Rheumatologists are medical specialists who assist your primary care physician by taking care of these types of musculoskeletal health conditions. Board certified Dr. Cohen specializes in the diagnosis and treatment of arthritis and other diseases affecting the joints and muscle. We successfully manage a wide range of conditions, including the ones listed below.

General Information about Arthritis

The word “Arthritis” was derived from the Greek word “arthron”, which means joint; therefore, “arthritis” means inflamed joint. In modern day medicine, “arthritis” is used to describe a group of distinct diseases, primarily affecting joints of the body, all having related symptoms. These may include pain, swelling, and stiffness of the joints and surrounding areas.

Arthritis can affect one or many joints, suddenly or more gradually over time, depending on the particular type of arthritis one may have. Symptoms may be constant, or may come and go, but generally the effects of arthritis will last for a long time, perhaps for the rest of your life. A diagnosis of arthritis does not mean that you are confined to a life of pain and immobility, however. There are many different treatments that slow the progression of your disease, increase your range of motion and lessen pain. When you visit the Pacific Arthritis Care Center, our physicians will discuss with you the therapeutic options and will institute the treatment which is right for you. It is important to keep a positive outlook throughout your treatment, as this will assist in the healing process.

Types of Arthritis

Arthritis is a condition that attacks the joints and tissues surrounding them, as well as other parts of the body in some types. Each of your joints is built differently – some joints work as a hinge, others swivel, and some do a combination of several different types of motion. But all share a set of common characteristics.

In most joints, two bones meet, end-to-end. They are connected to each other directly by ligaments, which are short fibrous strips of tissue placed at several different points in the joint, at different angles, holding the bones in the correct position during motion. Stability is also provided by the muscles surrounding the joint, which attach to the bone by tendons. The surfaces of the bones in the joint are covered with a thin layer called articular cartilage. This cartilage is smooth and slippery. When the joint bends or twists, the cartilage keeps the movement smooth and fluid. Finally, the joint itself is surrounded by the synovium, which is a thin layer of tissue that produces synovial fluid. This layer, plus thicker ligamentous tissue, forms a “capsule” around the joint, with the fluid inside keeping the joint well-lubricated.

Among the more than 100 types of arthritis, some are more common than others. The four types that are the most prevalent in both the adult and juvenile populations include:

  • Osteoarthritis
  • Rheumatoid Arthritis
  • Gout and Pseudogout
  • Ankylosing Spondylitis

If you experience swelling or stiffness in your joints for more than two weeks, you should see your primary care doctor. It is important to find out if you have arthritis or any other condition affecting the musculoskeletal system. Early diagnosis and treatment are essential to minimize pain and disability that these conditions can commonly cause.

Appropriate care usually includes evaluation by a specialist called a Rheumatologist. The physicians at Pacific Arthritis Care Center are specialize in the diagnosis and medical management of all forms of arthritis and other musculoskeletal disease including the diagnosis and treatment of osteoporosis, chronic forms of neck and back pain, bursitis, and tendonitis. They work with you and your primary care physician to determine the diagnosis and management and treatment plan. When we see you for the first time regarding your symptoms, we will ask questions about when and how the condition started. You will receive a physical examination to check your general health, and then receive a more thorough examination of the joints, muscles and other components of the musculoskeletal system that are bothering you. You may also need other tests to help confirm or rule out a diagnosis and determine the extent and severity of the problem. Such tests may include:

  • Lab Tests
  • Joint aspiration
  • X-rays
  • MRI of joints
  • Dual Energy X-ray Absorptiometry or DEXA


Ankylosing Spondylitis (AS)

Ankylosing Spondylitis (AS) is a chronic inflammatory disease of unknown etiology characterized by prominent inflammation of spinal joints and adjacent structures. This inflammation leads to progressive fusion of the spine. Peripheral joints are less affected although the hips and shoulders may become involved in one third of cases. Also, inflammation of extraarticular organs, such as the eye and heart, may occur. Read More.


Patients with fibromyalgia complain of chronic widespread pain, fatigue and stiffness. They usually report sleep disturbances that involve repeated awakenings and greater fatigue on rising in the morning than on retiring at night. There may also be a component of depression, migraine headaches, irritable bowel problems, tempomandibular joint pain and dizziness when rising from a seated position. Read more.

Gout / Pseudogout

Gout is a disease caused by too much uric acid in your body. Uric acid can be deposited in various sites in the body including joints. Too much uric acid may not cause symptoms for years. But after time, the accumulation of deposits may cause painful joint inflammation (arthritis). Read more.

Inflammatory Bowel Disease-related Arthropathy

Peripheral arthritis occurs in approximately 10%–20% of people with inflammatory bowel disease, either Crohn’s disease or ulcerative colitis. Some patients actually present with the
inflammatory arthritis before the diagnosis of inflammatory bowel disease is recognized. The disease may begin at any age, but occurs most often in young adults, affecting males and females in equal distribution. Read more.

Psoriatic Arthritis

Psoriasis affects about one percent of the population in North America. Psoriatic arthritis is an inflammatory arthritis seen in 4 to 6 percent of patients with psoriasis. Read more.

Reactive arthritis

Reactive arthritis refers to a form of peripheral arthritis often accompanied by one or more extra-articular manifestations that appears shortly after certain infections of the genitourinary or gastrointestinal tracts. The majority of affected individuals have inherited the HLA B27 gene. Cases have been observed following epidemics or sporadic outbreaks of diarrheal illnesses caused by Shigella, Salmonella, and Campylobacter microorganisms, as well as by venereally acquired genitourinary infections, usually Chlamydia trachomatis. Reactive arthritis typically begins acutely two to four weeks after venereal infections or bouts of gastroenteritis. Most venereally acquired cases of reactive arthritis occur in young men. Read More.

Rheumatoid arthritis

Rheumatoid arthritis (RA) involves inflammation of the lining of joints in the body. In early RA, for reasons that are not yet fully understood, inflammatory cells that usually circulate in the blood and protect against infections become activated and migrate to the lining of the joints. This lining is called synovium. In RA, inflamed synovium grows to 10-20 times its normal size and is filled with inflammatory cells. This inflammatory process progressively causes damage to the joint structures leading to chronic pain and permanent damage and in a relatively short time. Read more.


Scleroderma is a multi-system disease characterized by functional and structural abnormalities of small blood vessels, thickening of the skin and internal organs, and immune system activation. It is an acquired, non-contagious, rare disease of unknown etiology that occurs sporadically worldwide. Age, gender and genetic background are host factors that modify disease susceptibility. It occurs in individuals with a peak age of 35 – 65 years. Female predominance is most pronounced during mid- and late-childbearing years. Read more.

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Osteoarthritis, also known as degenerative joint disease, is the most common form of arthritis in the United States. It affects more than 20 million Americans. Osteoarthritis has been generally thought of as a “wear and tear” condition on joints that only affects elderly individuals. In reality, osteoarthritis can occur in younger men and women, especially if prior joint damage occurred through trauma. Read more.


Osteoporosis is a skeletal disease, marked by low bone mass and microarchictectural deterioration that leads to an increased susceptibility to fractures. Fractures are the single most important clinical consequence of osteoporosis and represent a major health problem in the elderly. Low bone mass, skeletal fragility and propensity to fall are the primary determinants of fracture risk in older persons. Bone density, a measure of bone mass, can be measured non-invasively using widely available densitometric techniques. Read more.

Polymyositis / Dermatomyositis

Inflammatory myopathies represent a group of diseases of unknown cause in which muscle injury results from inflammation. Polymyositis and dermatomyositis are the characteristic diseases in this group. Read more.

Primary Immune Deficiency Conditions
Sjogren’s Syndrome

Sjogren’s Syndrome (SS) is a debilitating autoimmune disorder. Salivary and lacrimal gland involvement is prominent and associated with decreased production of saliva and tears. Other components of the body that are commonly involved include the skin and the urogenital, respiratory and gastrointestinal tracts. Read more.

Systemic Lupus Erythematosus

Systemic Lupus Erythematosus is an inflammatory multi-system disease of unknown etiology. It is recognized worldwide and clearly more prevalent in women, especially in their reproductive years. Read more.


Vasculitis is inflammation and necrosis of a blood vessel with subsequent impairment of flow. It is a multi-system inflammatory disease. Vessel wall destruction can lead to perforation and hemorrhage into adjacent tissues with subsequent endothelial injury leading to thrombosis and ischemia/infarction of dependent tissues. Read more.

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