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

Early inflammatory arthritis

Joints that have been swollen and stiff for weeks, before a diagnosis: why the first twelve weeks decide so much.

Rheumatoid arthritis

An immune condition of the joint linings, in which early treatment spares the joints lasting damage.

Psoriatic arthritis

Inflammation of the joints, tendons and spine that goes with psoriasis and answers well to early treatment.

Axial spondyloarthritis

Inflammation of the spine and pelvis, often first felt as back pain in early adult life.

Reactive arthritis

Inflamed joints that follow an infection somewhere else in the body.

Viral arthritis

Joints that turn painful, stiff or swollen with a viral illness or soon after it, and usually settle within weeks.

Enteropathic arthritis (IBD-associated)

Inflamed joints that go with inflammatory bowel disease: Crohn's disease or ulcerative colitis.

Enthesitis

Inflammation at the spot where a tendon or ligament joins the bone.

Palindromic rheumatism

Attacks of joint inflammation that flare without warning and then clear completely.

Adult-onset Still's disease

Spiking fevers, a passing rash and painful joints: a rare inflammatory illness.

Juvenile idiopathic arthritis (JIA)

Arthritis that began in childhood and carries on into adult life, and what an adult rheumatologist adds.

Immunotherapy-related arthritis

Inflamed joints as a side effect of checkpoint inhibitor treatment for cancer.

SAPHO syndrome

Inflamed bones and joints, often at the front of the chest, paired with acne or pustules: a rare condition.

Septic arthritis

Rare, and seldom the reason for a hot, swollen joint: how it is spotted, ruled out and treated.

Crystal arthritis

Gout

Urate crystals bring on sudden, fierce pain in a joint: a common arthritis, and a very treatable one.

CPPD & pseudogout

Much like gout in its attacks, though the crystal that causes them is a different one.

Wear-related

Osteoarthritis

Arthritis in which joint tissues change faster than they mend: the most frequent kind, and one a good plan can ease.

Autoimmune & connective tissue

Lupus (SLE)

An autoimmune condition that can involve the joints, skin, blood and internal organs, and looks different in everyone.

Sjögren's syndrome

An autoimmune condition whose hallmark is dry eyes and a dry mouth, often with joint pain and fatigue.

Systemic sclerosis (scleroderma)

An autoimmune condition in which the skin tightens and the small blood vessels and internal organs can be affected.

Inflammatory myopathies (myositis)

Autoimmune conditions in which inflamed muscles lose their strength, dermatomyositis and polymyositis among them.

Connective tissue disease (UCTD & MCTD)

Autoimmune conditions in which the features of several diseases overlap, or fit none of them exactly.

Raynaud's phenomenon

Fingers or toes that change colour in the cold, harmless for most people and a clue for a few.

Antiphospholipid syndrome (APS)

An autoimmune condition that makes the blood clot too readily, found alone or together with lupus.

Behçet's disease

A rare vasculitis whose hallmarks are recurring mouth and other ulcers.

Sarcoidosis

Pockets of inflammation in the lungs, skin, eyes, joints or other organs, and the symptoms, tests and care that follow.

Haemophagocytic lymphohistiocytosis (HLH) and MAS

An immune response that will not switch off: rare, life-threatening, and a matter for urgent hospital care.

Relapsing polychondritis

A rare autoimmune condition in which repeated flares inflame cartilage, typically of the ears, nose and airways.

Uveitis

Uveitis, inflammation within the eye, and the rheumatic conditions it often accompanies, spondyloarthritis among them.

Interstitial lung disease (ILD)

Lungs inflamed and scarred (pulmonary fibrosis) in some rheumatic conditions, watched by two specialties.

VEXAS syndrome

Serious, rare, mostly in men past 50: an autoinflammatory disease from a gene change acquired in the bone marrow.

IgG4-related disease

Rare, sometimes mistaken for cancer, usually responding well to treatment: immune-driven inflammation and scarring.

Vasculitis & polymyalgia rheumatica

Polymyalgia rheumatica (PMR)

Stiff, aching shoulders and hips after 50, and a condition that answers to treatment within days.

Giant cell arteritis (GCA)

Inflamed arteries in the head and beyond, treated the day it is suspected because sight hangs on it.

Vasculitis

Inflamed blood vessels of every size, from a skin rash to a threat to the kidneys, and how each kind is treated.

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

Bones that have lost strength and break more easily, and how the risk of a break is found and lowered.

DEXA bone density scan

A quick, low-dose scan of bone density that helps judge how strong the bones are and how likely a break is.

Paget's disease of bone

A disorder of bone renewal that can bring bone pain or a change of shape, often well controlled by treatment.

Metabolic bone disease

Bone weakened by a problem with minerals, hormones or vitamins, and how its cause is traced and treated.

Soft tissue & MSK

Frozen shoulder

A shoulder that grows painful and then stiff over months, and slowly frees up.

Rotator cuff problems

Shoulder pain and weakness on lifting the arm, from irritated or torn tendons.

Tennis & golfer's elbow (epicondylitis)

Elbow pain from irritation of the tendons there.

Carpal tunnel syndrome

Fingers that tingle or go numb, often at night, from a nerve pressed at the wrist.

De Quervain's tenosynovitis

Thumb-side wrist pain from tendons squeezed in their tunnel.

Trigger finger

A finger or thumb that catches, clicks or sticks bent, from a tendon snagging in its tunnel.

Ganglion cysts

Smooth, harmless lumps of fluid that bulge from a wrist or finger joint or a tendon sheath.

Plantar fasciitis

Heel pain that bites hardest on getting up in the morning, and usually fades with stretching, good shoes and time.

Tendinopathy (tendonitis)

Painful, overloaded tendons, and the graded exercise plan with the best evidence for settling them.

Bursitis

When a small cushion of fluid by a joint swells and hurts: what sets it off, what settles it, and when it needs more.

Joint hypermobility syndromes

Joints that bend further than most, which for some people bring pain and a feeling of instability.

Fibromyalgia

A real and common condition of pain across the body, tiredness and broken sleep.

Long Covid

After COVID-19, aches in the joints and muscles that will not go: what a rheumatologist checks, inflammation first.

Back pain

Usually a strain that eases in time, helped by keeping active; a few patterns, and a few warning signs, need a doctor.

Neck pain

Why necks hurt, from a bad night and the wear of later life to a nerve caught in the neck or an inflamed spine.

Ehlers-Danlos syndromes (EDS)

Inherited conditions of the body's connective tissue, from the common hypermobile type to the rare vascular one.

Costochondritis

Sore, inflamed rib cartilage beside the breastbone: common and harmless, once other causes of chest pain are ruled out.

Knee pain

Twists, torn cartilage, worn joints, gout and swollen knees: what a painful knee may mean and when it needs a doctor.

Baker's cyst

A fluid-filled swelling behind the knee, usually harmless, with ultrasound to confirm it when the picture is unclear.

Hip pain

Groin, outer hip or buttock: what each kind of hip pain tends to be, what eases it, and the signs that need a doctor.

Joint pain without swelling

Why joints can ache and stiffen while looking normal, from overuse and the menopause to early inflammatory arthritis.

Hand and wrist pain

Why hands and wrists hurt, from the base of the thumb and a catching tendon to a trapped nerve or an inflamed joint.

Joint swelling

What a swollen joint can mean, sore or painless, from fluid and an inflamed lining to a cyst or bursa beside the joint.

Pregnancy & family planning

Arthritis, autoimmune conditions and pregnancy

The medicines, timing and care that help pregnancy go well when you have arthritis or an autoimmune condition.

Diet, exercise & lifestyle

Gout and diet

Foods and drinks that raise urate, changes that help, and why diet backs up urate-lowering treatment.

Diet and arthritis

The evidence on eating for arthritis: what helps, which claims to doubt, and why food backs up treatment.

Arthritis and exercise

How exercise helps arthritis, why it does not wear joints out, how to begin and when to stop.

Gut health and arthritis

Bowel disease, gut infections, gut bacteria and NSAIDs: how the gut and the joints affect each other.

Managing a flare

A plan for when a flare starts: the first days, safer pain relief, and the signs that need a doctor.

Fatigue and arthritis

Where arthritis fatigue comes from, what eases it, and the signs alongside it that need a doctor quickly.

Inflammation and your heart

The extra heart and stroke risk that inflammation brings, the rarer ways it reaches the heart, and what lowers it.

Weight and weight-loss medicines

What weight does to the joints, how the newer weight-loss medicines work, and the warning signs to know.

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 are used in rheumatology

Ways a corticosteroid is given in rheumatology, its side effects, and why it is not an anabolic steroid.

DMARDs: disease-modifying anti-rheumatic drugs

The medicines that change the course of inflammatory arthritis, why they are slow to start, and how they are checked.

Methotrexate

The DMARD rheumatologists prescribe most: the weekly routine, the side effects, and the monitoring that keeps it safe.

Biologics, biosimilars and JAK inhibitors

How the targeted medicines work, where biosimilars and JAK tablets fit, and the checks made before you start.

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

Reading a DEXA report: the T-score, the Z-score, and why your risk of a break depends on more than one number.

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