Joint and soft tissue aches and pains are a common occurrence. It has been estimated that up to 15% of consultations at a family practitioner's clinic are for musculoskeletal problems. While most aches and pains are self-limiting, it is important to recognise that some joint pains may signal the onset of rheumatic disease.
You should consult your doctor if you have: joint pains lasting more than a few weeks, joint redness or swelling; other accompanying symptoms such as fever, weight loss and skin rash.
- Evaluation and management of joint or soft tissue pain
- Rheumatoid Arthritis
- Ankylosing Spondylitis
- Psoriatic Arthritis
- Systemic Lupus Erythematosus
- Antiphospholipid Syndrome
- Sjogren's Syndrome
- Inflammatory Myopathy (eg. Polymyositis/ Dermatomyositis)
- Systemic Vasculitis (eg. Churg-Strauss Syndrome, Wegener's Granulomatosis)
- Soft Tissue Rheumatism
- Regional Pain Syndromes
- Non surgical management of Carpal Tunnel Syndrome/ Trigger Finger
Miscarriages are an emotionally difficult time for couples that are trying to establish a family. A miscarriage refers to a pregnancy loss before 5 months' gestation. Although miscarriages on the whole are a common occurrence, recurrent miscarriage (loss of two or more consecutive pregnancies) is a perplexing problem that affects up to 3% of couples trying to conceive.
Numerous causes for recurrent miscarriage (RM) have been identified in the literature. Apart from genetic or chromosomal, advancing age, uterine abnormalities, certain medical conditions such as hormonal and sticky blood syndrome are also increasingly recognised. More recently, studies have also demonstrated that sticky blood as well as thyroid antibodies can affect implantation and alterations in the immune system have been demonstrated in those with unexplained multiple implantation failures following in-vitro fertilization. Presently no explanation is found in up to 40% of couples. It has been suggested that a certain proportion in this group may be linked to immune dysregulation in implantation and pregnancy.
The evaluation of RM requires a detailed history and physical exam as well as a systematic approach to investigations; in order for the most appropriate management plan to be devised in partnership with each couple. You may be comforted to know that with close monitoring alone, the chance of a successful outcome at the next pregnancy may be as high as 60-70%. However, the identification of treatable causes has also significantly improved outcomes for couples.
- Evaluation of recurrent miscarriages
- Management of "sticky blood" conditions in pregnancy
- Management of rheumatic disorders in pregnancy
- Management of immune-related recurrent miscarriages/ implantation failure