bursitis is inflammation or irritation of the bursa. The bursa is a sac filled with lubricating fluid, located between tissues such as bone, muscle, tendons, and skin, that decreases friction, and irritation. This condition is most often caused by repetitive motion, minor impact on the area, or from a sudden, more serious injury. Tendinitis is inflammation or irritation of the tendon, a thick cord that attaches bone to muscle. There are many activities that can cause Tendinitis, including gardening, carpentry, painting, scrubbing, golfing and pitching to name a few.