If necessary, we may also perform anesthetized removal of joint fluid (arthrocentesis) for microscopic examination including crystal analysis. We interpret our on-site bone density (DEXA) testing in light of comorbidities and medications and send a detailed osteoporosis report including recommendations to your primary care physician.
Once the diagnosis or diagnoses are assertained, a consultation report and recommended treatment plan will be forwarded to your referring physician. This will include suggestions for management. The correct management of rheumatic diseases is usually an ongoing and complicated task that needs to be individuallized and based on serial assesment of disease activity and response to treatment. This is best done by an experienced rheumatologist. It is therefore often necessary to return for regular followup appointments with the frequency depending on disease status or the need for monitoring for medication adverse effects.
Medication management may include several arthritis medications including medicines classified as NSAIDs, steroids, DMARDs, and Biologic agents. We make every effort to select the most effective medication for a given problem, taking into account disease severity, other concomitant diseases, other medications and patient factors such as age. Obviously, safety is also a prime concern and we try to avoid all disease as well as medication associated toxicity. In addition to medical management, it may be in your best interest to recieve a steroid injection into a joint, bursa, tendon sheath, or trigger point. These are done with great care using surface, subcutaneous and deep local anesthesia. We have been very successful at providing these important procedures even to young children when necessary with little or no discomfort.
Infusion therapy is an office procedure performed by an experienced medical assistant with physician supervision. This involves the placement of an IV into an arm vein and infusing intravenous fluid containing medication over 1 to 4 hours depending on the medicine. Medications provided by infusion include Remicade, Orencia, Rituxan, Solumedrol, Boniva, Reclast, Cytoxan, and Aredia.
Since joining our practice five years ago, Doctor Gao has extended the scope of our musculoskeletal evaluation and management abilities by providing Pain Management Consultations, evaluation of neuropathic pain, and provision of various direct intervensions. After the initial consultation, she may need to perform electromyography and nerve conduction studies in order to define one or several nerve or muscle problems. MRI or X-ray may help identify specific pathology contributing to nerve impingement or cord compression. | 
