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Rheumatological Diseases

Rheumatological Diseases and COVID-19

In view of the concern with the announcement of the new coronavirus infection pandemic by the World Health Organization (WHO) and in view of the recognition of the beginning of community transmission (when it is no longer possible to identify the focus) in the country, the best rheumatologist in Delhi ratifies the positions of several serious medical entities, especially with regard to patients with rheumatic diseases.

1- It is important to note that most infected people have mild symptoms and recover completely without any specific treatment. The risk of progressing to a more serious illness increases with age and when there are associated diseases such as diabetes, chronic heart and lung disease. There is NOT enough information about the effect of immunosuppressive or immunobiological medications on a possible COVID-19 infection. It is recommended that measures of suspension of treatments in the presence of suggestive symptoms be discussed individually, considering the risk of disease activity and the infectious condition by the specialist physician who performs the monitoring. Preventive interruption can also be assessed, but there is no evidence that this will have any protective effect against infection.

2- Preliminary studies indicate that the medication ibuprofen may be related to a worse evolution of the pulmonary condition. Therefore, it is recommended to avoid the use of this drug, giving preference to the use of paracetamol or dipyrone in case of pain or fever.

3- Rheumatic patients should schedule an appointment with the attending arthritis specialist in Delhi only in cases of need for reassessment for disease activity and medication in use, otherwise, it is recommended to postpone or use communication resources to clarify doubts.

4- We reiterate that the MOST IMPORTANT and EFFICIENT measure at this moment is SOCIAL ISOLATION. We recommend that patients with rheumatic diseases and their contact family remain at home, leaving only in situations where this is absolutely necessary. This is the action that will bring the most PROTECTION.

5- Finally, we warn you to always seek institutional information so that the frequent “fake news” circulating on social networks does not generate unnecessary panic. We need to act with serenity, seriousness and firmness in order to minimize the serious damage that this crisis could cause us.

arthritis specialist in Delhi


With age, various changes naturally occur in our body. We have more wrinkles, grey hair appears. All of these are external changes. However, many of us are not aware that ageing also affects our skeletal system. Our bones and joints also change with age. Here we talk about what happens to our skeletal system, and what needs to be done to maintain the health of our bones and joints.


Throughout life, our bones are constantly changing. The body naturally gets rid of the “aged” bone tissue and replaces it with a new 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 people is about 30 years old.

When the bone mass reaches its peak value for some time, approximately as much new bone tissue is formed in the body as it is lost, however, after about 40 years, bone formation processes begin to lag behind. Bones as a result of this become thinner and weaker, gradually increasing the risk 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 are also living and active structures that change with age. The decrease in water content, as well as natural wear and tear, gradually leads to the destruction of articular cartilage – one of the most 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 each other, absorbing some of the loads on the joint. A disease characterized by wear of the articular cartilage is called osteoarthrosis.

Some problems associated with age-related changes in the joints can be avoided. One of the problems that often accompany ageing, but which is not its natural component, is low physical activity. As we get older, we move less. It must be understood that the less we move, the less mobile our joints become. Along with joints, muscles also suffer – they become weaker. People leading an active lifestyle despite old age have healthier bones and joints.


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

  • Ask your rheumatologist in Delhi what medications may affect your bones. There are many drugs that enhance bone loss, such as long-term use of anticonvulsants, some drugs used to treat cancer, anti-inflammatory drugs from the corticosteroid group used to treat arthritis and many other diseases, such as bronchial asthma, Crohn’s disease, lupus.
  • Exercise regularly. Physical activity not only allows you to maintain the mobility of your joints, it minimizes bone loss, and also supports muscle tone and strength, thereby helping to prevent 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 they need. If you are not sure that you are getting enough of them with food, ask your arthritis specialist in Delhi to give them to you.
  • Maintain a healthy weight. Being overweight is a cause of joint overload and leads to accelerated wear of bones and joints, increasing the risk of osteoarthritis.

Mutilated Psoriatic Arthritis

Mutilated arthritis is a rare and severe form of arthritis that affects the hands and feet. It is most common in people with psoriatic arthritis, but can also develop in those with rheumatoid arthritis.

Mutilated psoriatic arthritis is very rare. About 5% of people with psoriatic arthritis (PsA) develop this condition. Mutilated arthritis can cause loss of bone mass, also called osteolysis, which leads to changes in the shape of the fingers or toes and can affect a person’s mobility. It can also cause a sore throat or back pain.

PsA mutilation can lead to permanent damage to the fingers, hands, and feet. However, studies have shown that early diagnosis and Psoriatic Arthritis Treatment in Delhi can prevent the progression of joint damage to the stage of mutilating arthritis.

Symptoms of mutilating psoriatic arthritis

Mutilating PsA occurs by worsening PsA, resulting in inflammation attacking bone tissue and destroying it. The body then reabsorbs the bone. When someone develops mutilating PsA, they experience the following symptoms:

– the fingers or toes are shortened and coupled together, which is called telescoping.
– The skin gathers over the shortened fingers.
– the mobility of the joints of the hands and feet is reduced.
– bone fusion also called ankylosis.
– other anatomical abnormalities of the fingers.

Patients with mutilating PsA also have other symptoms of PsA and psoriasis:

– joint pain or tremor.
– stiffness or swelling of the joints.
– fatigue.
– separating the nails from the finger.
– red spots on the skin with silver “scales”.
– tenderness, pain, and swelling of the tendons that connect the muscles to the bones.
– uveitis, which can cause redness and pain in the eyes as well as blurred vision.

Causes of mutilating psoriatic arthritis

Mutilated PsA occurs by aggravating PsA and interferes with normal bone growth and regeneration. PsA and psoriasis are autoimmune diseases in which the immune system attacks healthy cells in the body.

At PsA, the immune system attacks healthy joints and leads to inflammation, pain, swelling, and other symptoms.

In psoriasis, the immune system causes the epithelial cells to renew too quickly, leading to rashes that cover the skin with silver scales, which exfoliate.

The exact cause of the excessive immune response is not clear, but it could have a genetic component. Researchers have identified several genes that increase the risk of exposure to psoriasis and PsA.

About 40% of PsA patients have a family member suffering from psoriasis or arthritis.

However, we cannot limit ourselves to hereditary causes. Experts believe that certain environmental factors, such as injuries or infections, could also affect a person’s chances of contracting psoriasis.

Risk factors

Patients with PsA or psoriasis are at risk of developing mutilating PsA. However, most people with these conditions will not reach mutilating PsA.

The authors of a case study say that with today’s effective treatments for PsA, mutilating PsA has become extremely rare. Many of the cases reported in the medical literature show that mutilating PsA often develops when a person with PsA has not received proper treatment for several years.

One possible conclusion is that even if a person has PsA, the risk of mutilating PsA is low when effective medications are given to control inflammation.

Experts are not sure why PsA occurs in some people and not in others. One study found that both obesity and severe psoriasis symptoms increase a person’s risk of having PsA. However, studies have not correlated these factors with a person’s risk of developing mutilating PsA.

Diagnosis of mutilating psoriatic arthritis

The best rheumatologist in Delhi may identify mutilating arthritis during a body check, noticing the distinct changes in the fingers. However, other tests may be needed to determine if PsA or rheumatoid arthritis (RA) has led to mutilating arthritis. These analyzes may include:


Any x-ray can show damage or reabsorption of bones and joints. Doctors may notice a “pencil in the glass” formation of the joints. One part of the joint or one end of the bone resembles the sharp tip of a pencil, while the adjacent bone has a flat, glass-like appearance.

The blood test

Although arthritis doctor in Delhi cannot use blood tests to diagnose PsA, they can help diagnose RA. Patients with RA usually have a specific antibody in their blood. In addition, patients with PsA may have higher levels of inflammation in their blood.


An MRI can provide a more detailed look at the joints.

Skin examination

The symptoms of psoriasis can be an indication. In this case, look for distinct red eruptions with silver scales.

Natural treatments and remedies

There is no specific treatment for mutilating PsA per se, but effective PsA treatments can stimulate or stop joint damage and bone loss. Such treatments include:

– non-steroidal anti-inflammatory drugs.
– Non-steroidal anti-inflammatory drugs may relieve pain, but are not as effective as a treatment in itself for mutilating PsA.
– disease-modifying antirheumatic drugs (DMARD).
– DMARD helps control PsA by reducing the body’s hyperactive immune response. DMARDs are also effective in controlling the inflammation caused by PsA and in stopping its worsening.

Organic products

Biological products stop certain proteins or cells from attracting an immune response. They are given as an injection or by intravenous infusion.

New oral treatments

These pills target small molecules in immune cells to stop the mutilating PsA inflammation.

Physical therapy

Aggressive physiotherapy can help some people with mutilated PsA keep their joints mobile. Joint movement can help relieve inflammation resulting from mutilating PsA.

Turmeric (turmeric)

Turmeric has strong anti-inflammatory properties and could help prevent or reduce PsA eruptions.

There is insufficient evidence to suggest that turmeric alone can treat mutilating PsA or PsA. However, the authors of a systematic report and meta-analysis concluded that it could complement drugs and other clinical treatments.

It is important to talk to a rheumatologist in Delhi before taking supplements and other remedies, as they may interfere with some medications and may have side effects.

Physical exercises

Physical activity offers several benefits to people with PsA. This can help maintain joint flexibility, stimulate mood, and improve overall mental well-being.

Exercise can help with weight loss, which reduces stress on the joints and the risk of type 2 diabetes, most likely to affect people with psoriasis.

How can mutilating PsA be controlled

Because mutilating PsA can cause loss of function in the affected joints, it can interfere with the patient’s quality of life. People who have digital abnormalities from mutilating PsA may have difficulty performing daily tasks.

Some of the following measures can help a person with mutilated PsA cope with the symptoms:

– consult an arthritis doctor in Delhi regularly to guarantee the functioning of the treatment and prevent the aggravation of the disease.
– discussing all health issues with a doctor. Pain may be a symptom of PsA, but studies suggest that the disease could also cause depression, anxiety, and other mental disorders. Tell arthritis specialist in Delhi if mutilating PsA affects your well-being in any way.
– finding a support group. Talking about PsA and mutilating arthritis with others who understand the situation can help emotional health. These support groups are available both online and locally and nationally for PsA patients.
– ask for help. If possible, seek the help of friends, neighbors, or family members for difficult things. Patients with mutilating PsA could benefit from private health care or a nurse if they are unable to perform personal or household tasks.


Experts have not identified a clear way to prevent mutilating PsA, but taking PsA medications and keeping inflammation under control can help prevent or at least slow its progress.

Many can reach remission through today’s drug treatment. Remission means that the condition is not active in the body and does not get worse, which can help reduce the risk of the individual developing mutilating PsA or joint damage from PsA.

Even after remission, however, a person will need to continue taking PsA treatment to prevent the disease from returning.