Full programme transcript >>
In today’s edition of Case Notes, Dr Mark Porter goes behind the scenes in a busy rheumatology clinic to find out more about this speciality.
Rheumatology may have a comparatively low profile, but it has a very broad reach, encompassing conditions ranging from arthritis and gout, to connective tissue disorders like lupus and the tick-borne infection Lyme disease.
The British Society for Rheumatology is having its annual meeting this week to discuss recent advances in the field.
Mark joins the Society's president, Dr Andrew Bamji, at one of his busy outpatient clinics at Erith Hospital in Kent.
There he meets patients visiting the clinic for treatment for problems such as rheumatoid arthritis and carpal tunnel syndrome, and finds out what can be done to alleviate these debilitating conditions, including drug treatments and physiotherapy.
The focus of this programme, rheumatoid arthritis, is different to osteoarthritis, which used to be called wear-and-tear arthritis, because it was associated with ageing.
Rheumatoid arthritis (RA) is a chronic, progressive and disabling auto-immune disease which is very painful.
The disease can progress very rapidly causing swelling and damaging cartilage and bone around the joints. Any joint can be affected, but it is common in the hands, feet and wrists. Sometimes the whole body is affected - even in internal organs like the lungs, heart and eyes, though this doesn't happen to everyone.
Nowadays, as well as treating the pain caused by RA, doctors are keen to tackle the underlying disease itself with so-called biologic agents, which target the body's faulty immune system response.
Many patients benefit from disease modifying drugs like Methotrexate (also used to treat cancer) which is used at higher doses than it used to be.
These treatments mean that it is now more possible than ever before to get the disease under control and for people with RA to enjoy a better quality of life.
Steroids are also used, either in the form of a tablet or in an injection, directly into a troublesome joint. They too appear to modify the body's immune response but can have unwanted side effects.
Physiotherapy is also a valuable tool in helping RA patients to mobilise their painful joints and improve the quality of their lives.
Next week: health screening