Our rheumatologists—Dr. John Botson, Dr. Ryan Ragle, and Dr. Cristina Copus—are board-certified and fellowship-trained physicians. They focus on the diagnosis and treatment of a wide range of rheumatologic conditions, helping patients manage their disease.
Rheumatology is a subspecialty of internal medicine that focuses on the diagnosis and treatment of systemic autoimmune diseases and inflammatory arthritis. The hallmark of most rheumatic diseases is inflammation that affects the connecting or supporting structures of the body. Often, this means the joints, but inflammation can also impact the tendons, ligaments, bones, muscles, blood vessels, and organs. Accurate diagnosis and patient-specific treatment can reduce symptoms and reduce long-term severity and loss of function related to rheumatologic diseases.
The most common rheumatologic conditions include rheumatoid arthritis, osteoarthritis, gout, ankylosing spondylitis, vasculitis, inflammatory myopathies, osteoporosis, lupus, Sjögren’s syndrome, and other complex autoimmune diseases affecting the musculoskeletal system.
Bone is living tissue; it’s constantly changing, with new bone replacing older bone. However, when the body fails to form enough new bone, bone density diminishes, fracture risk increases and conditions like osteoporosis may develop. Osteoporosis is the most common bone disease. It’s is a chronic, progressive disease in which bone mass deteriorates — often in the spine, hip or wrist —and becomes brittle. The good news is that there are things you can do to reduce your risk and strengthen your bones even if you’ve already developed osteoporosis or osteopenia. At OPA, our bone health specialists offer education and consultation, evaluation, and treatments that range from basic nutrition and exercise plans to injectable medicine.
Bone Health Services:
- Bone health consultations & screenings
- Post-fracture treatment
- Pre-surgical bone health evaluations
- Osteoporosis and osteopenia treatment & monitoring
- In-house bone densitometry
- In-house lab draws for established patients
- In-house infusion for Reclast® (Zoledronic acid)
OPA Rheumatology Team
The OPA team includes Alaska’s leading rheumatology specialists and offers some of the latest, most advanced treatment procedures available today.
OPA treats a wide variety of conditions and offers comprehensive treatment options — including many non-surgical solutions, minimally invasive, and total joint replacements.
All treatments work to restore pain-free function that allows patients to lead active, fulfilling lives, be it walking pain-free or getting back into athletic action.
OPA offers a wide variety of infusion services in a comfortable, semi-private infusion room complete with heated massage chairs, warm blankets, and privacy curtains. Port access and ultrasound-guided vascular access available for patients with difficult to access veins. Cortisol stimulation tests are also available. Patients receive compassionate care and expertise from On-site rheumatologists and nurses with Oncology Nursing Society Biotherapy & Chemotherapy certifications.
Infusion Treatments Include:
- Actemra® (Tocilizumab) Treats moderate to severe rheumatoid arthritis.
- Benlysta® (Belimumab) Treats systemic lupus erythematosus.
- Calcitriol (aka Rocaltrol,® Vectical,® Calcijex,®) Treats Vitamin D deficiency, malabsorption syndrome.
- Cimzia (certolizumab) Treats rheumatoid arthritis, Chron’s disease, psoriatic arthritis, ankylosing spondylitis, plaque psoriasis, non-radiographic axial spondylarthritis
- Cytoxan® (Cyclophosphamide) Treats lupus nephritis, pulmonary fibrosis, Wegener’s granulomatosis.
- Entyvio (vedolizumab) Treats ulcerative colitis, Crohn’s disease
- Evenity (romosozumab) Treats osteoporosis in women
- Iron Replacement (Injectafer/Venofer) Treats iron deficiency anemia
- IVIG treats Primary Immune Deficiency-PI, chronic Inflammatory demyelinating polyneuropathy-CIDP, idiopathic thrombocytopenia purpura-ITP
- Krystexxa® (Pegloticase) Treats tophaceous gout.
- Nucala (mepolizumab) Treats eosinophilic granulomatosis with polyangitis, moderate to severe eosinophilic asthma, nasal polyps, hypereosinoplilic syndrome
- Nulojix (belatacept) prevents transplant rejection in kidney transplant patients
- Orencia® (Abatacept) Treats moderate to severe rheumatoid arthritis (RA) in adults who have taken other medicines for RA.
- Prolia (denosumab) Treats osteoporosis
- Reclast® (Zoledronic acid) Treats osteoporosis.
- Remicade® (Infliximab) Treats rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn disease, plaque psoriasis, and ulcerative colitis.
- Rituxan® (Rituximab) Treats rheumatoid arthritis, Wegener’s granulomatosis.
- Saphnelo (anifroluman-fnia) Treats systemic lupus erythematosus
- Simponi® Aria™ (Golimumab) Treats moderate to severe rheumatoid arthritis in adults.
- Soliris (Eculizumab): Treats paroxysmal nocturnal hemoglobinuria, atypical hemolytic uremic syndrome, myasthenia gravis, neuromyelitis optica spectrum disorder
- Solu-Medrol® (Methylprednisolone) Treats acute autoimmune disease flare.
- Stelara (ustekinumab) treats psoriatic arthritis, Crohn’s disease, ulcerative colitis
- Tepezza (Teprotumumab) Treats thyroid eye disease
- Ultomiris (ravulizumab-cwvz) Treats paroxysmal nocturnal hemoglobinuria, atypical hemolytic uremic syndrome
- Xolair (omalizumab) Treats moderate to severe asthma, chronic hives, nasal polyps
Please note that all rheumatology and infusion services require referral from a primary care provider.
How do I get an appointment with a rheumatology provider?
In order to be seen by an OPA Rheumatology provider, your primary care provider will need to send us a referral. We review all referrals for appropriateness for rheumatology care. As such, each referral should include a reason for the referral, along with pertinent chart/visit notes, current lab results, and imaging and biopsy reports to support the referral. If we determine that you are a candidate for rheumatology care at OPA, we will contact you to schedule an appointment. Please note that wait times for appointments can be lengthy due to the high demand for rheumatology care. However, we make every effort to get new patients in as quickly as possible.
What things are needed for a rheumatology referral?
Lab results, chart notes, and any available imaging and biopsies. Blood work (or labs) is a fundamental part of rheumatology diagnostics, so all patient referrals should include current results. Your primary care provider should also include a chart note that details why they feel you should be seen by OPA Rheumatology. Available x-ray, MRI, CT, and/or biopsy reports are also helpful. If your primary care provider has any questions about which labs or documentation are needed for your specific case, they should call our office.
What should I expect at my first office Visit with OPA Rheumatology?
During your first visit, be prepared to discuss your medical history and your family medical history. Bring an up-to-date list of your current medications. You will have a physical exam that will focus on identifying common signs of rheumatologic disease. The provider will review previous imaging and blood tests and order additional blood tests and imaging studies if needed.
What are signs of rheumatoid arthritis?
Rheumatoid arthritis (RA) is a chronic disease that causes pain, stiffness, swelling, and decreased range of motion in the joints. There is often swelling of joints in pairs especially the smaller joints in both hands, both wrists, etc. Generally, symptoms are worse in the mornings and get better with movement. There are other signs of RA as the disease progresses and having your primary care provider do a thorough exam is the best way to help answer any concerns you may have.
What is an autoimmune disrease?
Normally, our immune system protects us from harm. When a person has an autoimmune disease, our immune system mistakenly identifies our healthy tissue as being foreign and begins to attack it. Autoimmune diseases have many different signs and symptoms.
Are there certain conditions or diseases that you do not manage?
OPA Rheumatology does not treat or manage care related to fibromyalgia, Ehlers-Danlos syndrome, or primary osteoarthritis.
What is DEXA scan?
Also known as a “bone scan” or “densitometry screening,” a DEXA scan is a test that shows the density or strength of your bones. The report gives your health care provider insight into how much of a risk you have for broken bones in the future. The scan is similar to an x-ray and takes about 15 minutes.
Why get a DEXA scan?
People can have osteoporosis or thinning, weakening bones and not know it. There are no warning signs or symptoms prior to a person suffering a broken bone. Knowing the health of your bones is important to help prevent fractures and slow the loss of bone mass. A DEXA scan is often the first step. There is no need for referral from a primary care provider; you can call OPA directly to schedule a DEXA scan and/or a consultation with our bone health specialist.
Who needs to have a bone density test (DEXA)?
Both men and women should have their bone density tested — at age 65 (women) and age 70 (men). Younger folks should be tested if they have risk factors or symptoms such as a broken bone, rheumatoid arthritis, a parent who had a broken hip or a history of smoking, heavy drinking, or long-term use of corticosteroid drugs.
The OPA team includes Alaska’s leading specialists and offers some of the latest, most advanced treatment procedures available today.
OPA treats a wide variety of conditions and offers comprehensive treatment options — including many non-surgical solutions, minimally invasive arthroscopies (repairs), and total joint replacement.