expert type icon EXPERT

Dr. Thomas Olenginski, M.D.

Rheumatologist

Dr. Thomas Olenginski is a rheumatologist practicing in Danville, PA. Dr. Olenginski specializes in the treatment of musculoskeletal diseases and systematic autoimmune conditions that can affect the bones, muscles or bones. Eventually, if not treated, these illnesses can also impact the skin, eyes, nervous system and internal organs. Dr. Olenginski treats diseases similar to orthopedists but does not perform surgery. Often times, research is conducted to find potential alternatives for the patients illness.
44 years Experience
Dr. Thomas Olenginski, M.D.
  • Danville, PA
  • Penn State University
  • Accepting new patients

What could be the cause of my joints pain?

Thank you for your question Joint pain and in particular ankle pain can have many potential causes If 1 had an ankle injury in the past this could potentially lead to what we call READ MORE
Thank you for your question Joint pain and in particular ankle pain can have many potential causes If 1 had an ankle injury in the past this could potentially lead to what we call a post traumatic osteoarthritis When we use the term inflammatory arthritis we are talking about conditions such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and others. Typically these conditions cause very marked morning stiffness and inflammatory swelling around the joints affected Ankle pain commonly can relate to tendonitis and this has typically determined by listening to a patient's symptoms and then examining them and then doing further testing Joint pain can caused by infection but I doubt that that is the cause of your symptoms simply because that cause rash acute pain swelling fever chills and is a medical emergency The ankle can be affected by osteoarthritis and we would suspect that if we thought the range of motion of the ankles were less than normal and x-rays supported the diagnosis with joint space narrowing and bone spurring called osteophytes My advice to you would be to see your primary care physician and determine what can be done and or get a referral to a specialist I hope you get feeling better and wish you well!

Is rheumatoid arthritis serious?

thank you for your question Rheumatoid arthritis is a symmetric polyarthritis that has the potential for systemic manifestations - what that means is the pattern of arthritis is READ MORE
thank you for your question Rheumatoid arthritis is a symmetric polyarthritis that has the potential for systemic manifestations - what that means is the pattern of arthritis is typically what is on 1 side is also on the other side and it involves many joints. Patients with rheumatoid arthritis can develop nodules under the skin, they can develop inflammation that affects the lining of the long and or the heart, what we term pleural pericarditis and the condition can be associated with dryness of the eyes and dryness of the mouth related to what we call secondary Sjogren's syndrome. There are other manifestations that are less common The treatment of rheumatoid arthritis changed dramatically in 1999 Late in 1998 the drugs Enbrel and Remicade were approved and revolution ionized our treatment approach I am old enough to tell you that I practiced before that. Of time and prior to that time we did not have the treatments available that we do today The general philosophy of treatment in rheumatoid arthritis is to begin with what we call a traditional disease modifying antirheumatic drug - this would be drugs like Plaquenil, sulfasalazine, methotrexate, and leflunomide We try with the use of these medicines to reduce the amount of pain, swelling, and stiffness and hope to return that patient to his or her previous level of function The standard treatment really today is methotrexate. Methotrexate can be administered by oral tablets that are taken once weekly. Additionally, the drug can be administered by self-injection subcutaneously and that method is typically more effective and better tolerated than the pills If 1 does not achieve an acceptable response to methotrexate, then we typically try to get approval to use 1 of the biologic agents - so initially we had ENBREL and Remicade; then we saw the approval of Humira, Cimzia, Simponi. Additionally other type drugs were developed called Orencia, Actemra, Kevzara, rituximab, Xeljanz, Olumiant, and Rinvoq In this combination of treatments, we are usually able to markedly reduce pain and swelling, return the patient to their usual function, and prevent joint damage that can be seen on x-ray Unquestionably, our patients with rheumatoid arthritis today do better than 20 years ago and it is likely that we are going to see more advances in therapy over the next few years. Is rheumatoid arthritis serious ? I think the answer is yes But, rheumatoid arthritis is much more treatable today and our patients do much better today than 20 to 30 years ago Best wishes and good luck Thomas P. Olenginski, M.D., FACP Staff Attending Physician - Geisinger Medical Center, Danville PA Department Rheumatology HiROC FLS Physician Champion BMD Committee Chairperson 570-271-6416 Fax: 570-214-2924

What's the life expectancy of a child with lupus?

Thank you very much for the question I would start off by saying that lupus is a very treatable illness and we treat it much better today than 20 to 30 years ago There have been READ MORE
Thank you very much for the question I would start off by saying that lupus is a very treatable illness and we treat it much better today than 20 to 30 years ago There have been a number of recent developments and discovery regarding new treatments I am an adult rheumatologist but most of the sources that I reviewed indicated that the life expectancy of a child with lupus is on the order of 85 to 90 percent. I would suggest that this be discussed with your granddaughters rheumatologist I hope this helps some and I wish your granddaughter excellent health and happiness Thomas P. Olenginski, M.D., FACP Staff Attending Physician - Geisinger Medical Center, Danville PA Department Rheumatology HiROC FLS Physician Champion BMD Committee Chairperson 570-271-6416 Fax: 570-214-2924

What medications can my daughter take for joint pain?

thank you for the question If someone with juvenile inflammatory arthritis or JIA has symptoms and they are not controlled with anti-inflammatory medication, then the addition READ MORE
thank you for the question If someone with juvenile inflammatory arthritis or JIA has symptoms and they are not controlled with anti-inflammatory medication, then the addition of a drug such as methotrexate or what we would term a biologic medication such as ENBREL or Humira should be considered I would highly recommend that your daughter sees a pediatric rheumatologist for a confirmatory diagnosis and more importantly a treatment plan to help her signs and symptoms and reduce the chance of the condition affecting her joints and causing joint damage over time Best wishes and I hope you daughter gets better Thomas P. Olenginski, M.D., FACP Staff Attending Physician - Geisinger Medical Center, Danville PA Department Rheumatology HiROC FLS Physician Champion BMD Committee Chairperson 570-271-6416 Fax: 570-214-2924

Is joint pain a sign of lupus?

thank you for your question Muscle and joint pain particularly with morning stiffness can be a presenting sign of lupus Other potential manifestations include sun sensitivity, READ MORE
thank you for your question Muscle and joint pain particularly with morning stiffness can be a presenting sign of lupus Other potential manifestations include sun sensitivity, Raynaud's phenomenon - were fingers especially turn white and purple in response to the cold and then are able to be re warmed to the normal state. Patients with lupus can have inflammation of the heart and lung lining, conditions termed pericarditis and pleuritis. Fatigue and weight loss can occur. Involvement of the kidney can include what we term glomerulonephritis and blood pressure elevation and edema can be seen. Additionally, some patients with lupus can be predisposed to blood clotting because of phospholipid antibodies. Patients with rheumatoid arthritis can also present with wrist and ankle pain as well as other inflammatory arthritis conditions I would emphasize that there are many less serious causes of wrist and ankle pain. With your concern and with your family history, I would notify your primary care physician to have this investigated Wish you well and I hope you are feeling better Thomas P. Olenginski, M.D., FACP Staff Attending Physician - Geisinger Medical Center, Danville PA Department Rheumatology HiROC FLS Physician Champion BMD Committee Chairperson 570-271-6416 Fax: 570-214-2924

Anything I can do for ankylosing spondylitis?

Thank you for your question. Ankylosing spondylitis is a condition that can cause inflammatory back pain because of inflammation involving the sacroiliac joints. Additionally, READ MORE
Thank you for your question. Ankylosing spondylitis is a condition that can cause inflammatory back pain because of inflammation involving the sacroiliac joints. Additionally, the condition condition can progress and involve the lower back, mid back, and sometimes the cervical spine. The condition can be associated with extra-articular manifestations, including anterior uveitis or eye inflammation. Patience with psoriasis or inflammatory bowel disease can develop enclosing spondylitis or certainly a condition mimicking that If the patient with ankylosing spondylitis does not respond to a trial of two non-steroid anti-inflammatory drugs, it is generally felt that the next step would be the addition of an anti-TNF biological therapy, these medicines include, Humira, Remicade, CIMZIA, and SIMPONI. Additionally, other medication can be considered for treatment, including drugs, like TALTZ, and COSENTYX as well as Jack inhibitors like XELJANZ and RINVOQ. I want to emphasize that we can treat this condition so much better because of these newer medications. Importantly, I would advise you to see your rheumatologist and ask about the medication's that I have listed Best wishes and I hope you feel better.

Why does my son have sacroiliac joint pain?

This is a very good question because on physical examination, we cannot feel the sacroiliac joint. We have indirect measures of assessing this on exam, but we really rely on imaging READ MORE
This is a very good question because on physical examination, we cannot feel the sacroiliac joint. We have indirect measures of assessing this on exam, but we really rely on imaging modalities to help determine if, in fact, the sacral iliac joint is involved. The most common disorders of the sacral iliac joints include a family of conditions called the spondyloarthropathy. This family includes conditions such as ankylosing, spondylitis, psoriatic, arthritis, reactive, arthritis, and arthritis related to underlying inflammatory bowel disease, such as Crohn's disease or ulcerative colitis. Importantly, there are pain, symptoms, and pain symptoms that do not directly relate to the sacral iliac joints. Therefore, my recommendation is for your son to have an evaluation to try to get to the bottom of this problem.

How does juvenile arthritis affect bone development in children?

Thank you for the question and I hope your daughter does well In some patients with juvenile arthritis, we can see leg length discrepancy or joint contracture Additionally, we READ MORE
Thank you for the question and I hope your daughter does well In some patients with juvenile arthritis, we can see leg length discrepancy or joint contracture Additionally, we may also see the development of micrognathia, or under growth of the lower jaw Today, we feel that if juvenile inflammatory arthritis is effectively controlled then we should not see the complications of Bone development that you asked about Again, I think the best solution is that everyone has access to pediatric rheumatology for accurate diagnosis and defective therapies and long-term follow up Thomas P. Olenginski, M.D., FACP Staff Attending Physician - Geisinger Medical Center, Danville PA Department Rheumatology HiROC FLS Physician Champion BMD Committee Chairperson 570-271-6416 Fax: 570-214-2924

What are the symptoms of psoriatic arthritis in kids?

thank you for the question Children can develop inflammatory arthritis, much of which is termed juvenile inflammatory arthritis or JIA and with in the subtypes of inflammatory READ MORE
thank you for the question Children can develop inflammatory arthritis, much of which is termed juvenile inflammatory arthritis or JIA and with in the subtypes of inflammatory arthritis is a psoriatic arthritis or spondyloarthritis category It is also important to know that if someone has a definite diagnosis of psoriasis that perhaps 25 percent of them over their lifetime will develop psoriatic arthritis Psoriatic arthritis has subtypes: There is a subtype that involves 4 or fewer joints and we call that pauci articular; there is a polyarticular form that for all intents and purposes can be considered to be juvenile inflammatory arthritis or RA like; there is a form that is extremely unusual and that is fortunate because it is a very active and destructive arthritis that is called mutilans; there is a form that can cause inflammation in the sacroiliac joints and this can mimic a condition called ankylosing spondylitis; and there is a form that can involve the end knuckle what we call the D IP or end knuckle joint Patients with psoriasis can have abnormal fingernails and abnormal toenails There symptoms will typically include pain, stiffness, particularly morning stiffness, and inflammatory swelling of the joints and or marked stiffness of the low back Pediatric rheumatologists are incredibly skilled at trying to determine the cause of musculoskeletal symptoms in children Again thank you for the question Thomas P. Olenginski, M.D., FACP Staff Attending Physician - Geisinger Medical Center, Danville PA Department Rheumatology HiROC FLS Physician Champion BMD Committee Chairperson 570-271-6416 Fax: 570-214-2924

I have a lot of pain in my joints. Could it be rheumatoid arthritis?

Rheumatoid Arthritis is a condition that tends to cause a symmetric polyarthritis - typically that means what happens on 1 side happens on the other and polyarthritis means many READ MORE
Rheumatoid Arthritis is a condition that tends to cause a symmetric polyarthritis - typically that means what happens on 1 side happens on the other and polyarthritis means many joints that are involved Morning stiffness is a characteristic symptom of rheumatoid arthritis were it may take a patient 1 or 2 hours to limber up in the morning and be able to get on with their day. Also squeeze tenderness of the knuckles of the hands and the metatarsal regions of the feet is common When we evaluate someone who has pain swelling and or stiffness of many joints we consider rheumatoid arthritis, psoriatic arthritis, or conditions termed spondyloarthropathy Characteristic lab abnormalities in rheumatoid will include an elevation of the sedimentation rate and C-reactive protein, which are inflammation indicators. About (3/4) patients with rheumatoid arthritis produce a rheumatoid factor antibody and there is a newer more specific antibody called an anti CCP that can assist in the diagnosis My advice would be to get your symptoms checked so that a diagnosis and treatment plan can be initiated Thomas P. Olenginski, M.D., FACP Staff Attending Physician - Geisinger Medical Center, Danville PA Department Rheumatology HiROC FLS Physician Champion BMD Committee Chairperson 570-271-6416 Fax: 570-214-2924

Is it safe to massage a patient who is suffering from arthritis?

I am sorry to hear that your father is having this difficulty Yes, it is permissible to massage if the correct technique is used If someone nor to have acute swelling and pain, READ MORE
I am sorry to hear that your father is having this difficulty Yes, it is permissible to massage if the correct technique is used If someone nor to have acute swelling and pain, then I might consider using ice as an adjunctive therapy Heat tends to be more effective for chronic pain There are topical anti-inflammatory medications that can be applied to the skin such as diclofenac gel Acetaminophen taken on a regular basis can also be effective In general, we avoid using nonsteroidal anti-inflammatory drugs in elderly patients with knee arthritis because of the risks of side effects At times, cortisone injections can be helpful I hope this is of some benefit to you and I hope your father is feeling better

Are there foods that can improve my arthritis?

The most important thing in giving treatment recommendations for arthritis is to know what specific form of arthritis we are dealing with The most common arthritis that affects READ MORE
The most important thing in giving treatment recommendations for arthritis is to know what specific form of arthritis we are dealing with The most common arthritis that affects the knees is osteoarthritis That is a condition where the cartilage which cushions the joint space slowly wears down And in doing so, the joint space narrows, and patients experience pain and difficulty walking etcetera The treatment of arthritis suffers from lack of understanding of some of the reasons and mechanisms behind arthritis, whether it is osteoarthritis or rheumatoid arthritis or psoriatic arthritis etcetera I am not aware of any clear study that shows that a medical food or specific diet and or dietary changes clearly effects the progression of a patient's arthritis The most important thing in osteoarthritis is weight management and weight loss if necessary as well as an exercise program I have many patients who follow an anti inflammatory diet and they seem to be helped by this There was no good evidence however to show that 1 diet is better than another in a rigorous scientific way So my patients that they can follow choose or learn about an anti-inflammatory diet Patients who have gout, they develop problems because of the accumulation of excess amounts of uric acid Patient is can follow a low purine diet and help lower being of your to some degree, although in almost all patients with recurrent gout, a uric acid lowering medicine is necessary Again I would advise anyone with questions about arthritis to be sure that they know exactly what type of arthritis they have I hope your pain improves and I hope you have a good day.

Is there a prescription medication that will help ease the pain of my arthritis?

Thank you for your question The most important thing in determining what the best treatment rests on determining what specific form of arthritis you have Patients with rheumatoid READ MORE
Thank you for your question The most important thing in determining what the best treatment rests on determining what specific form of arthritis you have Patients with rheumatoid arthritis or psoriatic arthritis can be treated with very specific disease-modifying medications and or water-termed biological medications Alternatively if you have osteoarthritis, which is the most common arthritis in the world, then our treatments become symptom-based treatments would include acetaminophen/Tylenol; Advil or Aleve, 2 over-the-counter nonsteroid anti-inflammatory drugs; prescription anti-inflammatory medications such as naproxen, Voltaren, Celebrex, meloxicam, etcetera; we typically, we do not use strong pain relievers for arthritis pain. That is because of the risks of side effects, including lightheadedness, dizziness, sedation, and dependence. A topical anti-inflammatory cream such as diclofenac or Voltaren gel can be considered Sometimes physical therapy and or occupational therapy or a hand therapy evaluation can be helpful Finally, pain modulators such as duloxetine can be considered Again, the best treatment plan is based on a specific diagnosis Best wishes and good luck.

Autoimmune

I am going to answer question really addressing how we evaluate a patient with Raynaud's Raynaud's can be primary, where a patient starts to have signs and symptoms of Raynaud's READ MORE
I am going to answer question really addressing how we evaluate a patient with Raynaud's Raynaud's can be primary, where a patient starts to have signs and symptoms of Raynaud's at a relatively young age We will say primary when we see no signs or symptoms of any other condition Secondary Raynaud's is a condition linked to an underlying autoimmune or immunologic condition The most common condition associated with secondary Raynaud's is scleroderma and there are different forms of scleroderma, the most common form being what we call limited scleroderma and the other form being called diffuse scleroderma Additionally, we can see Raynaud's in patients with lupus or a condition we call mixed connective tissue disease or an overlap condition, really meeting that we see signs and symptoms of more than 1 condition but we can not diagnose the patient as lupus or scleroderma or Sjogren's Finally, patients with an inflammatory muscle condition called dermatomyositis can also have Raynaud's From a clinical standpoint, if I do not see any signs or symptoms of Raynaud's that is very reassuring Typically, when we do laboratory tests to evaluate the most important test is the antinuclear antibody The ANA test is a test that can be performed by different methods and there are more specific methods that can be used Nonetheless, when there is an apparent abnormality in the ANA screening test, we do more specific autoantibodies to better define the ANA Those antibodies are typically anti DNA, anti SSA SSB, anti-SM/RNP The ANA test will often return with a titer, example 1 to 160, and with a pattern, example homogeneous or speckled When the ANA pattern is centromere, that indicates that there is a centromere antibody in the patient's system and that antibody is most typically seen in patients with limited scleroderma An antibody called anti Scl 70 can be detected in patients with diffuse scleroderma So, from what I think I understand in your situation, the additional testing and the interpretation of that will be very important I wish you well and thank you for your question

My immunoglobulin G subclass 4 level was high at 148 - what does this mean?

The first question I would want to know is what was the reason for the test. One could order IgG subclasses in the evaluation of a suspected immune deficiency state. The most common READ MORE
The first question I would want to know is what was the reason for the test. One could order IgG subclasses in the evaluation of a suspected immune deficiency state. The most common thing for rheumatologists to order this test would be in the evaluation of suspected IgG for related disease. It is important to know that a small percentage of the otherwise normal population will have an elevated test. Additionally, this test can be elevated in many inflammatory and infectious and allergic disorders. So again, I would want to know why your doctor ordered this test. And then based on the test results and his or her suspicions, further testing may be necessary. The most important point is that many conditions can cause an elevation of this specific test Best wishes

Fibromyalgia rheumatica

I am sorry that you are having difficulties I presume that the prednisone and methotrexate have been used to treat polymyalgia rheumatica or what we call PMR This is an inflammatory READ MORE
I am sorry that you are having difficulties I presume that the prednisone and methotrexate have been used to treat polymyalgia rheumatica or what we call PMR This is an inflammatory syndrome of the elderly that is very responsive to prednisone, usually On occasions, we will encounter patients who have difficulty getting to lower doses of prednisone The big concern with chronic prednisone therapy, even at low dose, our side effects including osteoporosis, muscle weakness, bruising of the skin, cataracts, etcetera There is a new medication that is recently approved for the treatment of polymyalgia rheumatica when the patient has trouble tapering off or to lower doses of prednisone That medication is Kevzara or Sarilumab This is a medication in the category of Biologic and it is similar to a medication called Actemra, which is used to treat rheumatoid arthritis and giant cell arteritis In general, medications such as methotrexate and Plaquenil are not as reliably effective in trying to bring the dose of prednisone down in somebody with PMR From what I see here, you may very well be a candidate for Kevzara and I would encourage you to talk to your rheumatologist about that Best wishes to you

I have severe pain in my joints when I stand. Could it be arthritis?

Pain, swelling, stiffness, deformity, or difficulty using your joints are all potential signs of arthritis. Having said that, there are many different forms of arthritis and it READ MORE
Pain, swelling, stiffness, deformity, or difficulty using your joints are all potential signs of arthritis. Having said that, there are many different forms of arthritis and it is very important to know what type of arthritis affects you so that the best treatment can be recommended. Best wishes to you and I hope you feel better

I have a dull feeling and pain in my wrist. Is it the start of arthritis?

This symptom could potentially be the start of arthritis. However, I would look at the symptoms as a reason to be evaluated to know specifically what is going on. Arthritis of READ MORE
This symptom could potentially be the start of arthritis. However, I would look at the symptoms as a reason to be evaluated to know specifically what is going on. Arthritis of the wrist is not as common as arthritis of the hips or knees or back or some other joints. Wrist pain can be the sign of what we will term an overuse injury, perhaps a tendonitis, perhaps a prior injury that may lead to a post traumatic arthritis. While numbness in the 1st 3 fingers is often related to carpal tunnel syndrome, wrist pain can be a sign as well. Additionally, chronic infections can present as wrist pain and wrist arthritis and wrist arthritis can be a consequence of an earlier inflammatory condition such as juvenile arthritis or Still's disease. Again, I would recommend evaluation so that you will have peace of mind and a treatment plan

I had a pain in my calf muscles last night. Could it be rheumatic pain?

It sounds to me like you had a cramp or other muscular pain There are many potential causes for calf pain Should this continue and/or worsen, then I would get checked by your primary READ MORE
It sounds to me like you had a cramp or other muscular pain There are many potential causes for calf pain Should this continue and/or worsen, then I would get checked by your primary care doctor Best wishes

Can hot oil massage help in managing my mother's knee pain better?

Thank you for this question I appreciate the question and from what I read you indicate that your mother has very severe knee arthritis, most likely osteoarthritis Osteoarthritis READ MORE
Thank you for this question I appreciate the question and from what I read you indicate that your mother has very severe knee arthritis, most likely osteoarthritis Osteoarthritis is a condition where the cartilage breaks down and over a long period of time there can be the development of joint deformity and or severe pain and or difficulty walking We indicate that treatment for osteoarthritis is symptom based, meaning that we unfortunately do not have a way to stop the arthritis Traditional recommendations include acetaminophen, physical therapy, topical diclofenac which can be rubbed into the knee regions 3 times daily, steroid injections, and possibly water called intra-articular hyaluronic acid injections Anything applied locally to a painful region may be of benefit, whether hot or cold Hot oil massage is a treatment that does not have any clear-cut scientific evidence From my standpoint, massage may be helpful to the muscles above the knee as these muscles are very important to getting up and down, especially in someone with knee arthritis I hope this helps and I wish your mother well Dr O