Author - rheumatologist-in-pune

Who is a Rheumatologist?

Who is a Rheumatologist?

Rheumatologists are physicians who are specifically trained to diagnose and treat over 100 types of arthritis and various related disorders that affect the body’s bones, joints, muscles, and connective tissue. Common examples are rheumatoid arthritis, osteoarthritis, lupus, ankylosing spondylitis and gout.

Rheumatic conditions are mostly chronic, which means the conditions persist over long periods, often lifetime, not necessary symptoms may be present. Rheumatic disorders affect a large amount of the population around the world.

Why See a Rheumatologist?

A patient usually consults a rheumatologist when one needs:

  1. An accurate diagnosis for chronic symptoms affecting the musculoskeletal system

      2. Expertise in devising pain relief and treatment plans for a rheumatologic condition

Rheumatologists have the depth and breadth of experience necessary to accurately diagnose and treat a large type of conditions. A patient can then receive an early diagnosis and begin suitable treatments before developing joint damage.

Diagnosis may be challenging:

Rheumatologic disorders are often difficult to diagnose because symptoms may come and go or mimic other conditions. For instance, rheumatoid arthritis, reactive arthritis, lupus and fibromyalgia can exhibit similar symptoms. The sooner a patient receives an accurate diagnosis, the better effective medical treatment and pain relief can begin.

Early treatment may facilitate long-term wellness:

Getting treatment early within the disease process helps a patient return to normal activities as soon as possible. Early treatment is additionally important for two more reasons:

Some rheumatic conditions are more respond well to treatment in their early stages.

Early treatment can minimize the long-term, cumulative damage that’s sometimes caused by chronic rheumatic conditions.

For example, among people that are diagnosed with rheumatoid arthritis but don’t receive treatment within the first 2 to three years, 20 to 30% experience a permanent disability that forestalls them from working.

Do Patients with Osteoarthritis Need a Rheumatologist?

A large number of populations is affected by osteoarthritis and is one of the foremost commonly treated and extensively researched medical conditions within the world.

What’s Osteoarthritis?

A person who has osteoarthritis may seek treatment from a rheumatologist, a medical care doctor, a physiatrist, an orthopedist, or a mix of these. Additionally, the patient could also be referred to as a physical or occupational therapist.

What sort of health care professional an osteoarthritis patient should see depends on many factors, including the patient’s personal preferences, access and proximity to worry, and whether or not there are additional medical problems which will complicate diagnosis and treatment.

Rheumatologists typically play one amongst two roles in patient care:

A rheumatologist may serve as the patient’s primary medical doctor, providing therapy and coordinating to take care of the patient.

A consultant rheumatologist may work in accordance with a patient to diagnose a condition and recommend a tailored treatment plan which will be implemented by the patient and his or her primary care doctor.

The second option is the most typical. In these cases a primary care provider oversees a patient’s care, and also the patient may revisit the rheumatologist once a year for monitoring or when the treatment plan has to be adjusted.


What is gout?

What is gout & what are its types?

Gout is a common and complicated type of arthritis that causes intense pain, inflammation, and stiffness within the joints. In many cases, the disease affects the large toe (toes).

Episodes of the disease can occur quickly and return periodically, slowly damaging the tissues within the inflamed region.

Also, gout has been linked to an increased incidence of cardiovascular and metabolic diseases. It’s the foremost common sort of inflammatory arthritis in men, but women may also be affected, especially after the onset of menopause.

Causes and risk factors:

Normally, uric acid is dissolved within the blood and is excreted within the body through urine. If an excessive amount of uric acid is produced or it’s not eliminated properly, urate can form which may build up within the joints producing the clinical picture of gout.

Excess acid within the blood is termed hyperuricemia and might be the results of eating foods rich in substance, like red meat and seafood.


There are different stages through which gout progresses. These stages correspond to differing types of gout and are represented by:

Asymptomatic hyperuricemia – uric acid levels could also be high, but no manifestations. At this stage, treatment isn’t necessary, although the crystals formed are stored within the tissues. People at this stage should avoid factors that contribute to the buildup of uric acid;

Acute gout – this stage occurs when uric acid crystals cause acute inflammation and intense pain. It normally disappears within 3 to 10 days. Attacks of this kind are often triggered by stressful events, alcohol and drug use or by cold weather;

Intercritical period – this period is asymptomatic and is found between two acute gout attacks. During this period, uric acid crystals are still stored within the tissues;

Chronic gout to face – is that the most serious kind of gout and causes permanent damage to the joints and kidneys. At this stage, gouty tufts develop i.e. large accumulations of uric acid crystals.

It should be noted that it takes about 10 years to achieve this stage. If Best Rheumatologist in Pune treats the condition in the early stage one can stop the progression of the disease to the present stage.

A condition easily confused with gout is chondrocalcinosis. It’s also called pseudogout, and therefore the symptoms are very similar. The main difference between these two conditions is that the substances accumulated within the joints.

In the case of pseudogout, it’s phosphate, and within the case of gout acid crystals. Also, pseudogout requires a special treatment than gout.

How Ones Bone & Joints Change With Age

How Ones Bone & Joints Change With Age

With age, various changes naturally occur in our body. we’ve more wrinkles, grey hair appears. All of those are external changes. However, many people aren’t aware that ageing also affects our skeletal system. Our bones and joints also change with age. Here we discuss what happens to our skeleton, and what must be done to take care of the health of our bones and joints.


Throughout life, our bones are constantly changing. The body naturally gets obviate the “aged” bone tissue and replaces it with a replacement one. While we are young, bone tissue is replaced much faster than lost. Therefore, bones at a young age are much denser and stronger. Peak bone mass in most of the people is about 30 years old.

When the bone mass reaches its peak value for a time, approximately as about new bone tissue is created within the body because it is lost, however, after about 40 years of age, bone formation processes begin to lag. Bones as a result of this become thinner and weaker, gradually increasing the chance of osteoporosis.

Osteoporosis is a disease characterized by progressive bone loss. Osteoporotic bones are structurally different from normal. In women after menopause, bone loss accelerates.


Our joints have active structures that change with age. The decrease in water content, as well as natural wear and tear, gradually destroys articular cartilage – one among the foremost important components necessary for the normal functioning of the joint.

The articular cartilage covers the articular surfaces of the bones and ensures their free sliding relative to one other, absorbing some of the loads on the joint. A disease characterized by wear of the articular cartilage is termed osteoarthrosis.

Some problems related to age-related changes within the joints are often avoided. one among the issues that always accompany ageing, but which isn’t its natural component, is low physical activity. As we grow old, we move less. It must be understood that the less we move, the less mobile our joints become. besides joints, muscles also suffer – they become weaker. People leading an energetic lifestyle despite old age have healthier bones and joints.


Everyone is ageing, but there are many various things you can do to keep your bones and joints in good shape, delaying the appearance of problems or perhaps preventing them. Try these tips:

Ask your rheumatologist in Pune what medications may affect your bones. Many drugs enhance bone loss, like long-term use of anticonvulsants, some drugs used to treat cancer, anti-inflammatory drugs from the corticosteroid group used to treat arthritis and lots of other diseases, like asthma, Crohn’s disease, lupus.

Exercise regularly:

Physical activity not only allows you to take care of the mobility of your joints, it minimizes bone loss, and also supports muscular tonus and strength, thereby helping to stop falls.


Eat enough calcium and vitamin D with food. These nutritional supplements are essential for normal bone function. The doctor will tell you how many you require. If you’re unsure that you simply are getting enough of them with food, ask your arthritis specialist in Pune to offer them to you.


Maintain a healthy weight. Being overweight may be a reason behind joint overload and results in accelerated wear of bones and joints, increasing the chance of osteoarthritis.

Considering all these factors Dr. Nilesh Patil Best Rheumatologist in Pune always suggest his patients follow a healthy lifestyle by exercising regularly, eating a healthy diet and maintain their weight.

ankylosing spondylitis

(Ankylosing Spondilitis ) बांबू वात 

(Ankylosing Spondilitis )कडक कमरेचे दुखणे- बांबू वात

कडक कंबरेचे दुखणे म्हणजे (ankylosing spondilitis).अन्क्स्पोन.अन्क्स्पोन  म्हणजे कंबरेचा
आमवात. हा एक प्रतीकार्षाक्तीचाच आजार. त्याचे नेम्के करण माहित नाही.तो माकड हाडाच्या संध्यान
पासून(सक्रोइलिअक सांधाप्रकरण)सुरु होतो. प्रधीर्गाकाळ हळू हळू तो वादात जातो.अन्क्य्लोसिंग म्हणजे मानके
एकमेकांना चिकटणेआणि स्पोन्दिलीतीस म्हणजे मणक्यांना सूज येणे.मणक्यांचे तेन्डोंस(कंधार)आणि लीगामेंत्स
जेथे मणक्यांना जोडलेलें असतात तेथे सूज येणे हे याचे वैश्शिस्थ्या.

करणे आणी प्रकार:
नेमके कारण माहित नसले तरी HLA B27 नावाचे अनुवौंशिक तत्व याच्या 90%रुग्णांमध्ये सापडते.
जवळच्या नातेवायाकाला असेल तर एहाद्यालाहोण्याची शक्यता सामान्य लोकांपेक्षा तिपटीन जास्त.
कळत न कळत सुरु होणारे ३ महिन्यांपेक्षा जास्त काळाचे दुखणे.
सकळी १/२ तासापेक्षा जास्त वेळ कडकपणा.
व्यायामाने बरे वाटणे , विश्रांती ने नाही.
कंबरेच्या दुखण्याने उत्तररात्री जाग येणे.
उज्या डाव्या नितंबात दुखणे.
वय    १० – ४५
उपचार :
अंक्य्स्पोन पूर्णपणे बारा होत नाही, पण नियंत्रणात मात्र ठेवता येतो.  व्यायाम , व्यायाम आणि व्यायाम हास याचा
उपचार. रोज नियमित व्यायाम हा आयुष्याचा अपरिहार्य घटक झाला पाहिजे. १/२ तास व्यायाम केला तर वेदना
आणि कडकपणा कमी होतात. पोहणे हा सगळ्यात चांगला व्यायाम.
सूज कमी करणारी वेदनाशामक औषधे कमीत कमी मात्रेत नियमितपाने घ्यावी. सारे वेदनाशामक औषेढे
सारखीच, या औषधांनी वेदना कमी होऊन व्यायाम कतार य्रतो, झोप लागते. सूज कमी होऊन आजार बळावत
नाही, नियंत्रणात राहतो.


गोउत आणि युरिक एसिद ( Gout and Uric Acid)

गोउत आणि युरिक एसिद
आपल्या शरीरात अनेकविध पेशी नाश पावत असता. आणि त्या जागी नावूया तयार होत असतात. अशा जीर्ण पेशींची विलेवत लावताना त्यापासून युरिक एसिड बनते. युरिक इसिद चे प्रमाण जास्त झाले म्हणजे त्याचे सांध्यांमध्ये स्फटिक बनतात. अशा स्फटिका मुळे संध्याला अचानक सूज येते व विंचू चावाल्यासारख्या वेदना होतात. स्फातीकामुळे सांधा सुजणे म्हणजे गोउत.फक्त युरिक एसिड वाढणे म्हणजे गोउत न्हावे.
करणे :
वाढणारे आयुर्मान , बदलती जीवन शैली व आहाराच्या सवयी हीच याची करणे आहेत. स्त्रियांमध्ये estrogen हे संप्रेरक लाघ्विवते युरिक एसिड बाहेर टाकते. पाळी गेल्यानंतर estrogen कमी झ्ल्यामुळे युरिक एसिड वाढून गोउत चे attack येऊ शकतात. आहारातले काही पदार्थ युरिक एसिड वाढवतात. यात मांस व मासे, बीअर व दारू, तसेच शीतपेय हे महत्वाचे. हृदय्विकारातील अस्पिरीन व लघवीचे प्रमाण वाढवणारी औषधे (diuretics ), तसेच काही कर्करोगावरील औषधांनी युरिक एसिड वाढते.
पायाच्या अंगठ्चा सांधा विशेषता थंडीच्या दिवसात रात्रीच्या वेळी अचानक दुखू लागतो. अत्यंत तीव्र वेदना होतात. काही तासातच सांधा सुजतो, लाल व गरम होतो, याला गोउत चा attack म्हणतात. यांपैकी सुमारे २/३ लोकांना वर्षभरात पुन्हा attack येतो. काही रुग्णांना ४-६ आठवड्यानी वारंवार attack येतेत. रुग्णांमध्ये गुडघा, घोटा, मंघात व कोपर सुजू शकते. एकापेक्षा जास्त सांधे सुजू शकतात. वारंवार य्रणाऱ्या attack दर्य्मान हे स्फटिक संध्यातच राहतात व सांध्यातील कुर्च्या,तसेच अन्य भाग खराब करीत राहतात. युरिक एसिड मुलेमुत्रापिंडांना हि इजा होऊ शकते. तसेच स्फातीकांचे मुत्खाडे बनून त्यांचाही त्रास होऊ शकतो.
गोउत पूर्णपणे बारा होत नाही. तो कायम औषधे घेऊन नियंत्रणात ठेवावा लागतो. गोउत मुळे अचानक सांधा सुजतो, तेव्हा colchicine किवा वेदनाशामक औषधे वापरतात. हल्ली या साठी स्तेरोइद्स हि वापरतात. गोउत मध्ये युरोक एसिड ६mg पेक्षा कमी झले तरच संध्यातले स्फटिक विरघळून जातात. रक्तातातले युरिक एसिड ६ mg पेक्षा कमी झाले, तरी देखील दर ६ महिन्यानीन युरिएसिड तपासत औषधे घेतली पाहिजेत.
डॉ निलेश जयवंत पाटील.


झिजेचा संधिवात (OSTEOARTHRITIS)

झिजेचा संधिवात ( ओस्तेओअर्थ्रितिस) हा चाळीशी नन्तर होणारा आजार, वाढत्या वयाने संश्यामध्ये ओस्तेओअर्थ्रितिस होतो.जसे जसे वय वाढेल तसे तसे हा संधिवात होण्याची शक्यता जास्त. सांध्यातील कुर्च्या झिजाल्याने ओस्तेओअर्थ्रितिस नावाचा संधिवात होतो. ज्या सांध्यांना आयुष्यभर जास्त काम पडते,तेथे असा संधिवात होण्याची शक्यता जास्त असते.त्यामुळे गुढगा , मानेचे आणि कमरेचे मानके तसेच बोठांच्या पुढच्या पेरांच्या सांध्यांना हा संधिवात विशेष करून होतो.
सांधा दुखणे,कधी जाकाद्ल्या सारखा वाटणे, थोडीशी सूज, हालचाल करताना कर कर आवाज येणे,अशी याची लक्षणे. काम केल्या नंतर किवा व्यायामानंतर हे दुखणे वाढते, आणि विश्रांतीने कमी होते. गुढघाजास्त बिघडत गेला की तो सैल होतो आणि चालता चालता अचानक वाकतो.त्यामुळे धडापाद्ण्याची हि शक्यता असते.सांध्यांचा आत हाडांच्या छोट्या छोट्या गाठी (अस्तेओफ्य्तेस) होतात. त्यामुळे कडी सांधा अडकतो आणि अजिबात हळू शकत नाही.एका जागी फार वेळ बसले तर उठल्यावर पाऊले टाकणे मुश्कील होते. असे सांधे रात्रीहि दुखतात आणि सकाळी जखडल्यासारखे होतात.दुखणारा सांधा साहजिकच कमी वापरला जातो.त्यामुळे आजूबाजूचे स्न्यायु अशक्त होतात आणि सांधा आणखीन बिघडत जातो. संधायांचा आत वांगना सारखा द्रव असतो.स्निघ्नता, चिकटपणा हे त्याचे गुणधर्म. दुखण्याने हालचाली नीटहोत नाहीत. त्यामुळे कधी सांध्यांच्या आत इजा होऊन सूज येते. सुजेमुळे संध्यातल्या द्रवाचे प्रमाण वाढते. द्रवाचा चिकटपणा कमी होतो,लीगामेंत्स ताणल्या जातात,स्नायू आखडतात आणि दुखत राहतात.
स्त्री-पुरुषांचा गुडघा दुखत असेल आणि तपासताना गुडघ्यात खर खर जाणवली कि, या संधिवाताचे निदान पक्के होते. xray तपासणीत संधिवाताचे गांभीर्य समझते.
झिजलेल्या कुर्च्या पुन्हा निर्मान करण्याची आपल्याशरीरात सोय नाही. वेदना कमी करणे आणि सांध्यांची कार्याषमता सुधारणे हे ओस्तेओअर्थ्रितिस च्या उपचाराचे मुख्य उद्दीश्ते.मसाज , अच्चुपुंक्टुरे इत्यादी उपायांनी तात्पुरता आराम मिळतो. सांध्यात स्तेरोइद्चे इन्जेक्तिओन दिले तर दुकःने ३-४ महिन्यांसाठी थांबते,त्यात काही धोका नाही.मात्र वर्ष्तून ३पेक्षा जास्त इन्जेक्तिओन देता येत नाहीत.
संध्यातल्या द्रवाचा चिकटपणा कमी झाला म्हणून त्यात नवीन वंगण घातले कि सांधा सुधारेल अशी एक संकल्पना, त्यासाठी महागडी विस्को सुप्प्लीमेंत्स निघालेत. काही रुग्णांमध्ये त्याचा उपयोग दिसून येतो.
खूप दुखत असेल आणि सांधा दुकून निकामी झला असला, तर ओपेरातीओन करून गुडघा बालालाण्याची शाश्त्राक्रिया आवश्य करावी, त्यासाठी वजन नित्यान्त्रणात हवे.
डॉ निलेश जयवंत पाटील.