On the Attack

Affecting roughly 1.5 million Americans, rheumatoid arthritis (RA) is one of the most frequent diagnoses by rheumatologists at UHS. RA is an autoimmune disorder that occurs when the body’s immune system attacks its own tissue, particularly the joints. This leads to painful swelling and inflammation, which can eventually cause bone erosion and joint deformity.

Fortunately, according to Henda Bouali, MD, board-certified specialist in rheumatology and internal medicine at UHS, the earlier RA is diagnosed, the better the outcome is for the patient. “The sooner the diagnosis and the sooner we treat RA, the lesser the damage to the joints and the cartilage,” she says. “The patient will also be less likely to need or use more medication or stronger medication, so they stay active, stay productive, and have no disabilities or loss of range of motion.”

Dr. Bouali notes that this is currently a good era for treating RA, because there are many different medications available that are effective and work within a patient’s lifestyle, age and medical history, from prescription biologics to corticosteroid medications and infusions. She explains, “If a patient is over 60 and forgetful, for example, I don’t expect them to remember to take a pill every day, so maybe infusions will be better because they can come in, get it done and provide their feedback.”

Rheumatologists at UHS are also using ultrasound to monitor and detect inflammation caused by RA, so they can treat it before bone erosion can occur. Remission is the ultimate goal of treatment, but rheumatologists can also help slow the progression of RA and reduce the swelling, stiffness, fatigue and pain, so that patients can still perform their daily activities.

Aches and pains that occur with aging are one thing, Dr. Bouali says, but anyone who is experiencing swollen, red or tender joints that hurt longer than a week, especially those with a family history of rheumatoid arthritis or other condition, should speak to their primary care provider about seeing a rheumatologist.

While rheumatoid arthritis is the most common diagnosis, rheumatologists at UHS also deal with other autoimmune and musculoskeletal diseases that affect the muscles, bones and joints, such as osteoporosis, lupus and vasculitis.

Rheumatologists work directly with primary care providers for referrals, and the move to the new UHS Orthopedic Center allows for even more communication between specialties, says Dr. Bouali. “Having everyone in one space will allow easy discussion and better care for patients overall.”