Woman suffering from pain in hands and fingers, arthritis inflammation.


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Rheumatology at CNOS

Rheumatic diseases can be treated with proper diagnosis and therapy. When muscle and joint pain are not resolved on their own, additional evaluations and care may be needed. CNOS physicians are here to provide specialty treatment services for the following:

Meet Your Team!

Joint, arthritis & inflammation pain relief from caring experts

When inflammation or arthritis impacts your joints, muscles, or bones, it’s time to see a rheumatologist. Our experts deliver the finest care and advanced treatment for a wide range of conditions. From therapy to surgery, we provide relief.

Our team of local rheumatologists will help you achieve pain relief, movement restoration, and disease remission.


Joint Pain & Swelling

Joint pain and swelling can keep you from moving as you would like to. We provide medication for conditions such as gout and pseudogout–both of which can cause joint inflammation resulting in pain and discomfort.

Other conditions, like hypermobile joints, cannot be cured completely. But with the right therapy and care from CNOS, these conditions can be more manageable as we help keep you moving.

Woman suffering from pain in hands and fingers, arthritis inflammation.


Arthritis comes in many forms, but all types of arthritis can cause chronic pain and discomfort. If you are in need of rheumatoid arthritis management, our caring physicians understand your pain–and use the most advanced methods to treat it.

  • Our interdisciplinary team will provide the medication, therapy and self-care recommendations for conditions including:
  • Osteoarthritis: the most common form, affecting cartilage
  • Rheumatoid and juvenile joint rheumatoid arthritis: affects joints but can damage body systems such as skin, eyes, lungs, heart and blood vessels
  • Septic arthritis: joint infection
  • Ankylosing spondylitis: primarily affecting the spine and spinal joints (vertebrae)

Arthritis can affect your cartilage, organs, joints, and overall quality of life. CNOS rheumatologists are here to help you improve your health.


Muscle Pain

Factors like stress can cause muscle pain, stiffness, and discomfort. If you’re feeling chronic muscle pain, our rheumatologists can help.

Fibromyalgia is a widespread musculoskeletal pain that is often accompanied by fatigue, tenderness, and altered sleep, memory, and mood. An expert team at CNOS is prepared to help you improve these conditions through medication and therapy, as well as offering suggestions for reducing the stress that may be causing your condition.

Polymyalgia rheumatica is a similar inflammatory condition that causes muscle pain and stiffness, most often in the shoulders. Treatments are usually simple and, although they can last for a few years, can help you feel better after only a few days.

An uncommon disease known as polymyositis causes muscle weakness on both sides of the body. With this condition, you might have trouble climbing stairs or lifting objects overhead. We’ll take a complete look at your symptoms and start treating them accordingly.


Immune System Disorders

Autoimmune diseases cause the immune system to mistakenly attack healthy body cells. These diseases can impact many different body systems, and each one should be evaluated and treated by a highly trained specialist.

  • Lupus: The immune system attacks the body’s tissues and organs. Resulting inflammation can also impact joints, skin, kidneys, blood cells, brain, heart and lungs.
  • Sjogren’s Syndrome: Affects the cells that produce saliva and tears. Often occurs with conditions like rheumatoid arthritis and lupus.
  • Scleroderma: A rare condition that hardens and tightens the connective tissues and skin.
  • Wegener’s granulomatosis: Affects the ears, nose, throat, lungs, and kidneys. May cause damage to organs and tissues due to reduced blood flow.

At CNOS, we’ll use every resource—from expert physicians to personalized care—to help improve your condition.

Other Rheumatic Conditions

Our rheumatology experts can help these and other conditions, including rare diseases such as amyloidosis. Anything that affects your quality of life is something we are prepared to treat.

Osteoporosis Care at CNOS

Osteoporosis is a bone disease that causes a decrease in the quality and density of the bone due to the bone being broken down faster than it can form.  Osteoporosis typically will slowly progress over time and can be asymptomatic.  As a result, this causes the bone to become fragile and brittle.

Treatment of osteoporosis is crucial for several reasons. First being the increased risk of fracture which can lead to significant pain, disability, loss of independence, decreased mobility, posture changes, and decreased quality of life and mental well-being. Some fractures such as a hip fracture can even lead to increased morbidity and mortality. Additionally, the fractures that occur due to osteoporosis significant increase healthcare costs due to hospitalizations, surgeries, rehab services, and ongoing medical treatment.

Who should be screened?
  • Women over 65 years old, and men over 70 years old regardless of any risk factors
  • Postmenopausal women
  • Men over the age of 50 with risk factors
  • Individuals with a fall history, especially if they are over the age of 50
  • Individuals with concerns of bone health
  • Individuals with increased risk factors
Common risk factors
  • Age, gender, family history, ethnicity, diet, tobacco use, sedentary lifestyle, excessive alcohol consumption, hormonal changes, rheumatoid arthritis, celiac disease, thyroid disorders, GI disorders, long term steroid use, low BMI, and previous fractures.
    • Women who are postmenopausal or have had a total hysterectomy are at increased risk of developing osteoporosis because of decreased estrogen levels. In general Women are at a high risk then men to develop osteoporosis.
    • A family history of osteoporosis does increase the risk of the patient developing this. It is also important to assess if either of the patient’s parents ever sustained a hip fracture.
    • Caucasian and Asian ethnicities seem to have a higher risk of developing osteoporosis, however, it is seen in all ethnicities.
Preventative measures
  • Balanced diet
  • Adequate calcium and vitamin D
  • Regular exercises and weight bearing exercises
  • Avoid tobacco use, and excessive alcohol consumption
  • Preventing falls
  • Healthy body weight and lifestyle choices
  • Routine DEXA Scans

DEXA Scan:

A DEXA Scan is an imaging test used to measure bone density and is commonly used to diagnosis osteoporosis, and assess fracture risk. It can also be used for body composition and to evaluate body fat distribution. This test is similar to a X-ray but has less radiation exposure.

Undergoing a DEXA scan is painless, non-invasive, and typically takes under 30 minutes to complete. When having your DEXA scan completed, there are no restrictions to follow before or after the test, and no fasting is needed. These scans typically focus on the low back, and hips to assess bone density.

FRAX Score:

FRAX stands for Fracture Risk Assessment Tool. The FRAX score calculates how likely an individual would be to experience a major osteoporotic fracture, or a hip fracture over a 10 year time span. This tool also takes into account multiple factures including age, gender, height and weight, previous fractures, parental history of hip fracture, current smoking history and alcohol consumption, glucocorticoid use, rheumatoid arthritis, and secondary osteoporosis.

Katie Wictor, NP-C

Osteoporosis Care Provider

Start the conversation with our rheumatologist today, and we will start you on the path to healing

Request an appointment now at one of our local clinics near you by calling 605-217-2667.

CNOS Rheumatology Clinic Locations

The following CNOS clinics offer rheumatology care in communities throughout Siouxland. Find a clinic near you to visit with a rheumatologist.