A Rheumatologist is a physician, who has received further training in the diagnosis and treatment of musculoskeletal disease and systemic autoimmune conditions commonly referred to as rheumatic diseases. These diseases can affect the joints, muscles and bones causing pain, swelling, stiffness and deformity. Autoimmune conditions occur when the immune system sends inflammation to areas of the body when it is not needed causing symptoms. These diseases can also affect the eyes, skin, nervous system and internal organs like kidneys, heart, lungs. While orthopedicians treat joint disease surgically, rheumatologists treat joint diseases medically. Apart from the common arthritis like, rheumatoid arthritis, osteoarthritis, rheumatologist also treat gout, chronic back pain, tendinitis, osteoporosis, ankylosing spondylitis, myositis, fibromyalgia and SLE. Rheumatological disorders range from chronically disabling arthritis and critical illnesses involving multiple organs of the body down to milder but nagging and persistent illnesses such as chronic back aches and neck aches due to occupational hazards such as teaching, farming or long hours on the computer.
Most of us experience joint or muscle pain at some point in time. Although most of the joint symptoms resolve by itself some of them persists. If your pain is not resolving in 1-2 weeks it is better to take an expert opinion. If joint symptoms are associated with following symptoms it is always advised to take a rheumatologist’s opinion –
* Systemic symptoms like fever, weight loss
* Most severe pain in the morning hours
* More than 3 joints are involved at the same time
* Skin rash, abdominal pain
Earlier referral should be made if you have relatives with autoimmune or rheumatic disease (as these conditions run in families) or if the symptoms are significantly worsening over a short period of time. Some of the signs and symptoms can improve or temporarily resolve when initially treated but can return once the medication is stopped. If the symptoms continue to return, a rheumatology evaluation may be needed. Joint damage can occur if the symptoms of joint pain are ignored or not treated properly over a period of time. This damage cannot always be reversed with treatment and may be permanent. Do not delay appropriate evaluation.
Rheumatic diseases are sometimes complex in nature and difficult to diagnose, so rheumatologists will gather a complete medical history and perform a physical exam to look for signs and symptoms of inflammation throughout the entire body and musculoskeletal system. A family history can be very important to diagnosis of rheumatic disease and will also be assessed. The rheumatologist will review the results of any prior testing that has been performed on a patient and may order additional laboratory tests to confirm the diagnosis. All of these results will be combined to determine the source of a patient’s symptoms and develop a personalized treatment plan. Treatment recommendations may include medications, referral to physical therapy, referral to other specialists, or joint/tendon injections. Some rheumatic diseases can be difficult to diagnose and may require several visits for the rheumatologist to fully understand the underlying process. During follow-up appointments, rheumatologists may treat reoccurring conditions or talk with patients about medications, coping mechanisms, techniques for preventing disability or regaining function, and ways to improve their quality of life.
What should I bring to my first Rheumatology visit? Please bring the following to your first rheumatology visit: * Any previous lab and/or radiographic X-ray/ultrasound/MRI tests results for review (Sometimes tests need to be repeated to confirm the result).
* An up-to-date medication list with the specific dosages you are taking (include a list of medications you have already tried to reduce duplication of prior treatments).
* A list of allergies to medications.
* Your family history, including any known relatives with rheumatologic/autoimmune disease.