Landspitali - University Hospital
Rheumatology Outpatient Clinic
Common rheumatic diseases
The immune system attacks its own cells and causes inflammation and damage in joints, usually in the limbs.
Symptoms: morning stiffness, pain, inflammation of the joints, reduced mobility, fatigue, fever and weakness.
The disease can cause irreversible damage to the joints, reduced skills and inability.
Common Treatments
First-line treatment for RA: disease-modifying antirheumatic drugs (DMARDs)
Most common: methotrexate
If response is inadequate: biologics or other DMARDs
Treatment is individualized
Many need to change treatment once or more
A rheumatologist will help find the most suitable treatment
Living with Rheumatoid Arthritis
Regular follow-up with a rheumatologist – key to managing disease symptoms
Take medications as prescribed
Report any side effects or problems
Light aerobic and strength exercises to improve muscle strength
Quit smoking – tobacco reduces the effectiveness of medications on the disease
A long-term inflammatory disease affecting bones, muscles and ligaments in the spine, neck and chest.
What is Ankylosing Spondylitis?
A long-term inflammatory disease that mainly affects the spine and sometimes other joints.
It often starts with pain and stiffness in the lower back or sacroiliac joints.
Ongoing inflammation can cause stiffness and reduced movement in the spine.
Some people also develop joint inflammation in the legs or arms, or inflammation where tendons attach to bone.
The condition usually begins in young adults and is slightly more common in men.
Main symptoms
Pain and stiffness in the lower back, especially in the morning or after rest.
Fatigue and general stiffness.
Joint pain in the arms or legs may also occur.
Diagnosis
Based on medical history and physical examination by a doctor.
Imaging (X-ray or MRI) and blood tests may support the diagnosis.
Some patients carry the HLA-B27 gene, which is linked to the disease.
Treatment
Physiotherapy and regular exercise are key to maintaining mobility.
Anti-inflammatory medicines (NSAIDs) help reduce pain and swelling.
Steroid injections may relieve local inflammation.
Biologic medicines can be very effective when standard treatments are not enough.
Living with Ankylosing Spondylitis
Most people live active and normal lives with proper treatment.
Regular physical activity improves well-being and joint flexibility.
It’s important to avoid smoking.
Support groups and education can help manage this long-term condition.
An inflammatory disease that damages joints and most commonly occurs in association with the skin disease psoriasis.
What is Psoriatic Arthritis?
Psoriatic arthritis (PsA) is a long-term autoimmune disease that causes inflammation in the joints.
It occurs in people who also have psoriasis, a skin condition that causes red, scaly patches.
PsA can affect:
Large joints (like knees and shoulders)
Small joints in fingers and toes
The spine or lower back
Symptoms usually start between ages 30 and 50.
It affects men and women equally.
Without proper treatment, ongoing inflammation can lead to joint damage.
Main symptoms
Joint pain, swelling, and stiffness, sometimes in one or several joints.
“Sausage-like” fingers or toes (dactylitis).
Nail changes such as pitting or thickening.
Tendon and ligament pain (enthesitis).
Back pain or stiffness.
Some people may develop inflammation in the eyes (uveitis) or bowel inflammation.
Diagnosis
Based on physical examination and review of symptoms.
Doctor checks joints, nails, and skin for signs of psoriasis.
Imaging (X-ray, ultrasound, or MRI) can show joint inflammation or damage.
Blood tests help rule out other forms of arthritis.
Treatment options
Aim: to reduce pain and inflammation and prevent joint damage.
Mild cases: Anti-inflammatory medicines (NSAIDs) like ibuprofen or naproxen.
Steroid injections: For quick relief in affected joints.
DMARDs (Disease-Modifying Anti-Rheumatic Drugs) such as methotrexate, sulfasalazine, or leflunomide for stronger or ongoing symptoms.
Biologic or targeted DMARDs may be used if standard treatments don’t work.
Your rheumatologist will help find the best treatment plan for you.
Living with PsA
Regular follow-up with your rheumatologist is important to keep the disease under control.
Exercise regularly – walking, cycling, or yoga help joint flexibility and heart health.
Monitor overall health: check blood pressure, weight, blood sugar, and cholesterol with your GP.
If you have psoriasis, your dermatologist may recommend additional skin treatments.
For more support, visit the Icelandic Arthritis Association (Gigtarfélag Íslands).
What is lupus?
Lupus is an autoimmune disease, meaning the body’s immune system mistakenly attacks its own healthy tissues.
It can affect many organs and systems in the body — including the joints, skin, kidneys, heart, and lungs.
For many people, the first signs appear in the skin and joints.
Main symptoms
Joint pain and swelling, often in the fingers, wrists, or knees.
Fatigue and general feeling of being unwell.
Fever without infection.
Skin rashes, especially across the cheeks and nose (the “butterfly rash”).
Sensitivity to sunlight – skin may react strongly to sun exposure.
In some cases, there may be inflammation in the kidneys or other organs during active disease.
About the disease
Symptoms and severity vary greatly from person to person.
Some people have mild symptoms, while others may need ongoing medical treatment and monitoring.
Regular check-ups and working closely with your doctor are essential to manage lupus effectively.
Living with lupus
With proper treatment, most people with lupus can lead active and fulfilling lives.
Helpful steps include:
Following your treatment plan and taking medications as prescribed.
Avoiding strong sunlight and using sunscreen daily.
Getting enough rest and listening to your body.
Contacting your doctor if new symptoms appear.
Education and support can make a big difference in coping with this long-term condition.
More information
See also: The Lupus Foundation of America – offers education and support for people living with lupus and their families.
What is vasculitis?
Vasculitis is an inflammatory condition where the blood vessels become inflamed.
This inflammation can damage the vessels themselves and affect the organs that depend on them for blood supply, such as the skin, kidneys, or digestive system.
There are many different types of vasculitis, ranging from mild to more severe forms.
Common symptoms
General symptoms that may appear in many people include:
Fever
Fatigue
Headache
Unintentional weight loss
Muscle or joint pain
Symptoms can also depend on which organs are affected:
Skin: rashes, bruising, or sores
Digestive system: stomach pain, nausea, or diarrhea
Kidneys: changes in urine, swelling, or pain in the side
Nerves: numbness or weakness in the arms or legs
About the condition
The type and severity of vasculitis vary between individuals.
Some people experience mild symptoms, while others may need ongoing medication and medical follow-up.
Treatment focuses on reducing inflammation and preventing damage to blood vessels and organs.
Living with vasculitis
With the right diagnosis and treatment, most people can live an active and fulfilling life.
It’s important to:
Follow your doctor’s treatment plan and attend regular check-ups.
Contact your healthcare provider if new symptoms appear or your condition worsens.
Take care of your general health — good sleep, balanced nutrition, and regular physical activity can make a difference.
What is GCA?
Giant Cell Arteritis (GCA) is an inflammatory condition that affects the arteries in the head and scalp, especially the temporal arteries.
It is often linked to Polymyalgia Rheumatica (PMR):
Around 5–15% of people with PMR also develop GCA.
About half of those with GCA have PMR symptoms as well.
GCA affects adults over 50, and is more common in women.
Main symptoms
New or unusual headache, often at the temples
Tiredness, loss of appetite, and weight loss
Flu-like symptoms
Jaw pain when chewing
Vision problems – double vision or sudden vision loss
👉 If you have PMR and develop any of these symptoms, contact your doctor immediately.
Diagnosis
There is no single blood test for GCA, but doctors may use:
ESR (sed rate) and CRP blood tests to check for inflammation
Ultrasound of the temporal arteries
Biopsy from the temporal artery to confirm the diagnosis
Treatment
Treatment must start as soon as possible to prevent vision loss.
The main treatment is prednisolone (steroids), usually 40–60 mg daily.
Symptoms often improve quickly.
The dose is then gradually reduced over several months.
Most people can stop steroids within 1–2 years.
Tocilizumab, given by injection, can help reduce the need for steroids.
Living with GCA
Steroids can cause side effects, especially at higher doses:
Bone thinning (osteoporosis)
Weight gain and sleep problems
Bruising and cataracts
Your doctor may recommend bone density checks and vitamin D, calcium, or bone-strengthening medication.
Most side effects are temporary and manageable.