Private Rheumatologist in Chiswick and West London

Persistent joint pain or swelling should not automatically be put down to “wear and tear.” It may be caused by osteoarthritis, tendon or soft tissue problems, crystal arthritis such as gout, or inflammatory arthritis.

Early assessment can help identify the cause, guide the right treatment and, where inflammation is present, reduce the risk of long-term joint damage.

Persistent fatigue that does not improve with rest can sometimes be linked to autoimmune or inflammatory rheumatic disease, especially when it occurs alongside joint pain, stiffness, rashes, fevers, weight loss, Raynaud’s symptoms or abnormal blood tests.
Because fatigue has many possible causes, careful assessment is important to decide whether there is evidence of inflammation, autoimmune disease or another medical explanation.

Joint stiffness lasting more than 30 minutes after waking can be a sign of inflammatory arthritis, particularly when it is associated with swelling, warmth or difficulty using the hands, feet or other joints. Early specialist assessment can help identify whether symptoms are inflammatory and guide targeted treatment to reduce the risk of joint damage and longer-term problems.

Back pain is common, but some patterns can suggest inflammatory arthritis of the spine or pelvis. This is more likely if pain starts at a younger age, wakes you at night, causes prolonged morning stiffness, or improves with movement rather than rest.

Specialist assessment is particularly important if you also have psoriasis, inflammatory bowel disease, uveitis, or a family history of psoriasis or spondyloarthritis. Early investigation can help distinguish inflammatory back pain from more common mechanical causes and guide the right treatment plan.

Skin rashes, particularly facial or photosensitive rashes, persistent dry eyes or dry mouth, and feeling unwell after sun exposure can sometimes be associated with autoimmune rheumatic diseases such as lupus or Sjögren’s disease.

These symptoms are common and can have many causes, but specialist assessment may be helpful when they are persistent, unexplained or occur alongside joint pain, fatigue, Raynaud’s, mouth ulcers or abnormal blood tests.

Frequent, painful ulcers in the mouth or genital area can sometimes be linked to inflammatory or autoimmune conditions, including Behçet’s disease, lupus or other systemic inflammatory disorders.

Most ulcers are not due to a rheumatic disease, but specialist assessment may be helpful when they are recurrent, severe, slow to heal, associated with joint pain, rashes, eye inflammation, fevers, bowel symptoms or abnormal blood tests.

Blood tests showing raised inflammatory markers, such as CRP or ESR, or autoantibodies, such as ANA or rheumatoid factor, do not automatically mean that you have arthritis or an autoimmune disease.

However, these results can be important when they occur alongside symptoms such as joint swelling, prolonged stiffness, rashes, Raynaud’s, dry eyes or mouth, mouth ulcers, fevers or unexplained fatigue.

A rheumatology review can help interpret abnormal blood tests in context, decide whether further investigation is needed and avoid both missed diagnosis and unnecessary concern.

If your fingers or toes change colour in the cold, often turning white, blue or red, and feel painful, numb or tingling, this may be Raynaud’s phenomenon.
Raynaud’s often occurs on its own, but it can sometimes be associated with autoimmune rheumatic diseases such as systemic sclerosis, lupus or Sjögren’s disease. Specialist assessment can help decide whether it is primary Raynaud’s or whether further investigation is needed.

Breaking a bone after a minor fall, losing height, developing new back pain or being told you have low bone density may suggest osteoporosis or an increased risk of fracture.

Osteoporosis is common, particularly in women after menopause and in people who have needed steroid treatment, but effective treatment can strengthen bones and reduce future fracture risk.

A specialist review can assess your bone health, identify risk factors, arrange appropriate investigations such as a DEXA scan where needed, and guide a personalised bone-protection plan.

Losing weight without trying, waking with drenching night sweats or having recurrent unexplained fevers can sometimes reflect significant inflammation or systemic illness.

There are many possible causes, including infection, inflammatory disease, autoimmune conditions and other medical problems, so these symptoms should not be ignored.

A specialist assessment can help identify the pattern, arrange appropriate investigations and decide whether rheumatology input or another specialist pathway is needed.

Sometimes symptoms do not line up neatly with one condition. A patient may have a combination of pain, fatigue, rashes, dryness, Raynaud’s phenomenon, mouth ulcers, abnormal blood tests or unexplained inflammation.

Autoimmune and rheumatic diseases can present in complex ways, but similar symptoms can also be caused by non-inflammatory conditions, medication effects, hormonal change, infection or other medical problems.

A specialist review can help bring the pattern together, interpret previous results in context and guide the next steps in your care.

If your symptoms remain unexplained, your test results are difficult to interpret or you feel you have not yet had a clear answer, a second opinion can help bring the clinical picture together.

Dr Singh offers detailed consultant-led assessment, careful examination and targeted investigations where appropriate, with the aim of clarifying the likely diagnosis, explaining what has already been found and agreeing practical next steps in your care.