Specialist Rheumatological Consultation:
Speciality consultation in both out-patient & in-patient settings regarding various rheumatological diseases including rheumatoid arthritis, osteoarthitis, lupus, gout, chronic back or neck pains, ankylosing spondylitis, fibromyalgia, tennis elbow, frozen shoulder and others, using an evidence-based comprehensive updated approach. Detailed explanation of the disease process, including diagrams, if necessary.
Specialist Medicine Consultation:General medical consultation regarding common illnesses including hypertension, diabetes, infections, asthma, viral illnesses, allergic conditions, thyroid disorders, electrolyte imbalances etc, in both out-patient & in-hospital settings, including critically ill conditions.
During the past decade biologic therapies such as monoclonal antibodies and fusion proteins have revolutionized the management of rheumatic diseases. Presently biologics are expensive, but mainstay therapies in the treatment of many rheumatic conditions. Their use has indeed allowed for a better prognosis in several rheumatic diseases (such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematosus) and to obtain a clinical remission. Biologics approved in India at present are –
• Intravenous: Infliximab, Rituximab, Tocilizumab, Abatacept
• Sub-cutaneous: Adalimumab, Etanercept, Secukinumab
• Oral: Tofacitinib, Baricitinib
Synovial Fluid Replacement Therapy (Viscosupplementation):Viscosupplementation is a medical procedure during which a small amount of lubricating fluid, containing hyaluronic acid is directly injected into a joint. By adding hyaluronic acid to the existing joint fluid, the goal is to – facilitate better joint movement, reduce pain & perhaps slow osteoarthritis progression. Typical candidates for viscosupplementation are people with knee osteoarthritis who have failed to improve with other non-surgical treatments and want to avoid or postpone knee replacement surgeries. This procedure is intended mostly for knee joints, but can also be used for shoulder or ankle joint diseases. Almost 6 months to one year of pain free period can be achieved.
Joint Injection / Aspiration:
Joint injections or aspirations (taking fluid out of a joint) are performed in an OPD or hospital setting. Either joint fluid is obtained (aspirated) and used for appropriate laboratory testing or medications are injected into the joint space. Drainage of a large joint effusion can provide pain relief and improved mobility. For injections, corticosteroids (such as methylprednisolone and triamcinolone) frequently are used. They are given to treat inflammatory joint conditions, such as rheumatoid arthritis, psoriatic arthritis, gout, tendonitis, bursitis and osteoarthritis. Commonly injected joints include the knee, shoulder, ankle, elbow, wrist, base of the thumb, and small joints of the hands and feet.