Denver Arthritis Clinic physicians specialize in treating and diagnosing bone, joint and muscle conditions – from the most visible to the highly complex and unseen. Our approach is based on a combination of leading-edge techniques, the latest research and proven clinical methods. Below is specific information on various conditions, diagnostic tools and treatments. We encourage patients to visit these sections as they are being treated at DAC.
Antiphospholipid syndrome (APS) is an autoimmune disease that causes frequent, and sometimes dangerous, clotting in the arteries and veins. With APS, your body makes abnormal proteins called antiphospholipid autoantibodies in the blood, causing blood to flow improperly. APS mostly affects women over the age of 30 and can cause pregnancy complications or miscarriages.
APS does not present any symptoms and is typically diagnosed after a clotting event or recurrent miscarriages. To diagnose APS, your rheumatologist at Denver Arthritis Clinic will run a series of tests on your blood sample to determine the presence of antiphospholipid autoantibodies. If you are diagnosed with APL, your doctor will work with you to determine the best treatment options for your condition. Treatments for APL to prevent the recurrence of clotting include oral anticoagulation medication and platelet inhibiting medication. To prevent miscarriages, people with APL typically take subcutaneous injections of heparin and low-dose aspirin from the beginning of the pregnancy until just after the delivery.
Calcium Pyrophosphate Deposition (CPPD)
Calcium pyrophosphate deposition (CPPD), formerly known as pseudogout, is a type of arthritis that causes crystals of pyrophosphate, a calcium salt, to build up in the joints. CPPD typically affect the knees but can affect other joints as well. CPPD usually occurs in people over the age of 60 as the chances of developing it increase with age.
CPPD is characterized by severe pain and swelling in the affected joint and can cause cartilage damage and more acute forms of arthritis. There are currently no treatments available to break up the crystal deposits. However, acute attacks of CPPD can be managed with nonsteroidal anti-inflammatory drugs. There are other medications available as well to manage CPPD in those who are not prone to acute attacks. Your rheumatologist at Denver Arthritis Clinic will discuss your best treatment options with you.
Fibromyalgia is a chronic health problem that causes widespread pain and tenderness. The pain and tenderness tend to come and go, and move throughout the body. Fibromyalgia occurs most often in middle-aged women but can occur in men and women of any age.
Symptoms of fibromyalgia vary, as does the severity of the symptoms. Common symptoms of fibromyalgia include tenderness to touch or pressure affecting joints and muscles, fatigue, trouble sleeping, problems with memory or thinking clearly. There is no cure for fibromyalgia, but there are a variety of treatment options to help manage and reduce the symptoms. Common treatment options include medicine to change some of the brain chemicals that help control pain levels, medicine to block the overactivity of nerve cells involved in pain transmission and sleep aids. Some non-drug treatments for fibromyalgia that are commonly recommended are gentle body-based therapies including Tai Chi and yoga, cognitive behavioral therapy, acupuncture, chiropractic and massage therapy.
Giant Cell Arthritis
Giant cell arthritis (GCA) is a type of arthritis that causes inflammation of the blood vessels, specifically the arteries of the scalp and head. GCA can occur with polymyalgia rheumatica. Though GCA is most commonly found women over the age of 50, it can occur in men over 50 as well.
The most common symptom of GCA is a persistent headache, usually around the temples but can also occur anywhere on the head. Other common symptoms of GCA include fatigue, loss of appetite, weight loss and flu-like symptoms. If GCA spreads to the blood supply of the eye, eyesight can be affected as well. If you are experiencing symptoms of GCA, your rheumatologist at Denver Arthritis Clinic may want to take a biopsy of a small piece of the temporal artery and study it under a microscope for signs of inflammation. If you are diagnosed with GCA, your rheumatologist will immediately start you on a treatment plan involving high doses of corticosteroids. Over time the doses of corticosteroids will be decreased gradually depending on the decrease of symptoms. Patients can typically stop this medicine after 1-2 years.
Gout is a painful form of arthritis that occurs when excess uric acid collects in the body, causing urate crystals to deposit in the joints. There are several reasons for the buildup of uric acid: an increase in uric acid production; the kidneys cannot remove uric acid from the body well enough; or certain foods and drugs that can cause higher uric acid levels. Anyone can be affected by gout, but it is most commonly found in men, women after menopause and people with kidney disease.
The first symptom of gout is typically painful joint swelling, usually in the foot and big toe. The joint can also be red and warm to touch. There are several ways of diagnosing gout including extracting fluid from an affected joint to determine the presence of urate crystals, blood tests, X-rays, ultrasounds and CT scans. If you are diagnosed with gout, your rheumatologist at Denver Arthritis Clinic will tailor a treatment plan to your specific needs. Treatments for acute attacks of gout include colchicine, nonsteroidal anti-inflammatory drugs and corticosteroids. Other treatments for gout that remove excess uric acid include medicines to lower blood uric acid levels, help the kidneys remove uric acid or to breakdown uric acid.
Granulomatosis with Polyangilitis (Wegener’s)
Granulomatosis with polyangilitis (GPA), also known as Wegener’s, is a rare blood vessel disease that most commonly affects the sinuses, lungs and kidneys but can also impact other organs as well. GPA causes granulomatous inflammation in small and medium sized blood vessels, which can lead to organ damage. GPA most often occurs in people over the age of 40, but can happen at any age.
Symptoms can vary depending on the organ affected by GPA. Some of the more common symptoms include nasal congestion, frequent nosebleeds, shortness of breath, a cough that may produce bloody phlegm, joint pain, decreased hearing, skin rashes, eye redness, vision changes, fatigue, fever, appetite and weight loss, night sweats and numbness or loss of movement in the fingers, toes and limbs. If you are diagnosed with GPA, your rheumatologist at Denver Arthritis Clinic will work with you to determine the best treatment plan based on the severity of the condition and the organ affected. GPA is typically treated with various types of medications that treat the severity of the condition as well as symptoms.
Inflammatory myopathies is a muscle disease that occurs when the body’s immune system attacks the muscles, causing inflammation that can damage muscle tissue and make muscles weak. Anyone can get inflammatory myopathies, but it most commonly occurs in children age 5 to 10 and adults ages 40 to 50.
Common symptoms of inflammatory myopathies include weakness in the large muscles around the neck, shoulders and hips, trouble climbing stairs or getting out of a sitting position, little to no pain in the muscles, choking while eating, shortness of breath and cough. People with inflammatory myopathies can also develop polymyositis and dermatomyositis. While both have symptoms of muscle inflammation and weakness, a rash that appears as purple or red spots on the upper eyelids or as scaly, red bumps over the knuckles, elbows or knees also characterizes dermatomyositis. Depending on the symptoms you present, your rheumatologist at Denver Arthritis Clinic may want to run some tests to determine if you have inflammatory myopathies. If you are diagnosed with inflammatory myopathies, your rheumatologist will most likely treat it with medication in the form of corticosteroids, a combination treatment or immune treatments in addition to physical therapy.
Lupus, also know as systemic lupus erythematosus or SLE, is a chronic autoimmune disease that causes inflammation. Lupus mainly affects the joints, kidneys and skin but can also affect the lungs, nervous system and other organs of the body. Cases of lupus range from mild to severe with patients experiencing periods when the disease is active followed by periods when the disease is in remission.
Lupus can cause a range of symptoms including fever, fatigue, weight loss, blood clots, hair loss, rashes, mouth sores, arthritis, muscle and joint pain, heartburn, stomach pain and abnormal blood tests. While there is no cure for lupus, there are a number of treatment options available. Your rheumatologist at Denver Arthritis Clinic will determine the best treatment option for you based on your symptoms and the severity of those symptoms. Common treatments for lupus symptoms include nonstreoidal anti-inflammatory medicine or antimalarial medicine, corticosteroids and immune suppressants, biologics and various combinations of medications to control lupus and prevent tissue damage.
Osteoarthritis (OA) is the most common form of joint disease in middle age to elderly people. OA causes the breakdown of joint cartilage, changes in joint bones, deterioration of tendons and ligaments and inflammation of the joint lining. This is can be due to mechanical stress or biochemical alterations to the joint. The joints most commonly affected by OA are the hand joints, spine, hips, knees and big toes.
Common symptoms of OA include joint pain and stiffness, knobby swelling at the joint, a cracking or grinding noise with joint movement and decreased function of the joint. Though there is not cure for OA, various treatments can be used to reduce pain and improve joint function. Your rheumatologist at Denver Arthritis Clinic can discuss with you the best options for treating your symptoms. Common treatments for symptoms of OA include weight loss and exercise, use of braces and walking canes for added support, massage, chiropractic manipulation and medicine therapy including pain relievers and non-steroidal anti-inflammatory medicine. In more severe cases of OA, surgery may be recommended to repair damage to the joint or replace the joint entirely.
Osteoporosis occurs when the loss of bone mass or changes in bone structure cause the bones to become weak and brittle, which can lead to fractures and breaks. Decreasing bone mass can occur in both men and women starting in their mid-30s and increase as they grow older. Some risk factors that can contribute to osteoporosis include low levels of estrogen (in women), cigarette smoking, alcohol abuse, low calcium and vitamin D intake, sedentary lifestyles, family history of osteoporosis and inflammatory arthritis.
Osteoporosis does not present any symptoms, and many do not know they have it until they fracture a bone. Your rheumatologist at Denver Arthritis Clinic can diagnose osteoporosis by performing a test to measure your bone mineral density. If you are diagnosed with osteoporosis, your rheumatologist will discuss treatment options to help manage it. Common recommendations include simple lifestyle changes such as increasing your calcium and vitamin D intake and performing weight-bearing exercises regularly. There are also a number of medication options to help slow bone loss and prevent fractures. One medication often used is FORTERO.
Polymyalgia rheumatica (PMR) causes widespread aching and stiffness in older adults. PMR commonly affects the upper arms, neck, lower back and thighs and is most severe in the mornings. PMR can lead to other problems such as disturbed sleep, trouble getting dressed in the morning, and trouble getting out of the sitting position. PMR typically affects adults over 50, though the average age of onset is 70.
If your rheumatologist at Denver Arthritis Clinic determines that you have PMR, he or she will begin treating it with a trial of low-dose corticosteroids. Depending on your response to the medication, your doctor may begin decreasing the dosage so as to give the lowest dose that allows you to be comfortable.
Psoriatic arthritis is a type of arthritic inflammation that often occurs in patients who have a skin rash called psoriasis, which causes scaly red and white patches to develop on the skin. However, it can also occur in people without psoriasis, especially those who have relatives with psoriasis. It is typically found in men and women ages 30 to 50 but can sometimes begin as early as childhood. Psoriatic arthritis can affect any joint in the body or multiple joints at once and, if left untreated, could lead to severe joint damage.
Symptoms of psoriatic arthritis can vary from person to person and depend on the severity of the condition and the joint affected. Symptoms can include swelling, joint stiffness as well as pain and tender spots where tendons and ligaments join the bone. Treatment for psoriatic arthritis also varies depending on the symptoms and level of pain. Common treatment options for psoriatic arthritis include non-steroidal anti-inflammatory medicine and anti-rheumatic medicine, corticosteroid injections and, in more severe cases, surgery to repair or replace badly damaged joints. Frequently used medications include, ENBREL, HUMIRA, CIMZIA and SIMPONI – a self-injectable. Your rheumatologist at Denver Arthritis Clinic will work with you to decide on the best treatment option for your symptoms.
Reactive arthritis is a form of inflammatory arthritis that is caused by a bacterial infection. The bacteria that cause reactive arthritis come from the genitals, usually in the form of chlamydia, and the bowels. Anyone can be affected by reactive arthritis but it most commonly affects men between 20 and 50.
Common symptoms of reactive arthritis include pain and swelling in the knees, ankles and other joints, pain and swelling in the heels, extensive swelling of the toes and fingers and persistent lower back pain that is especially present in the mornings and at night. If diagnosed early, your rheumatologist at Denver arthritis Clinic can treat reactive arthritis with nonsteroidal anti-inflammatory drugs. Cases of chronic reactive arthritis require more aggressive treatment. Your rheumatologist may recommend disease-modifying antirheumatic drugs, corticosteroid injections and a prolonged course of two or more antibiotics.
Rheumatoid Arthritis (RA) is a chronic autoimmune disease that causes pain, stiffness, swelling and limited motion and function of many joints. While RA can affect any joint, the small joints in the hands and feet tend to be affected most often. RA is the most common type of autoimmune arthritis and can start at any age but is most common in women over 50.
Symptoms of RA vary greatly depending on the severity of the disease and the joint(s) affected. Some common symptoms include pain, stiffness, swelling, limited motion and function of the affected joint, loss of energy, low fevers, loss of appetite, dry eyes and mouth and firm lumps beneath the skin near the affected joint. Though there is no cure for RA, there are a number of treatments available to lessen your symptoms. Common treatment options for RA include disease-modifying antirheumatic medicine and nonsteroidal anti-inflammatory medicine, low-dose corticosteroids and medicine consisting of biologic response modifiers or “biologic agents.” Frequently used medications include, ENBREL, HUMIRA, CIMZIA and SIMPONI – a self-injectable. Your rheumatologist at Denver Arthritis Clinic will discuss your best treatment options with you.
Scleroderma is an autoimmune rheumatic disease that affects the skin and other organs of the body. Scleroderma causes a buildup of scar tissue, leading to the thickening and tightening of the skin and inflammation and scarring of organs such as the lungs, kidneys, heart and intestinal systems. Scleroderma is rare but can affect men and women of any age, most commonly women between 30 and 50. There are two types of scleroderma. Localized scleroderma typically affects the skin and sometimes muscles, joints and bones. Systemic scleroderma affects the skin, muscles, joints, blood vessels, lungs, kidneys, heart and other organs.
Symptoms of scleroderma include color changes in the fingers and toes after exposure to cold temperatures, skin thickening, swelling and tightening, enlarged red blood vessels on the hands, face and around nail beds, calcium deposits, high blood pressure, heartburn and other digestive issues, shortness of breath and joint pain. Though there is no cure for scleroderma or ways to reverse the damage, there are several treatments options available to help manage it by treating the symptoms and preventing further complications. Your rheumatologist at Denver Arthritis Clinic can determine the best treatment plan for you given your symptoms and the severity of your condition.
Sjogren’s syndrome is an autoimmune disorder that causes inflammation and can affect many different parts of the body, but most often affects the tear and saliva glands. Primary Sjogren's syndrome occurs in people with no other rheumatologic disease. Secondary Sjogren's occurs in people who have another rheumatologic disease. Sjorgen’s syndrome most commonly affects women over 45 but can occur in men and women of any age.
Symptoms of Sjorgen’s syndrome vary from person to person. Common symptoms include irritation, a gritty feeling or painful burning in the eyes, dry mouth or difficulty eating dry foods, swelling of the glands around the face and neck and dryness in the nasal passages, throat, vagina and skin. Treatment options for Sjogren’s syndrome vary as they are meant to treat the symptoms experienced by the patient, such as dry eyes, dry mouth or arthritis symptoms. Your rheumatologist at Denver Arthritis Clinic will work with you to decide the best treatment options based on your symptoms.
Spondyloarthritis is the name for inflammatory rheumatic diseases that cause arthritis. The most common form of spondyloarthritis is ankylosing spondylitis, which affects the spine. Other forms of spondyloarthritis include axial spondyloarthritis, peripheral spondyloarthritis, reactive arthritis, psoriatic arthritis and enteropathic arthritis. Spondyloarthritis affects the ligaments and tendons where they attach to the bones. Spondyloarthritis is genetic and commonly affects men in their teens and early twenties.
Common symptoms of spondyloarthritis include lower back pain, inflammation causing pain and stiffness in the spine, hands, arms, feet and legs as well as bone destruction that causes deformities of the spine and poor function of the shoulders and hips. Your rheumatologist at Denver Arthritis clinic may do some tests, X-rays or MRIs if you present symptoms consistent with spondyloarthritis. If you are diagnosed with spondyloarthritis, there are several treatment options available to you. Common treatments for spondyloarthritis include physical therapy and medication such as nonsteroidal anti-inflammatory drugs, corticosteroids, disease modifying antirheumatic drugs and TNF alpha-blockers. Frequently used medications include, ENBREL, HUMIRA, CIMZIA and SIMPONI – a self-injectable. In more severe cases, surgery may be required.
Vasculitis refers to the inflammation of blood vessels, including arteries and veins, which can cause poor circulation throughout the body. There are many types of vasculitis, which are characterized by the size of the arteries and veins they affect. Vasculitis can be genetic or occur as a reaction to certain medicines. Chronic infections, such as hepatitis C or hepatitis B, can cause it as well. Vasculitis can affect both men and women at every age.
Symptoms of vasculitis vary, but some more common symptoms include shortness of breath, coughing, numbness or weakness in the hand or foot and red spots, lumps or sores on the skin. The severity of vasculitis also varies from mild to disabling or life threatening. If you present symptoms of vasculitis, your rheumatologist at Denver Arthritis Clinic may want to run some tests such as a biopsy, angiography and blood tests. If you are diagnosed with vasculitis, there are several treatment options available to you. Vasculitis is typically treated with medications such as glucocorticoids, immune suppressing drugs and drugs designed to treat other autoimmune and inflammatory diseases. In more severe cases of vasculitis, surgery may be required to repair the damage to affected blood vessels.