Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Reactive arthritis is a chronic form of arthritis featuring
the following three conditions: (1) inflamed joints, (2)
inflammation of the eyes (conjunctivitis), and (3) inflammation of the
genital, urinary, or gastrointestinal systems.
This form of joint inflammation is called "reactive arthritis" because it is
felt to involve an immune system that is "reacting" to
the presence of bacterial infections in the genital, urinary, or
gastrointestinal systems. Accordingly, certain people's immune systems are
genetically primed to react aberrantly when these areas are exposed to
certain bacteria. The aberrant reaction of the immune system leads to
spontaneous inflammation in the joints and eyes. This can be confounding to the patient and the doctor when the infection has long passed at the time of presentation with arthritis or eye inflammation.
Reactive arthritis has, in the past, been referred to as Reiter
syndrome (a term that has lost favor because of Dr. Hans Reiter's
dubious past, one of enthusiastically embracing Nazi politics and medical abominations).
Reactive arthritis most frequently occurs in patients in their 30s
or 40s, but it can occur at any age. The form of reactive arthritis that occurs after genital infection (venereal) occurs more frequently in
males. The form that develops after bowel infection (dysentery) occurs in
equal frequency in males and females.
Reactive arthritis is considered a systemic rheumatic disease. This means
it can affect other organs than the joints, causing inflammation in tissues such as the eyes, mouth, skin,
kidneys, heart, and lungs. Reactive arthritis shares many features with
several other arthritic conditions, such as psoriatic arthritis,
ankylosing spondylitis, and arthritis associated with Crohn's disease and
ulcerative colitis. Each of these arthritic conditions can cause similar
disease and inflammation in the spine and other joints, eyes, skin, mouth,
and various organs. In view of their similarities and tendency to inflame
the spine, these conditions are collectively referred to as "spondyloarthropathies."
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
The knee joint is composed of three compartments and ligaments which stabilize the joint. Causes of knee pain may include injury, degeneration, infrequently infection and rarely bone tumors. Although routine x-rays do not revel meniscus tears, they can be used to exclude other problems of the bones and tissues. The knee joint is the most commonly involved joint in rheumatic disease, as well as immune diseases that affect various tissues of the body.
Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendinitis of the ankle can be caused by trauma or inflammation.
Ulcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding. Ulcerative colitis is closely related to Crohn's disease, and together they are referred to as inflammatory bowel disease. Treatment depends upon the type of ulcerative colitis diagnosed.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Ankylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing spondylitis is genetically inherited.
Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves antiinflammatory medications and exercise.
Bone spurs are pointy outgrowths of bone that develop in areas of inflammation or injury. They commonly occur on the heel and spine and may be the result of reactive arthritis, ankylosing spondylitis, or diffuse idiopathic skeletal hyperostosis. Symptoms include pain, numbness, and tenderness. Treatment focuses on decreasing inflammation and avoiding re-injury.
Heel spurs, pointed, bony outgrowths of the heel, are caused by localized soft tissue inflammation and can be located at the back of the heel or under the heel, beneath the sole of the foot. Plantar fascitis is associated with inflammation caused by heel spurs on the soles of the feet. Both conditions are treated with ice application and anti-inflammatory medications. Orthotics may also provide some relief.
Costochondritis is inflammation of the cartilage where the ribs attach to the sternum. Tietze syndrome affects the same region of the chest and causes inflammation, tenderness, and swelling. Anti-inflammatory medications, rest, physical therapy, and cortisone injections are suitable methods of treatment for both costochondritis and Tietze syndrome.
Graves' disease is an autoimmune disease that affects the thyroid. Some of the symptoms of Graves' disease include hand tremors, rapid heartbeat, trouble sleeping, enlarged thyroid, thinning of the skin or fine brittle hair. Causes of Graves' disease are thought to be multifactorial such as genes, gender, stress, and infection. Treatment for Graves' disease is generally medication.
Juvenile arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are three types of JRA: pauciarticular (less than four joints affected), polyarticular (more than four joints affected), and systemic-onset (inflamed joints with high fevers and rash). Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
Shigellosis is a disease caused by the Shigella bacteria. Bloody diarrhea, stomach cramps and fever are common symptoms. Mild infections usually resolve on their own. Antibiotics are used to treat more severe cases.
Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where
two different bones meet. A joint functions to move the body parts connected by its bones.
Arthritis literally means inflammation of one or more joints.
Arthritis is frequently accompanied by joint pain. Joint pain is
referred to as arthralgia.
There are many types of arthritis (over 100 identified, and the number is growing). The types range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation resulting from an overactive immune system (such as rheumatoid arthritis). Together, the many types of arthritis make up the most common chronic illness in the United States.
The causes of arthritis depend on the form of arthritis. Causes include injury (leading to osteoarthritis), metabolic abnormalities (such as gout and pseudogout), hereditary facto...
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