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  • Treatment of Raynaud’s phenomenon depends on its severity and whether you have any other health conditions. For most people, Raynaud’s phenomenon is more a nuisance than a disability.
  • Women are more likely to have Raynaud’s phenomenon. It's also more common in people who live in colder climates.
  • Avoid potential triggers such as smoking, stress and caffeine.
  • Raynaud’s can be a complex disease. As experts in diagnosing and treating autoimmune diseases such as Raynaud’s, rheumatologists can best advise patients about treatment options.

Raynaud's phenomenon. This term refers to color changes (blue, white and red) that occur in fingers and, sometimes, toes. Raynaud’s often occurs after exposure to cold temperatures. It occurs when the blood flow to the hands, fingers or toes is temporarily reduced. Raynaud's can lead to finger swelling, color changes, numbness, pain, skin ulcers and gangrene on the fingers and toes. People with have Raynaud's may have other diseases, and some people with Raynaud's do not have any other disease.

Raynaud's occurs in two main types:

  • Primary Raynaud's is the most common form of the disorder and is not connected to an underlying disease or related medical problem. It is also called Raynaud’s phenomenon.
  • Secondary Raynaud's is also called Raynaud's phenomenon. This form is caused by an underlying, or related, problem. Secondary Raynaud's is less common than the primary form, but it tends to be a more serious disorder. Symptoms of secondary Raynaud's often first appear at later ages — around 40 — while people with the primary form often see symptoms earlier.

Source: American College of Rheumatology


  • Reactive arthritis can affect the heels, toes, fingers, low back, and joints, especially of the knees or ankles.
  • Though it often goes away on its own, reactive arthritis can be prolonged and severe enough to require seeing a specialist. Effective treatment is available for reactive arthritis.
  • Reactive arthritis tends to occur most often in men between ages 20 and 50.
  • Most cases of reactive arthritis appear as a short episode. Occasionally, it becomes chronic.

Reactive arthritis is a painful form of inflammatory arthritis (joint disease due to inflammation). It occurs in reaction to an infection by certain bacteria. Most often, these bacteria are in the genitals (Chlamydia trachomatis) or the bowel (Campylobacter, Salmonella, Shigella and Yersinia). Chlamydia most often transmits by sex. It often has no symptoms, but can cause a pus-like or watery discharge from the genitals. The bowel bacteria can cause diarrhea. If you develop arthritis within one month of diarrhea or a genital infection – especially with a discharge – see a health care provider. You may have reactive arthritis.

In the past, it went by the name “Reiter’s syndrome.” Now it belongs to the family of arthritis called “spondyloarthritis.”

Source: American College of Rheumatology


  • Rheumatoid arthritis (RA) is the most common type of autoimmune arthritis. It is triggered by a faulty immune system (the body’s defense system) and affects the wrist and small joints of the hand, including the knuckles and the middle joints of the fingers.
  • Treatments have improved greatly and help many of those affected. For most people with RA, early treatment can control joint pain and swelling, and lessen joint damage.
  • Perform low-impact aerobic exercises, such as walking, and exercises to boost muscle strength. This will improve your overall health and reduce pressure on your joints.
  • Studies show that people who receive early treatment for RA feel better sooner and more often, and are more likely to lead an active life. They also are less likely to have the type of joint damage that leads to joint replacement.
  • Seek an expert in arthritis: a rheumatologist. Expertise is vital to make an early diagnosis of RA and to rule out diseases that mimic RA, thus avoiding unneeded tests and treatments. Rheumatologists are experts in RA and can design a customized treatment plan that is best suited for you.

People have long feared rheumatoid arthritis (commonly called RA) as one of the most disabling types of arthritis. The good news is that the outlook has greatly improved for many people with newly diagnosed (detected) RA. Of course, RA remains a serious disease, and one that can vary widely in symptoms (what you feel) and outcomes. Even so, treatment advances have made it possible to stop or at least slow the progression (worsening) of joint damage. Rheumatologists now have many new treatments that target the inflammation that RA causes. They also understand better when and how to use treatments to get the best effects.


Therapy for RA has improved greatly in the past 30 years. Current treatments give most patients good or excellent relief of symptoms and let them keep functioning at, or near, normal levels. With the right medications, many patients can achieve “remission” — that is, have no signs of active disease.

There is no cure for RA. The goal of treatment is to lessen your symptoms and poor function. Doctors do this by starting proper medical therapy as soon as possible, before your joints have lasting damage. No single treatment works for all patients. Many people with RA must change their treatment at least once during their lifetime.

Good control of RA requires early diagnosis and, at times, aggressive treatment. Thus, patients with a diagnosis of RA should begin their treatment with disease-modifying antirheumatic drugs — referred to as DMARDs. These drugs not only relieve symptoms but also slow progression of the disease. Often, doctors prescribe DMARDs along with nonsteroidal anti-inflammatory drugs or NSAIDs and/or low-dose corticosteroids, to lower swelling, pain and fever. DMARDs have greatly improved the symptoms, function and quality of life for nearly all patients with RA. Ask your rheumatologist about the need for DMARD therapy and the risks and benefits of these drugs.

Common DMARDs include methotrexate (Rheumatrex, Trexall, Otrexup, Rasuvo), leflunomide (Arava), hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine).

Gold is an older DMARD that is often given as an injection into a muscle (such as Myochrysine), but can also be given as a pill — auranofin (Ridaura). The antibiotic minocycline (Minocin) also is a DMARD, as well as the immune suppressants azathioprine (Imuran) and cyclosporine (Neoral, Sandimmune, Gengraf). These three drugs and gold are rarely prescribed for RA these days, because other drugs work better or have fewer side effects.

Patients with more serious disease may need medications called biologic response modifiers or “biologic agents.” They can target the parts of the immune system and the signals that lead to inflammation and joint and tissue damage. FDA-approved drugs of this type include abatacept (Orencia), adalimumab (Humira), anakinra (Kineret), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi) infliximab (Remicade), rituximab (Rituxan, MabThera) and tocilizumab (Actemra). Most often, patients take these drugs with methotrexate, as the mix of medicines is more helpful.

Janus kinase (JAK) inhibitors are another type of DMARD. People who cannot be treated with methotrexate alone may be prescribed a JAK inhibitor such as tofacitinib (Xeljanz).

The best treatment of RA needs more than medicines alone. Patient education, such as how to cope with RA, also is important. Proper care requires the expertise of a team of providers, including rheumatologists, primary care physicians, and physical and occupational therapists. You will need frequent visits through the year with your rheumatologist. These checkups let your doctor track the course of your disease and check for any side effects of your medications. You likely also will need to repeat blood tests and X-rays or ultrasounds from time to time.

Source: American College of Rheumatology