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TREATMENTS

TAKAYASU'S ARTHRITIS

What is Takayasu's Arteritis?

Takayasu's Arteritis (TA) is a type of vasculitis (disease in which inflammation of blood vessels occurs) of unknown cause and which chronically (ie, for a prolonged period of time, usually several years) affects the largest artery in the region. human body, the aorta, and its primary branches. Over time, TA causes a decrease in the caliber of the affected arteries (a phenomenon called stenosis) and can sometimes result in their complete closure (a fact called occlusion).

What is the profile of people affected by TA?

People of both genders are affected, with a female predominance in 80 to 90% of cases. The disease usually starts between 10 and 40 years of age, but persists for several years (chronic evolution) and the diagnosis can occur long after its onset, as the most characteristic changes develop very slowly and gradual.

What are the signs and symptoms?   

At the onset of the disease, general and non-specific symptoms may occur (that is, symptoms that also occur in several other diseases); fatigue (tiredness even without exertion), weight loss and fever. Later on, pain in the extremities may appear, triggered by its use, as the arteries already narrowed by the disease are no longer able to supply the amounts of oxygen required by the effort of these extremities, a phenomenon known as lameness.

Source: Brazilian Rheumatology Society

Takayasu

JUVENILE IDIOPATHIC ARTHRITIS

What is Juvenile Idiopathic Arthritis?

Juvenile Idiopathic Arthritis, also called Juvenile Rheumatoid Arthritis, is a chronic inflammatory disease that affects the joints and other organs, such as the skin, eyes and heart. The main clinical manifestation is arthritis, characterized by pain, increased volume and temperature in one or more joints. It is noteworthy that in some children the pain is minimal or even non-existent. Characteristically, it always starts before the age of 17 years.

Is it a frequent illness?

The incidence of Juvenile Idiopathic Arthritis is unknown in our country, but data from countries in North America and Europe indicate that about 0.1 to 1 in every 1,000 children have this disease.

What Causes Juvenile Idiopathic Arthritis?

The exact cause of Juvenile Idiopathic Arthritis is not yet known. Immunological, genetic and infectious factors are involved. Recent studies show that there is a certain family tendency and that some external factors, such as certain viral and bacterial infections, emotional stress and joint trauma can act as triggers for the disease.

Arthritis is not an infectious and contagious disease and patients can (and should) normally attend day care centers, schools, clubs and swimming pools.

Source: Brazilian Rheumatology Society

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Idiopática
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PSORIATIC ARTHRITIS

What is psoriatic arthritis?

Psoriatic arthritis (PAs) is a form of arthritis that affects people who have psoriasis. Psoriasis is characterized by the appearance of reddish, scaly lesions, which mainly affect the knees, elbows and scalp. Most people develop psoriasis first and then arthritis, but in some patients arthritis can start before the skin breaks.

When and how does psoriatic arthritis occur?

Statistics vary from country to country, but it is believed that between 5% and 40% of people who have psoriasis may experience joint pain and inflammation. As in skin disease, joint involvement affects more people of the white race. Men and women are equally affected and European countries such as Denmark, Sweden and Russia are the hardest hit. There is a very strong genetic component in APs. Psoriasis develops in approximately 50% of siblings of people with this disease when both parents are affected; in 16% when only one parent has psoriasis; and in 8%, when neither parent is affected.

Source: Brazilian Rheumatology Society

Psoriásica

RHEUMATOID ARTHRITIS

Which is?

Rheumatoid Arthritis (RA) is a chronic inflammatory disease that can affect multiple joints. The cause is unknown and affects women twice as often as men. It usually starts between 30 and 40 years old and its incidence increases with age

What are the symptoms?

The most common symptoms are arthritis (pain, swelling, heat and redness) in any joint in the body, especially hands and wrists. Involvement of the lumbar and dorsal spine is rare, but the cervical spine is often involved. Inflamed joints cause morning stiffness, fatigue and with the progression of the disease, there is destruction of the articular cartilage and patients can develop deformities and inability to carry out activities both in daily life and in work. The most common deformities occur in peripheral joints such as swan neck fingers, buttonhole fingers, ulnar deviation and hallux valgus (bunion).

In addition to the joints, can others be affected?

Yes, but less commonly, other organs or tissues such as skin, nails, muscles, kidneys, heart, lungs, nervous system, eyes and blood can show changes. The so-called Felty's Syndrome (enlarged spleen, lymph nodes, and decreased white blood cells in a patient with the chronic form of RA) can also occur.

Source: Brazilian Rheumatology Society

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Reumatóide
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BEHÇET'S DISEASE

Which is?

Behcet's disease is quite common in countries that are part of the ancient silk route, which stretches from Asia to the Mediterranean, affecting mainly Greeks, Turks, Arabs and Israelis, as well as Koreans, Chinese and Japanese. It gets its name from having been described in 1937 by Turkish dermatologist Hulusi Behcet.

What are the symptoms?

The onset of symptoms usually occurs between 20 and 40 years of age, men and women are similarly affected, but young men of Asian origin have more severe manifestations of the disease. Different genes increase the risk of developing Behcet's disease and it is believed that environmental factors such as infections can help trigger the disease.

The manifestations of Behcet's disease occur recurrently, that is, in crises that improve with treatment and return after a period without symptoms. The most important complaint is the presence of recurrent thrush that may or may not be associated with genital ulcers, skin lesions, joint pain, eye inflammation, neurological and intestinal changes, inflammation and thrombosis in veins, in addition to the formation of aneurysms in different arteries . Complaints of Behcet's disease usually start with very painful canker sores, many years before diagnosis. Canker sores affect any part of the oral cavity and vary in number and size. Canker sores usually last longer than a week and usually don't scar.

Source: Brazilian Rheumatology Society

Behçet

SCLERODERMY

What is scleroderma?

Scleroderma (skleros:hard and derma:skin) is a disease characterized by fibrosis (hardening) of the skin and internal organs, involvement of small blood vessels and formation of antibodies against the body's own structures (autoantibodies). The disease affects people all over the world and its cause is not known.

What are the types of scleroderma?

There are two types of scleroderma: the systemic form (systemic sclerosis) and the localized form (localized scleroderma). Systemic sclerosis affects the skin and the body's internal organs. This form is four times more frequent in females than in males and affects mainly the fourth decade of life. The localized form affects a restricted area of the skin, sparing the internal organs. Localized scleroderma is more common in children.

What are the types of localized scleroderma?

There are two main types of localized scleroderma: morphea and linear scleroderma. Morphea is the most common clinical form and presents as one or more patches of thickened skin with varying degrees of pigmentation. In linear scleroderma, on the other hand, the areas of skin thickening are in the form of a line in the vertical direction of the body.
Localized scleroderma can be mild, with only mild atrophy (loss of tissue) in the affected area, but sometimes it can be more severe,
  extending to deeper tissues (subcutaneous tissue, muscles and bones), and may even retard bone growth in a child.

Source: Brazilian Rheumatology Society

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Esclerodermia
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SPONDYLOARTHRITIS

What is spondyloarthritis?

Seronegative Spondyloarthropathies (Spondyloarthritis) correspond to a group of diseases that have the following clinical manifestations in common:

  1. Arthritis, with preference to the involvement of the sacroiliac joints and the spine;

  2. Negative test for rheumatoid factor (RF: blood test);

  3. Inflammation in tendons and ligaments that attach to bone (enthesitis);

  4. Similar genetic marker (HLA-B27);

Which diseases are part of the

spondyloarthritis?

There are two types of scleroderma: the systemic form (systemic sclerosis) and the localized form (localized scleroderma). Systemic sclerosis affects the skin and the body's internal organs. This form is four times more frequent in females than in males and affects mainly the fourth decade of life. The localized form affects a restricted area of the skin, sparing the internal organs. Localized scleroderma is more common in children.

What are the types of localized scleroderma?

The following are part of this group of diseases: Ankylosing Spondylitis, Undifferentiated Spondyloarthropathies (individuals who do not fully develop the disease), Reactive Arthritis (associated with infectious diseases), Psoriatic Arthritis (associated with Psoriasis), Enteropathic arthritis (associated with Crohn's disease , Ulcerative colitis, Whipple's disease, among others).

Source: Brazilian Rheumatology Society

Espondiloartrites

RHEUMATIC FEVER

What is Rheumatic Fever?  

Rheumatic Fever is an inflammatory disease that can affect the joints, heart, brain and skin of children aged 5 to 15 years.

What Causes Rheumatic Fever?  

Rheumatic fever is a reaction to a throat infection caused by a bacteria known as streptococcus. This throat infection is clinically characterized by fever, sore throat, lumps in the neck (enlarged nodes), and intense redness, red dots, or pus plaques in the throat. The child, usually older than 3 years of age, may present with the throat infection like any other child and, usually, one to two weeks later begins to present complaints of Rheumatic Fever.  

Can any child who has a throat infection have Rheumatic Fever?

No. Only those with a predisposition to present the disease. Many children have frequent throat infections, 7 especially in the first years of life, but this is not enough to predispose them to rheumatic fever. The predisposition necessary to present the disease is inherited from the parents and is already born with the child.  

Source: Brazilian Rheumatology Society

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Febre Reumática
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FIBROMYALGIA

What is Fibromyalgia?

Fibromyalgia (FM) is a condition characterized by generalized, chronic muscle pain (lasting more than three months), but with no evidence of inflammation at pain sites. It is accompanied by typical symptoms such as non-restorative sleep (sleep that does not restore the person) and tiredness. There may also be mood disorders such as anxiety and depression, and many patients complain of altered concentration and memory.

What Causes Fibromyalgia?  

Not yet fully clarified, but the main hypothesis is that patients with FM present an alteration in the perception of pain sensation. This is supported by studies that visualize the brains of these patients functioning, and also because patients with FM have other evidence of body sensitivity, such as in the bowel or bladder. Some patients with FM develop the condition after a trigger, such as poorly treated localized pain, physical trauma, or serious illness. Altered sleep, mood and concentration problems seem to be caused by chronic pain, not the other way around.

What is the impact on health?

FM is quite common, affecting 2.5% of the world's population, with no differences between nationalities or socioeconomic conditions. It usually affects more women than men and appears between 30 and 50 years of age, although there are younger and older patients with FM.

Source: Brazilian Rheumatology Society

Fibromialgia

DROP

What is Gout?

Gout is an inflammatory disease that mainly affects the joints and occurs when the level of uric acid in the blood is above normal levels (hyperuricemia).

What Causes Gout?

Increased levels of uric acid in the blood can occur either from excessive production or from deficient elimination of the substance. It is important to know that not everyone who has high uric acid levels (hyperukemia) will develop gout. Most gout sufferers are adult males with a higher incidence between 40 and 50 years of age and, especially, overweight or obese individuals, with a sedentary lifestyle and frequent alcoholic beverage users. Women rarely develop gout before menopause and are usually over 60 years of age when they develop it.

What are the symptoms?

With the increase in the concentration of uric acid in the blood, there is a deposition of crystals in the tissues, mainly in the joints, causing inflammation and consequently pain and swelling, mainly affecting the joints of the big toe, ankles and knees. Gout is initially characterized by recurrent attacks of acute arthritis, caused by the precipitation, in the joint spaces, of uric acid crystals. The classic picture consists of pain that often starts during the night and is intense enough to wake up the patient. Although any joint can be affected, especially those in the lower limbs, the hallux (great) is the joint most frequently involved in the first crisis. In addition to pain, the joint is often inflamed with the presence of heat, redness (redness) and swelling. Stones may also form, producing kidney cramps and deposits of uric acid crystals under the skin, forming lumps located on the fingers, elbows, knees, feet, and ears (tophus).

Source: Brazilian Rheumatology Society

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Gota

READ/DORT

Is RSI a disease?  

No, RSI does not correspond to an illness or disease. RSI stands for “Repetitive Strain Injuries” and represents a group of disorders of the musculoskeletal system. There are several affections that present distinct clinical manifestations and that vary in intensity.

Why the acronym DORT?  

It represents the acronym for “Work-Related Musculoskeletal Disorders” and was introduced to replace the acronym RSI, particularly for two reasons: first, because most workers with musculoskeletal system symptoms do not show evidence of injury to any structure; the other reason is that, in addition to repetitive effort (dynamic overload), other types of work overload can be harmful to the worker, such as static overload (use of muscle contraction for prolonged periods to maintain posture); excessive force used to perform tasks; use of instruments that transmit excessive vibration; work performed with inappropriate postures.

What are the most common disorders?  

The most frequent occupational musculoskeletal disorders are tendonitis (particularly of the shoulder, elbow and wrist), low back pain (pain in the lower back) and myalgia (muscle pain) in various parts of the body.

Source: Brazilian Rheumatology Society

LER/DORT

BACKACHE

What is Low Back Pain?

Low back pain is pain that occurs in the lower lumbar region. Lumbar sciatic pain is low back pain that radiates to one or both of the buttocks and/or the legs in the sciatic nerve distribution. It can be acute (lasting less than 3 weeks), subacute or chronic (lasting longer than 3 months). Low back pain is an extremely common problem that affects more people than any other condition, being the second most common cause of general medical consultations, second only to  common cold. Between 65% and 80% of the world population develop back pain at some stage of their lives, but in most cases there is spontaneous resolution. More than 50%  of patients improves after 1 week; 90% after 8 weeks; and only 5% continue to show symptoms for more than 6 months or have some disability.

What Causes Low Back Pain?

As there are a large number of structures in the spine (ligaments, tendons, muscles, bones, joints, intervertebral disc) there are many different causes of pain. In addition to this, there are numerous non-rheumatological systemic diseases that can manifest with low back pain. Most low back pain is caused by "misuse" or "overuse" of spinal structures (resulting in sprains and strains), repetitive strain, overweight, minor trauma, inadequate physical conditioning, postural error, non-ergonomic position in the work and osteoarthrosis of the spine (over time, the structures of the spine will wear out, which can lead to degeneration of the intervertebral discs and joints). Other causes include inflammatory diseases such as ankylosing spondylitis, infections, tumors, etc.

How is the diagnosis made?

The physician has a fundamental role in the diagnosis and, above all, needs a detailed history of pain, associated factors and a meticulous physical examination for a correct diagnosis. The diagnosis of low back pain is, as a rule, clinical. Imaging exams are generally not requested in acute low back pain, only in cases where some warning signs are observed, such as fever, weight loss, neurological deficit, age over 50 years and trauma. When the pain persists for another 4-6 weeks, exams should be requested.

Source: Brazilian Rheumatology Society

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Lombalgia
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SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)

What is Lupus?

Systemic Lupus Erythematosus (SLE or just lupus) is a chronic inflammatory disease of autoimmune origin, whose symptoms can appear in different organs slowly and progressively (in months) or more rapidly (in weeks) and vary with phases of activity and remission. Two main types of lupus are recognized: cutaneous, which manifests itself only with patches on the skin (usually reddish or erythematous, hence the name lupus erythematosus), especially in areas that are exposed to sunlight (face, ears, cervix ("V ” of the neckline) and in the arms) and the systemic, in which one or more internal organs are affected. As it is a disease of the immune system, which is responsible for the production of antibodies and organization of the mechanisms of inflammation in all organs, when a person has SLE, he can have different types of symptoms and different places in the body. Some symptoms are general, such as fever, weight loss, loss of appetite, weakness and discouragement. Others are organ-specific such as joint pain, skin blemishes, pleural inflammation, high blood pressure and/or kidney problems.

What Causes Lupus?

Although the cause of SLE is not known, it is known that genetic, hormonal and environmental factors participate in its development. Therefore, people who are born with a genetic susceptibility to develop the disease, at some point, after an interaction with environmental factors (solar irradiation, viral infections or by other microorganisms), start to present immunological alterations. The main one is the imbalance in the production of antibodies that react with the body's own proteins and cause inflammation in various organs such as the skin, mucous membranes, pleura and lungs, joints, kidneys, etc.). Thus, we understand that the type of symptom a person develops depends on the type of autoantibody the person has and, as the development of each antibody is related to the genetic characteristics of each person, each person with lupus tends to have clinical manifestations (symptoms) specific and very personal.

Source: Brazilian Rheumatology Society

Lúpus

RHEUMATIC MANIFESTATIONS RELATED TO THE HUMAN IMMUNODEFICIENCY VIRUS (HIV)

Some data about HIV:

The human immunodeficiency syndrome (AIDS - AIDS)  it was first described in 1981 and has since become a worldwide epidemic. According to World Health Organization (WHO) criteria, Brazil has a concentrated epidemic, with a 0.6% prevalence rate of HIV infection in the population aged 15 to 49 years. Brazil has approximately 600 thousand diagnosed carriers of the AIDS virus. The treatment of HIV infection has changed dramatically over the last decade. In the late 1980s the only medication available was AZT. In the last 10 years, there have been almost 20 different types of medications generally used in association, which has changed the natural history of HIV infection with prolonged control of the disease and longer survival of these patients. The natural history of the infection consists of the multiplication of the virus associated with the  gradual decline in the number and function of the individual's defense cells.

What is the relationship between HIV and rheumatism?

There are descriptions of several rheumatic diseases related to HIV infection. The role of HIV in the development of chronic inflammatory and autoimmune diseases is not fully understood. With the progression of the disease, there are rheumatologic diseases that appear or worsen like Reiter's Syndrome and at the same time pre-existing diseases like Lupus and Rheumatoid Arthritis can improve over time. In the last decade, the pattern of incidence of these diseases in HIV infection (human immunodeficiency virus) has changed. Diseases that were rarely described in early studies, such as diffuse infiltrative lymphocytosis syndrome and HIV-associated arthritis, are becoming increasingly common problems.

Source: Brazilian Rheumatology Society

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Manifestações reumáticas
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What is Osteoarthritis?

Osteoarthritis is the same as osteoarthritis, arthrosis or degenerative joint disease. In the set of diseases grouped under the designation of “rheumatism”, osteoarthritis is the most frequent, representing around 30 to 40% of consultations in Rheumatology outpatient clinics. In addition to this fact, its importance can be demonstrated through social security data in Brazil, as it is responsible for 7.5% of all absences from work; it is the second illness among those that justify the initial aid, with 7.5% of the total; it is also second in relation to sick pay (in extension) with 10.5%; it is the fourth to determine retirement (6.2%).

Osteoarthritis (arthrosis), as a whole, has a certain preference for women, but there are locations that occur more in females, for example, hands and knees, others in males, such as the hip joint (femur with pelvis). It increases over the years, being uncommon before the age of 40 and more frequent after the age of 60. By age 75, 85% of people have radiological or clinical evidence of the disease, but only 30 to 50% of individuals with changes seen on radiographs complain of chronic pain.

Osteoarthritis (arthrosis) is a disease characterized by the wear of the joint cartilage and bone changes, including osteophytes, commonly known as "parrot's beaks".

The can be divided into without a known cause (so-called primary) or with a known cause (so-called secondary). The causes of this last form are numerous, from joint defects, such as knees with deviations in direction (valgus or varus), to changes in metabolism. The participation of heredity is important, especially in certain clinical presentations, such as the nodules of the fingers of the hands, called the Heberden nodules (at the joint of the fingertips) or Bouchard (the nodules of the middle fingers).

Source: Brazilian Rheumatology Society

OSTEOARTHRITIS (ARTHROSIS)

Osteoartrite

OSTEOPOROSIS

What is Osteoporosis?  

Osteoporosis is a disease that can affect all the bones in the body, making them weak and likely to break with minimal effort.

The main types of Osteoporosis are:  

Postmenopausal osteoporosis: affects women after menopause. Spine fracture can occur.  

Senile osteoporosis: affects people over 70 years of age. Both spine and hip fractures can occur.

Secondary osteoporosis: affects people with liver, endocrine, hematologic kidney disease or who use some medications, for example, steroids.

What are the risk factors for Osteoporosis?

  There are a set of factors that influence and favor the development of Osteoporosis.

​​

  • Menopause: with the interruption of menstruation, there is a decrease in the levels of estrogen 7 (female hormone), which is essential to maintain bone mass.

  • Aging: Bone loss increases with age.

  • Heredity: Osteoporosis is more frequent in people with a family history of the disease.  

  • Low Calcium Diet: Calcium is essential in bone formation. Obtaining it from food is essential to prevent Osteoporosis.

  • Excessive smoking and alcohol: a higher incidence of Osteoporosis has been observed among people who consume alcohol and smoke in excess.

  • Prolonged immobilization: physical exercise is an important stimulus for the formation and strengthening of bones. Long periods of immobilization and lack of exercise can lead to osteoporosis. Medications: some medications, such as steroids, in long-term treatments, favor mass reduction.

Source: Brazilian Rheumatology Society

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Osteoporose
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POLYMYALGIA RHEUMATIC AND GIANT CELL ARTHRITIS

What is Polymyalgia Rheumatica?

Polymyalgia rheumatica (PMR) is a disease that affects people over 50 years of age, causing stiffness and pain in the neck, shoulders and hips. It is now known that the symptoms are caused by inflammation in the deep shoulder, neck and hip joints. The stiffness can be so severe that it can incapacitate the patient. Other symptoms are fatigue, weight loss, low-grade fever, and depression.

Cause:

They are still unknown, however the high incidence with and after the age of 50 suggests that it is somehow related to the aging process.

​​​

Impact on Health:

PMR rarely happens before age 50, and the average age of people with these conditions is approximately 70 years, and it is twice as common in women as in men.

Diagnosis:

The diagnosis of PMR is eminently clinical, with history, physical examination and laboratory tests helping to  rule out other conditions that can cause similar symptoms. The diagnosis is made when there is evidence in the history and physical examination, and there is an important change in tests that indicate inflammation, such as erythrocyte sedimentation rate (ESR) and C-reactive protein. These tests are elevated in several causes of inflammation, and are not specific for PMR, and should always be interpreted in the clinical context.

Source: Brazilian Rheumatology Society

Polimialgia

PSEUDOGOTA

What is Pseudogotha?

It is a form of arthritis caused by the deposit of calcium pyrophosphate crystals in the joints. The term pseudogout is used because of the inflammatory crises that occur in patients and are similar to those of gout.

The term chondrocalcinosis is used to describe the deposit of those crystals (calcinosis) in the articular cartilage (chondrus), which can be visible on radiographs of the joint. Therefore, chondrocalcinosis is commonly seen on radiographs of patients with pseudogout.

Cause:

Pseudogout is caused by deposits of crystals composed of calcium pyrophosphate in human body tissues, especially cartilage. In most cases, crystal formation happens for no specific reason, however, there is often a familiar pattern of metabolic disorders, including enzyme deficiencies. They can also be associated with pathologies of the thyroid and/or parathyroid glands.

​​​

Impact on Health:

Pseudogout is very common, especially among the elderly. The prevalence is approximately 03% after the age of 60 years, and increases every decade, reaching about 50% at the age of 90 years. Acute attacks of pseudogout happen frequently in the knees and can last for days to weeks. Crystalline deposits can contribute to a severe form of joint degeneration that results in permanent disability.

Diagnosis:

 

It is done by examining crystals in the synovial fluid aspirate (from inside the joint) and radiographs showing images of soft tissue calcifications (chondrocalcinosis).

Source: Brazilian Rheumatology Society

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Pseudogota
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RHEUMATISM OF SOFT PARTS

What is Soft Part Rheumatism?

The good function of the musculoskeletal system depends on the integrity of its components (bones, muscles and tendons, joints, bursae and ligaments). When one of these components does not work well, it is reflected in pain and difficulty in performing the movements. In the case of Soft Parts Rheumatism or Extra-articular Rheumatism (outside the joints), these symptoms result from injury or inflammation of the structures surrounding the joints (muscles, ligaments, bursae, enthesis and tendons), resulting in bursitis, tendonitis , enthesitis and myofascial pain. These inflammations are usually temporary and do not cause deformity, but they can become chronic.

Why do these inflammations occur?

Most of the time, inflammation/injury to these structures occurs due to local trauma. This trauma can occur as a single, violent accident with immediate injury, or it can be the result of chronic trauma resulting from postural or occupational addictions.

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What are Bursitis?

Bursas are small pockets with fluid inside, which have the function of protecting the muscles and tendons from contact with the bone and facilitating the sliding between structures. Bursitis (inflammation of the bursae) can occur in many places in the body, but the most common are the elbows, knees, shoulders and hips.

How can the diagnosis of these conditions be made?

The diagnosis of all these conditions is based on the patient's history and clinical examination. Radiographs rule out bone abnormalities. Tendons, ligaments and bursae are not visible on radiographs, however the use of ultrasonography and, more recently, nuclear magnetic resonance have been of great help in defining the inflamed site and the degree of inflammation of the lesion.

Source: Brazilian Rheumatology Society

Reumatismo De Partes Moles

ANTI-PHOSPHOLIPID SYNDROME (APS)

What is Anti-Phospholipid Syndrome?

Anti-Phospholipid Syndrome or Anti-Phospholipid Antibody Syndrome (AFS) is an autoimmune disorder in blood clotting that causes thrombosis (abnormal clotting) in arteries and veins, in addition to complications in pregnancy (repetitive abortions, high blood pressure and prematurity of the baby). This syndrome occurs due to the production of antibodies against the body's own proteins (called anti-phospholipid antibodies) that are measured in the blood through laboratory tests.

How is the diagnosis of Anti-Phospholipid Syndrome performed?

For the correct diagnosis to be made, there must be at least one clinical manifestation of thrombosis or pregnancy-related complications associated with the presence of autoantibodies detected in the blood through laboratory tests. Only the presence of antibodies in the blood, without the clinical manifestations of thrombosis or complications related to pregnancy do not constitute the “APS”.

What are the clinical manifestations of Anti-Phospholipid Syndrome?

The manifestation of thrombosis can occur in any vessel in the body. In the case of veins, thrombosis of the lower limbs is the most common location. Clinically we observe: pain, swelling and redness in the affected leg. In the case of thrombosis of the arterial system, the most common manifestation is stroke (stroke: stroke).

Source: Brazilian Rheumatology Society

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Síndrome Anti-Fosfolípide
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SJÖGREN'S SYNDROME

What is Sjögren's Syndrome?

Sjögren's Syndrome (SS) is an autoimmune disease that is mainly characterized by the manifestation of dry eyes and mouth associated with the presence of autoantibodies or signs of glandular inflammation. Some white cells (called lymphocytes) invade several organs and glands, especially the lacrimal and salivary glands, producing an inflammatory process that ends up harming them, preventing their normal functions.

Are there other causes of dry mouth and eyes?

If a person has dry eye or dry mouth, they should be evaluated for possible causes of these symptoms. Medications (including those used to treat high blood pressure, depression, colds, and allergies), infections, and other eye problems can also cause these same symptoms. An ophthalmologist's evaluation will be necessary to determine if there really is a lack of tear and signs of inflammation in the cornea as a result of this dryness. If these changes are confirmed, the patient should be referred to a Rheumatologist to assess the diagnosis of Sjogren's Syndrome (SS).

What are the other clinical manifestations of Sjögren's Syndrome?

Patients with “SS” may also have dryness of the skin, nose and vagina. They may have fatigue, arthralgia and arthritis. In addition, other organs in the body such as the kidneys, lungs, vessels, liver, pancreas and brain can also be affected. This disease is more common in middle-aged women, but it can also occur in men and at any age.

Source: Brazilian Rheumatology Society

Síndrome e Sjögren

VASCULITIS

What are Vasculitis?

The term “vasculitis” means inflammation of blood vessels. In Vasculitis, the blood vessel wall is invaded by immune system cells causing stenosis, occlusion, aneurysm formation and/or hemorrhage. All organs of the body are supplied with blood through the vessels, therefore, the decrease in blood supply, due to changes in the vessels caused by Vasculitis, can cause symptoms or damage to any system. For this reason, Vasculitis encompass a diverse group of conditions.

What are Primary Vasculitis?

Primary Vasculitis is a rare disease of little known cause and occurs when the blood vessel is the main target of the disease. The name and classification of Primary Vasculitis depend mainly on the size of the blood vessel that is usually affected. Among the Primary Vasculitis, there are still two groups. In the first, vasculitis occurs in an isolated form in only one organ or tissue. This group includes vasculitis isolated from the central nervous system, skin, eyes, etc. In the second group, the vasculitis affects simultaneously or sequentially, several organs or systems (Systemic Vasculitis). They are: Takayasu's Arteritis and Giant Cell Arteritis or Temporal Arteritis (vasculitis that preferentially affect larger vessels); Polyarteritis Nodosa and Kawasaki Disease (vasculitis that mainly affect medium-sized vessels); Wegener's Granulomatosis, Churg-Strauss Arteritis, Microscopic Polyangiitis, Urticaria Vasculitis, Henoch-Schönlein Purpura and Cryoglobulinemia (vasculitis that affect small blood vessels).

Source: Brazilian Rheumatology Society

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Vasculites

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La Sofia clinic

R. Elenita de Castro Cardoso, 527 - Vila Aurora, Rondonópolis - MT, 78740-038

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