General Practitioners

• Osteoporosis
  While our providers are granted hospital privileges at selected local hospitals, The Arthritis and Osteoporosis Center is an independent organization. Our local care center is fortunate to be a part of a national Rheumatology group, the American Arthritis and Rheumatology Associates (AARA). We are an organization that is owned and led by providers. We are independent from hospitals or corporations and have come together to practice medicine the way we believe it should be. We value our uniqueness, yet take comfort in the power of leveraging our collective strength and unity. We believe in teamwork and focusing on the totality of patients’ needs. We strive to make the healthcare experience personalized, convenient and pleasant.
• Arthritis
  Rheumatoid Arthritis, abbreviated “RA” is considered a chronic autoimmune disorder and an inflammatory arthritis. In patients with RA, the immune system confuses the lining of the joints (synovium) with a bacteria or virus and sends all parts of the immune system’s attack force against these joints. This results in inflammation, pain, swelling and stiffness of possibly any joint in the body, though small joints in the hands and feet are most commonly affected. While joints are the most obvious targets of RA, it is important to understand that RA is a systemic disease and can cause other manifestations. For example, aggressive forms of RA can affect the eyes, lungs, blood counts and even skin. Additionally, RA patients may suffer from a unique form of fatigue that is thought to be at least partially related to the overactive immune system and inflammation.
• Fibromyalgia
• Plantar Fasciitis
• Rheumatology
  Why a Gout Center of Excellence (GCE)? Our practice has a keen interest in diagnosing and treating gout. Gout is one of the most common inflammatory arthritis syndromes. Thanks to some great researchers, over the years the medical and rheumatology community has gained considerable insight about a number of details surrounding the disease: which patients are at risk, how best to diagnose, underpinnings of what causes the disease and the development of very effective medical treatments.  We also understand that it is extremely important to treat gouty arthritis aggressively as a chronic disease since the disease can lead to joint damage and disability.
• Primary Care
  Rheumatologists are physicians who, following 4 years of medical school and 3 years in an internal medicine residency, go on to complete an extra 2-3 years of fellowship training focused on the management of chronic musculoskeletal and autoimmune conditions. Rheumatologists treat arthritis, certain autoimmune diseases, musculoskeletal pain disorders, and osteoporosis. While some of these conditions may be treated effectively by a primary care physician, others require a rheumatologist.  There are more than 100 types of these diseases, including Rheumatoid or Psoriatic arthritis, gout, Lupus, Sjogren’s, Osteoporosis, Systemic Vasculitis to name a few. Some of these illnesses are very serious, even life-threatening diseases that can be difficult to diagnose and treat while others are common, routine musculoskeletal conditions.  Because autoimmune and inflammatory diseases can affect almost any organ system or part of the body, rheumatologists are required to be expert diagnosticians and will not focus solely on bones and joints. The correct diagnosis begins with a detailed history, physical exam, and, in some instances, special studies.  Rheumatologists understand how overwhelming and challenging it can be for the patient to figure out their illness.  With an accurate diagnosis, there are many specialized therapies for inflammatory arthritis and connective tissue disorders that require careful management and monitoring under a rheumatologist for safe, effective outcomes. The ultimate role of the rheumatologist is to help people live to their fullest potential by controlling their symptoms, restoring maximum function and alleviating discomfort.

Internists

• Internal Medicine
• Ovarian Cancer
  Osteoporosis is a relatively common disease. Approximately 54 million adults are affected by Osteoporosis or low bone mass. About 80% of Americans with Osteoporosis or significant bone loss are women, though men make up 20%. More importantly one in two women and up to one in four men above the age of 50 and over will break a bone related to Osteoporosis. Osteoporosis is a serious, even deadly disease. A woman’s risk of fracture is equal to her combined risk of breast, uterine and ovarian cancer. A man is more likely to break a bone due to osteoporosis than he is to get prostate cancer. 24% of hip fracture patients 50 and over die in the year following the fracture. Six months after a hip fracture, only 15 percent of patients can walk across a room unaided.
• Prostate Cancer

Neurologists

• Multiple Sclerosis
  Women lose bone sooner than men due to the loss of bone protective hormone estrogen at menopause.  Other important risk factors for bone loss and fractures include family history of Osteoporosis, previous history of Osteoporotic bone fracture, advanced age, smoking, excess alcohol intake, small body frame or loss of weight/height. Certain medical conditions including Rheumatoid Arthritis, Lupus, Multiple Sclerosis, Hyperthyroidism, Hyperparathyroidism, and loss of testosterone can reduce bone strength and increase risk of fractures. Many medications can be associated with bone loss, including corticosteroids (prednisone), certain seizure medications, hormonal treatments for breast cancer (aromatase inhibitors), and even common heartburn medications (proton pump inhibitors like Omeprazole).

Radiologist

• Ultrasound
  We recognize that Gouty arthritis can be difficult to confirm and properly diagnose. Did you know that just having an elevated uric acid level does not necessarily confirm gouty arthritis? In fact, having an elevated uric acid level is not uncommon, occurring in close to 20% of the population. Of the patients who have high uric acid levels only about 20% will develop gouty arthritis. Furthermore some patients with acute gouty arthritis have falsely lower or even normal levels of uric acid. We are committed to confirming a diagnosis of gouty arthritis. Often times to help confirm the diagnosis our providers will remove fluid from a joint and look at the fluid under our polarized light microscope (not so different from what a geologist would use) to visually confirm the presence of uric acid crystals (see picture).  In select cases imagin studies like X-ray, ultrasound, and even DECT scans are ordered.
• X-Rays

Dermatologists

• Psoriasis
  Remicade is given by intravenous (IV) infusion in our offices. If you are prescribed Remicade, after your first three doses, you will most likely return every 6-8 weeks. Each infusion takes up to 2 hours.

Physical Therapists

• Physical Therapy
  Once a diagnosis is confirmed, we help patients fully understand their illness. Our experience suggests that well-informed patients are better able to make decisions about their health. Before treatment options are discussed, we attempt to understand our patients’ needs, concerns and expectations. We strongly feel listening to patients, encouraging them to ask questions, and always including them in the decision-making process empowers them in their wellness journey. We believe in thinking broadly and holistically about our patients. Whenever possible we incorporate non-pharmacologic treatments (e.g. mindfulness, certain high-quality supplements, physical therapy, lifestyle modification) into the treatment plan. Many of these treatments can be of significant adjunctive benefit alongside more conventional pharmacologic treatments.  Rheumatology has been blessed with a variety of highly effective medical treatments which can put some of our chronic diseases in a remission state. These same treatments have been proven to avoid disability and preserve physical function over a lifetime. Cutting edge treatments will certainly be offered but we don’t ignore older medications that can be very effective especially in combination with newer treatments. The immune system is very complex and varies from patient to patient. While a particular treatment can be highly effective for one patient, another patient may not respond at all. For this reason, our treatment plans are not “one size fits all” and are rather tailored to the individual.

Podiatrists

• Plantar Fasciitis
  Psoriatic Arthritis, abbreviated “PsA” is a chronic autoimmune disorder and inflammatory arthritis. While many patients also have a form of skin Psoriasis, we frequently encounter patients who may have musculoskeletal manifestations without skin Psoriasis.  Here at AOC, we have a keen interest in diagnosing and treating Psoriatic Arthritis. This disease can be very difficult to diagnose in patients without skin disease. Our care center arguably has the most experience in diagnosing and treating this disease in the local area. Like Rheumatoid Arthritis (RA), PsA can affect a variety of joints. Somewhat unique to PsA compared to RA is the ability of the disease to inflame tendon structures. This problem is often termed ‘ Enthesitis ’ and our providers carefully evaluate Enthesitis by physical exam.  Patients we have ultimately diagnosed with PsA often suffer for years with various tendinitis and bursitis syndromes. Some patients have recurrent Plantar fasciitis.  It is important to understand that treating PsA aggressively will help avoid future joint damage and disability. Here at AOC we are constantly gathering information from our patients and adjusting medications regimens to achieve Minimal Disease Activity (MDA) in Psoriatic Arthritis. Outcomes are improving using this approach and aggressive treatments By following this methodical approach, we have found PsA patients are better able to reduce pain, fatigue and live more active, fuller lives.