Rheumatology

The Montefiore Approach

The Musculoskeletal Health and Rheumatology Program in Montefiore Orthopedics brings together a tremendous amount of knowledge and expertise for the diagnosis and management of disorders affecting bones, cartilage, muscles, tendons, and ligaments.

Our goal is to harness the resources of modern medicine to help individuals maintain their musculoskeletal capabilities throughout their life. We are poised to intervene in a variety of disorders that threaten musculoskeletal health, from autoimmune diseases to metabolic conditions.

As an academic medical center, we are committed to the treatment and study of musculoskeletal conditions. We are constantly striving to develop novel and cutting-edge techniques for the advancement of care within our own health system and beyond.

  • Our Patient-Centered Care

    The experience of our patients and their loved ones—not simply their ailments—demands our full attention. Your dedicated care team will be there to discuss your condition, answer questions, assess treatment options, and develop a treatment strategy that is best for you.

  • Our Expertise

    While common, musculoskeletal injuries and ailments can be the cause of pain and discomfort. At Montefiore, we recognize that our patients are unique individuals with unique values, concerns, and expectations. It is our belief that identifying the best treatment plan requires an understanding of and a sensitivity to each patient’s particular condition. Our patients deserve a comprehensive understanding of their problem and the treatment options available to them. By keeping our patients informed, our physicians allow for effective shared decision making.

  • Our Dedication to Research

    Our status as an academic medical center puts us at the forefront of our field. Together with our Albert Einstein College of Medicine, one of the highest NIH-funded institutions in the country, we are continually conducting research with the goal of discovering better treatment options for our patients. We routinely present our research findings and publish our study results in peer-reviewed publications.

Conditions We Treat

Montefiore treats a vast spectrum of conditions, a selection of which you will find listed below. In addition to these, we have experience treating many other conditions. Please contact us today to schedule a consultation so that we can review and discuss your specific healthcare needs.

Some Common Conditions

  • Osteoarthritis
  • Tendonitis
  • Bursitis
  • Rheumatoid arthritis
  • Ankylosing spondylitis
  • Psoriatic arthritis
  • Reactive arthritis
  • Systemic lupus
  • Discoid lupus
  • Sjogren’s syndrome
  • Adult onset juvenile arthritis (Still’s disease)
  • Lyme disease
  • Gout

Our Treatments

We believe that most musculoskeletal diseases can be treated nonoperatively, using lifestyle modifications designed to enhance musculoskeletal health. These treatments are often complemented by the expertise of physical therapists, occupational therapists, and nutritionists. For those seeking further information, we have included a few examples of common procedures that we perform at Montefiore.

Highlighted Treatments

  • Lifestyle Modifications

    Many rheumatologic and musculoskeletal conditions can be successfully managed by making a few simple yet important changes in daily life. These changes, designed to enhance musculoskeletal health, include optimization of body fat stores, increasing muscle strength, improving bone density, and augmenting mobility. These treatments are often overseen by physical therapists, occupational therapists, and nutritionists. After a detailed assessment of each patient’s medical conditions, prior treatment history, contributing factors, personal preferences, benefits, and risks, we provide recommendations that enable the patient to choose the most appropriate treatments.

  • Disease-Modifying Therapies

    While lifestyle modifications often help individuals achieve better musculoskeletal health, some patients have rheumatological diseases that require additional interventions. Commonly used conventional medical treatments often employ a variety of medications collectively referred to as disease-modifying anti-rheumatic drugs (DMARDs). These medications include non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, corticosteroids, hydroxychloroquine, and sulfasalazine. Additionally, some patients benefit from the use of immunosuppressive therapies, such as methotrexate, azathioprine, mycophenolate, and cyclophosphamide. We tailor the use of such medications to provide optimal benefit for each individual patient.

  • Biologics and Other Targeted Therapies

    Although conventional disease-modifying anti-rheumatic drugs (DMARDs) are often effective in controlling many musculoskeletal diseases, some rheumatic diseases, such as aggressive rheumatoid arthritis and psoriatic arthritis, merit additional approaches. Fortunately, great advances in medical research are providing a host of new treatment options for these diseases.

    Some of these new medications are referred to as “biologics,” as they are manufactured using living cells as production factories. These biologics possess antibody-like molecules that target inflammatory mediators like tumor necrosis factor (Enbrel, Infliximab, Humira, Simponi Aria, and Cimzia) and inhibitors of inflammatory cytokines like IL1 (Anakinra), IL 6 (Actemra), and IL 17 (Stelara, Cosentyx, and Taltz).

    There are also medications available that block immune system activation (Orencia), as well as monoclonal antibodies that selectively deplete specific populations of white blood cells involved in the disease process (Rituxan). Some medications act indirectly to limit antibody-forming B lymphocytes (Benlysta).

    Finally, we often administer oral medications that can inhibit certain cell-signaling systems involved in rheumatoid arthritis (Xeljanz) and psoriatic arthritis (Otezla). Along with well-established risk profiles, medications in this category are generally very powerful and have the ability to exert control over most rheumatic diseases. Treatments are tailored to achieve an optimal risk-and-benefit profile for each individual patient.