Patient information

Patient Guides

Clear, reliable guides to the conditions Dr Borukhson treats, the procedures and tests she offers, and living well with a rheumatic condition, written and reviewed by her

These guides are written in plain language to help you understand a condition or procedure, what to expect, and how an assessment can help. Each one is written and reviewed by Dr Liubov Borukhson, Consultant Rheumatologist (GMC 7021928). They are for general information and are not a substitute for individual medical advice.

AI in medicine

AI, ChatGPT and your care

What AI tools get right, where they go wrong, and why to check the answers with a specialist.

Inflammatory arthritis

Rheumatoid arthritis

An autoimmune arthritis of the joints where early treatment protects long-term joint health.

Psoriatic arthritis

Joint, spine and tendon inflammation linked to psoriasis, responsive to early treatment.

Axial spondyloarthritis

Inflammatory back pain affecting the spine and pelvis, often starting in early adulthood.

Reactive arthritis

Joint inflammation that follows an infection elsewhere in the body.

Enteropathic arthritis (IBD-associated)

Joint inflammation linked to inflammatory bowel disease such as Crohn's or colitis.

Enthesitis

Inflammation where a tendon or ligament attaches to bone.

Palindromic rheumatism

Sudden, recurring attacks of joint inflammation that come and go.

Adult-onset Still's disease

A rare inflammatory condition with high fevers, rash and joint pain.

Juvenile idiopathic arthritis (JIA)

Childhood-onset inflammatory arthritis that continues into adult life, and how adult rheumatology care helps.

Immunotherapy-related arthritis

Joint inflammation that can follow certain cancer immunotherapies.

SAPHO syndrome

A rare condition linking bone and joint inflammation, often at the front of the chest, with skin problems.

Septic arthritis

Rare, and rarely the cause of a hot, swollen joint. How it is recognised, ruled out and treated.

Crystal arthritis

Gout

A common, very treatable crystal arthritis causing sudden, intense joint pain.

CPPD & pseudogout

A crystal arthritis that can mimic gout but is caused by a different crystal.

Wear-related

Osteoarthritis

The most common arthritis, from gradual joint wear, where the right plan helps comfort and function.

Autoimmune & connective tissue

Lupus (SLE)

An autoimmune condition that can affect many parts of the body.

Sjögren's syndrome

An autoimmune condition mainly causing dryness of the eyes and mouth.

Systemic sclerosis (scleroderma)

An autoimmune condition causing skin tightening that can affect blood vessels and organs.

Inflammatory myopathies (myositis)

Autoimmune conditions causing inflammation and weakness of the muscles.

Connective tissue disease (UCTD & MCTD)

Autoimmune conditions where features of more than one disease overlap.

Raynaud's phenomenon

Colour changes in the fingers or toes in the cold, usually harmless but sometimes a clue.

Antiphospholipid syndrome (APS)

An autoimmune condition affecting blood clotting, sometimes alongside lupus.

Behçet's disease

A rare condition causing inflammation in blood vessels, with recurrent ulcers.

Sarcoidosis

An inflammatory condition that can affect the lungs, skin, eyes, joints and other organs.

Haemophagocytic lymphohistiocytosis (HLH) and MAS

A rare, life-threatening overactivation of the immune system that needs urgent hospital care.

Relapsing polychondritis

A rare autoimmune condition in which the immune system attacks cartilage, typically in flares.

Uveitis

Inflammation inside the eye, often linked to spondyloarthritis and other rheumatic conditions.

Interstitial lung disease (ILD)

Lung scarring (pulmonary fibrosis) that can accompany some rheumatic conditions and needs joint monitoring.

VEXAS syndrome

A rare, serious autoinflammatory disease of older men, caused by an acquired change in a bone-marrow gene.

Vasculitis & polymyalgia rheumatica

Polymyalgia rheumatica (PMR)

Shoulder, neck and hip stiffness in older adults that usually responds quickly to treatment.

Giant cell arteritis (GCA)

Inflammation of the arteries that needs prompt assessment to protect against complications.

Vasculitis

A group of conditions involving inflammation of the blood vessels.

Takayasu arteritis

A rare vasculitis of the aorta and its main branches, mainly in younger women. Symptoms, diagnosis and treatment.

Bone health

Osteoporosis & bone health

Weakened bones and fracture risk, assessed and managed before a fracture occurs.

DEXA bone density scan

A simple, low-dose scan that measures bone strength and fracture risk.

Paget's disease of bone

A condition that disrupts normal bone renewal, causing pain or bone changes.

Metabolic bone disease

Conditions affecting bone strength through minerals, hormones or vitamins.

Soft tissue & MSK

Frozen shoulder

A painful, stiff shoulder that develops gradually, where targeted treatment helps.

Rotator cuff problems

A very common cause of shoulder pain and weakness, where ultrasound helps.

Tennis & golfer's elbow (epicondylitis)

Elbow pain from irritation of the tendons at the elbow.

Carpal tunnel syndrome

Tingling and numbness in the hand from nerve pressure at the wrist.

De Quervain's tenosynovitis

Pain on the thumb side of the wrist from irritated tendons.

Trigger finger

A finger that catches or locks as it bends, from a tendon not gliding smoothly.

Ganglion cysts

Common, harmless fluid-filled lumps that form near a joint or tendon.

Plantar fasciitis

A very common cause of heel pain, especially with the first steps of the day.

Tendinopathy (tendonitis)

Tendon pain, often from overuse, where a structured plan aids recovery.

Bursitis

Inflammation of the small fluid-filled cushions around a joint.

Joint hypermobility syndromes

Very flexible joints that can sometimes cause pain and instability.

Fibromyalgia

A genuine, common condition of widespread pain, fatigue and disturbed sleep.

Long Covid

Persistent symptoms after COVID-19: how a rheumatologist assesses joint and muscle pain and rules out inflammation.

Back pain

Most back pain is mechanical and settles with self-care, but some patterns need a specialist eye.

Ehlers-Danlos syndromes (EDS)

A group of inherited connective tissue conditions affecting collagen, from hypermobile EDS to the rare vascular type.

Costochondritis

A common, benign cause of chest wall pain from inflamed rib cartilage, diagnosed once serious causes are excluded.

Pregnancy & family planning

Arthritis, autoimmune conditions and pregnancy

Planning a family with inflammatory arthritis or an autoimmune condition: medicines, planning and specialist care.

Diet, exercise & lifestyle

Gout and diet

What raises urate, what genuinely helps, and why diet supports rather than replaces treatment.

Diet and arthritis

What genuinely helps, the myths to ignore, and why diet supports rather than replaces treatment.

Arthritis and exercise

Why movement is one of the best treatments, why it will not damage your joints, and how to start.

Gut health and arthritis

How the gut and arthritis are linked, both ways: bowel disease, gut infections and the microbiome.

Managing a flare

What to do when a flare hits: practical steps, safe pain relief, and the red lines that need same-day help.

Fatigue and arthritis

Why fatigue in arthritis is real and physiological, what genuinely helps, and when to raise it with your team.

Inflammation and your heart

Why inflammation raises heart and stroke risk, can affect the heart itself, and how good disease control protects it.

Weight and weight-loss medicines

How weight affects your joints, what the newer weight-loss medicines do, and how they fit your care.

Procedures & what to expect

Your first rheumatology appointment

What to expect, how to prepare, and what happens during and after your visit.

Using your private medical insurance

How cover works, pre-authorisation, and what fee assured means for you.

Point-of-care ultrasound (POCUS)

Ultrasound during the consultation that enables one-stop assessment and treatment.

Ultrasound-guided injections

Targeted joint and soft-tissue injections, placed accurately under ultrasound vision.

Joint aspiration

Drawing off fluid from a swollen joint for relief and diagnosis, guided by ultrasound.

Steroid injections: when they help

When a steroid injection genuinely helps, what to expect, and when it is not the right choice.

Steroids: how they're used in rheumatology

How corticosteroids are used in rheumatology, their side effects, and how they differ from anabolic steroids.

DMARDs: disease-modifying anti-rheumatic drugs

The medicines that calm the disease process itself, why they take weeks to work, and how they are monitored.

Methotrexate

The most widely used DMARD: how weekly methotrexate works, its side effects, and why monitoring keeps it safe.

Biologics, biosimilars and JAK inhibitors

What biologics, biosimilars and JAK inhibitors are, how they differ, and what starting one actually involves.

Infections and arthritis medicines

Why arthritis medicines raise infection risk, the warning signs that matter, and what to do when you are unwell.

Vaccinations in rheumatology

Why vaccines matter more on immune-suppressing treatment, which are safe, and the live-vaccine caution.

Physiotherapy and rehabilitation

How physiotherapy, occupational therapy and rehabilitation restore function, and how they are timed around treatment.

Hyaluronic acid injections

An honest guide to hyaluronic acid injections for osteoarthritis: the mixed evidence and who might consider one.

Understanding blood tests in rheumatology

A plain-language guide to the blood tests used in rheumatology and what they mean.

Positive ANA and autoimmune blood tests

Why a positive ANA is common, not a diagnosis on its own, and how a specialist makes sense of it.

Rheumatoid factor and anti-CCP antibodies

What rheumatoid factor and anti-CCP tests mean, and why neither confirms nor rules out rheumatoid arthritis on its own.

Raised inflammatory markers (CRP & ESR)

What raised CRP and ESR mean, why they rise, and when a raised result needs a specialist look.

Understanding your DEXA scan results

What a DEXA report shows, T-scores and Z-scores explained, and why a score is only one part of fracture-risk assessment.

Have a question about your symptoms?

A specialist assessment, with ultrasound where helpful, can bring clarity and help you agree the right next steps

Book an appointment