Rheumatology

Rheumatology is a medical specialty which focuses on musculoskeletal (joints, muscles and bones) and autoimmune systemic (body-wide) conditions. Conditions can relate to aging and mechanical loading (osteoarthritis, lower back pain), overactivation of the immune system (rheumatoid arthritis, inflammatory eye disease, ankylosing spondylitis, systemic lupus erythematosus), and disorders of metabolism (gout). These conditions can involve any part of the body including the eyes, lungs, heart, skin, joints, kidneys, muscles and gut. A/Professor Sammel will take a history and examination and may recommend blood or imaging (x-ray, ultrasound, MRI) tests to confirm a diagnosis. Management of rheumatology conditions can include simple measures such as physiotherapy and lifestyle interventions or involve medications. Some patients may require complex medications which quieten the immune system to prevent ongoing attack on the body. These medications may require close monitoring by A/Prof Sammel and your GP.

Inflammatory Joint Conditions

Inflammatory joint conditions cause painful and swollen joints. The pain is normally worst in the mornings and may ease through the day. Any number of small (fingers and toes) and large (knees, hips and shoulders) can be affected. Some conditions cause back pain that is most severe overnight and in the morning.

Conditions treated by A/Prof Sammel include:

  • Rheumatoid arthritis
  • Ankylosing spondylitis
  • Psoriatic arthritis
  • Inflammatory bowel disease arthritis
  • Gout
  • Pseudogout
  • Viral and post-infective (reactive) arthritis
  • Sarcoidosis

Connective Tissue Diseases

Connective tissue diseases are a group of autoimmune conditions that can cause symptoms in many parts of the body. Common symptoms include dry eye and mouth, joint pain, muscle pain, fatigue, mouth ulcers, colour changes in the hands in cold weather and rash. In more serious cases the kidneys, lungs, heart and nerves can be affected.

Particular conditions treated by A/Prof Sammel include:

  • Systemic lupus erythematosus (SLE), known colloquially as “Lupus”
  • Sjogren syndrome
  • Systemic sclerosis (scleroderma)
  • Undifferentiated connective tissue disease
  • Mixed connective tissue disease

Inflammatory Eye Conditions

Eyes can be affected by inflammatory conditions. Symptoms can include dry eye, eye pain, sensitivity to light, eye swellings, red eye and vision loss. An ophthalmologist is the best person to assess these symptoms and may refer you to A/Prof Sammel to look for associated problems outside of the eyes and for assistance with medications.

Particular conditions treated by A/Prof Sammel in conjunction with your ophthalmologist include:

  • Uveitis (anterior, posterior, pan-uveitis)
  • Retinal vasculitis
  • Scleritis
  • Orbital inflammatory masses
  • Giant cell arteritis
  • Dry eye

Muscle Conditions

Patients with muscle conditions may experience pain, weakness or abnormal muscle fatigue. There are a large number of causes of these symptoms including local injuries and deconditioning, medications, inflammation, electrolyte disturbances, thyroid and other hormone imbalances, and inherited disorders of muscle fibres. Some of the conditions can affect other important parts of the body including the lungs, skin, joints and heart.

A/Prof Sammel is able to work through the list of possible causes and start therapy if required.

Particular conditions treated by A/Prof Sammel include:

  • Assessment of unexplained muscle symptoms to identify the cause
  • Dermatomyositis
  • Necrotising myositis
  • Antisynthetase syndrome
  • Polymyositis
  • Connective tissue disease related myositis

Other Joint & Tendon Conditions

Many people experience pain in and around their joints due to osteoarthritis (cartilage wear) or tears or excess loading of adjacent tendons. This often causes pain which is worse with particular activities such as walking, running, overhead reaching, wrist or hand movements. Some people have pain when they touch or lie on the affected regions. These conditions may be helped by lifestyle changes, activity modification, physiotherapy, footwear modifications, splints, local cortisone injections and/or anti-inflammatory medications.

Particular conditions treated by A/Prof Sammel include:

  • Osteoarthritis (knees, feet, finger/wrist, hip, back)
  • Tendon diseases including: rotator cuff tendinopathy, achilles tendinopathy, elbow flexor (golfers elbow) and extensor tendinopathy (tennis elbow), gluteal tendinopathy
  • Bursitis including: Subacromial bursitis, greater trochanteric bursitis