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Do I have a rheumatology problem?

Q: I am a 45 years old female. For the last three-four years, I am suffering from continuous muscle joint pain (hip) and psoriasis. I have done ANA tests and it shows positive +2, ANA 1:40. The doctors have given Ecosprin, Rejunuron 1-0-1 & other medicines for 3 months. Now the doctor has advised a DNA test; what will be the course of action. I have back pain too. I am taking treatment in Mumbai, should I consult a rheumatologist?

A:Please note the following important points: 1. Your history is rather typical of psoriatic spondyloarthritis. 2. You must see a good rheumatologist in Mumbai; one such person is Dr. Sanjiv Amin, a senior consultant rheumatologist. 3. Joint diseases are not the specialty of orthopaedic surgeons as they are not formally trained in this field. Joint diseases are best managed by rheumatologists (i.e. physicians trained in diseases of musculoskeletal system including joints, muscles, connective tissues, etc.) 4. Low-titre ANA is positive in psoriasis in approximately 30% of patients, it is well known to rheumatologists but orthopaedic surgeons, having not been trained in immunology, do not know this simple fact. 5. Modern scientific medicines can treat your disease rather well and quickly. 6. In the last ~ 40 years of my practice in this field, I have never seen a single patient suffering from any of the systemic auto immune musculoskeletal diseases (your disease is one of them) getting any relief with any alternative systems of medicine. In fact, till today there is not even a single well conducted scientific trial of any of the alternative systems of medicines that have shown any response in these diseases. Therefore, in short, my advice is: 1. Do not waste any more time with orthopaedic surgeons and do not waste further time in any of the alternative systems. 2. Immediately contact a rheumatologist and start modern scientific medicine for a quick and satisfactory response. 3. Totally ignore ANA test result, if your diagnosis is psoriasis.

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