Patient Education

What Is Rheumatology?

Rheumatology is a rapidly evolving medical sub-specialty, devoted to the diagnosis and therapy of rheumatic diseases. These diseases especially affect joints, tendons, ligaments, bones, and muscles. There are more than 200 types of these diseases, including rheumatoid arthritis, osteoarthritis, gout, lupus, back pain, osteoporosis, lupus and tendinitis. Some of these are very serious diseases that can be difficult to diagnose and treat. Rheumatic diseases can also involve internal organs.

The cause of every major rheumatological disorder is now best explained by imbalance in the autoimmune system. Hence, rheumatic diseases are often referred as autoimmune disease. The treatment modalities are also based on clinical research on autoimmune system. Evidence-based medical treatment of rheumatological disorders has helped patients with these disorders lead a near normal life.

There is an increasing demand for specialists in this field with an increasing population of patients who need specialized treatment. Rheumatologists are increasing in numbers in all countries.

Who Is a Rheumatologist?

A consultant rheumatologist is a doctor who specializes in diagnosing and treating arthritis and diseases related to rheumatology. Rheumatologists treat over 200 different health problems that affect the joints, bones, muscles and other internal organs (e.g. kidneys, lungs, blood vessels, brain). They focus on non-surgical treatment of arthritis and related rheumatic diseases.

Rheumatologists treat arthritis, certain autoimmune diseases, vasculitis, musculoskeletal pain disorders, and osteoporosis. There are more than 200 types of these diseases, including rheumatoid arthritis, osteoarthritis, gout, lupus, back pain, osteoporosis, and tendinitis. Some of these are very serious diseases that can be difficult to diagnose and treat.

Adult rheumatologists are specifically trained to be highly skilled in:
1. Developing a differential diagnosis of rheumatic disorders and autoimmune diseases
2. Efficient use of diagnostic evaluations in rheumatic disorders
3. Selecting appropriate medical therapy for treatment of rheumatic disease given the patient’s lifestyle and co-morbidities
4. Monitoring long term efficacy and side effects of multiple medications including anti-inflamatory and biologic agents used to treat rheumatic disease
5. Improving quality of life and decreasing disability of patients suffering from rheumatic disease
6. Providing longitudinal care for chronic rheumatic disease management such as, rheumatoid arthritis, systemic lupus erythematosus and many more.)(should be mention specific diseases or be more generic?)
7. Aspiration and injection of joints for diagnosis and treatment of rheumatic disease
8. Interpretation of radiographic, imaging, (e.g., ultrasound, MRI, CT, dual energy X-ray absorptiometry) and laboratory studies in context of rheumatic disease evaluation
9. Evaluation and management of osteoporosis

Rheumatologists provide a key role in the non-surgical treatment of osteoarthritis, soft tissue rheumatism, back pain, and other aspects of musculoskeletal health. Particularly, attention is paid to care of the geriatric patient who is may be unable or does not wish to have extensive surgical procedures for the treatment of osteoarthritis, spinal stenosis as well as other conditions.

What causes rheumatic diseases?

Rheumatic diseases are generally believed to be caused by a combination of genetic and environmental factors. In other words, you may be born with a susceptibility to a disease, but it may take something in your environment to get the disease started.

Some of these factors have been identified. For example, in osteoarthritis, inherited cartilage weakness or excessive stress on the joint from repeated injury may play a role. Certain viruses may trigger disease in genetically susceptible people. Gender is another factor in some rheumatic diseases. Lupus, rheumatoid arthritis, scleroderma, and fibromyalgia are more common among women. This indicates that hormones or other male-female differences may play a role in the development of these conditions.

Diseases Treated By Rheumatologist

  • Rheumatoid arthritis
  • Reactive Arthritis
  • Psoriatic arthropathy
  • Enteropathic spondylitis
  • Juvenile idiopathic arthritis(JIA)
  • Gout,pseudogout
  • Septic arthritis
  • Osteoarthritis
  • Osteoporosis,osteomalacia
  • Hypermobolity syndrome
  • Lupus
  • Seleroderma(systmic selerosis)
  • Dermatomyositis
  • Polychondritis
  • Vasculitis
  • Microscopic polyangiitis
  • Wegener’s granulomatosis
  • Henoch-Schonlein purpura
  • Takayasu’s arthritis
  • Kawasaki’s disease
  • Sjogren’s syndrome
  • Polymyositis
  • Polymyalgia rheumatiea
  • Sareoidosis
  • Churg-Strauss Syndrome
  • Giant cell arteritis, Temporal arteritis
  • Beheet’s syndrome
  • Churg- strass syndrome

Common Signs and Symptoms of Arthritis

  • Swelling in one or more joints
  • Stiffness around the joints in the early morning or with inactivity
  • Constant or recurring pain or tenderness in a joint
  • Difficulty using or moving a joint normally
  • Warmth and redness in a joint

Diseases For Patient Education

Do You Know?

  • Children do get arthritis too.
  • There are new treatments for RA which can stop disease progression.
  • Process of permanent joint damage can set in as early as 12 weeks from onset of symptoms in RA. Early treatment prevents joint damage.
  • Having RA increases risk of heart attack and stroke.
  • Patients do not get any symptoms from osteoporosis until they fracture a bone.
  • There are non-surgical treatment options for osteoarthritis.
  • In the early stages of arthritis blood tests and joint examination can be normal.
  • Rheumatoid Factor and ANA can be seen in normal population.
  • Ultrasound scan is 7 times more sensitive than plain X-ray in identifying the arthritis changes.

Frequently Asked Questions (FAQ's)

A Rheumatologist is a specialist who is an expert in diagnosis and treatment of diseases affecting the joints, bones, muscles, ligaments, soft tissue and autoimmune diseases.

Joint diseases which can be treated with medicines, are treated by a Rheumatologist. Orthopedic surgeons specialize in surgical treatment of joints and management of fractures.

There are more than 100 different Rheumatological diseases, some of the common ones include – Rheumatoid arthritis, psoriatic arthritis, Osteoarthritis, Ankylosing spondylitis, gout, osteoporosis, fibromyalgia, lupus, vasculitis and other autoimmune diseases.

Most Rheumatic diseases are autoimmune in nature. An autoimmune disease develops when your immune system, which normally defends your body against diseases by mistake attacks the healthy tissues and organs of your body resulting in various symptoms and diseases.

Rheumatoid arthritis is a common inflammatory disease that affects the joints. Rheumatoid arthritis causes severe pain and swelling in your joints, as a result, it becomes difficult to bend and use them.

Rheumatoid arthritis can affect all age groups including children. It affects people in 30’s 40’s with higher frequency over 50 years of age. The disease is 3 times more common n females than males.

Symptoms include-

  1. Swelling, redness, warmth in joints
  2. Stiffness in the joints worse in morning getting better with movement
  3. Some people can experience tiredness, weight loss, fever.

Yes, there are certain conditions like fibromyalgia which cause generalized pain in muscles and soft tissue.

Patients use phrases like “I hurt all over” or “I have head to toe pain”. They also describe poor sleep and feeling tired all the time. Patients may also have difficulties with headaches, irritable bowel syndrome, or mood.

Rheumatoid arthritis affects all joints but particularly tends to affect small joints first of hands and feet. As the disease progresses it involves the wrists, knees, ankles, elbows, hips and shoulders.

If the disease is left untreated it causes significant pain and disability in the person limiting day to day activities. Also, in the future, the disease can cause significant irreversible damage to the underlying joints resulting in deformities.

With early diagnosis, treatment can be initiated with medicines which reduces pain and prevents damage in joints.

Rheumatoid arthritis is a clinical diagnosis made by your Rheumatologist based on medical history and findings on physical examination. Blood tests can be ordered to look for inflammation and antibodies associated with Rheumatoid arthritis.

Rheumatoid arthritis is an autoimmune disease which causes inflammation in the joints whereas Osteoarthritis is the disease of “wear and tear”.

In most people with osteoarthritis cartilage in the joints can wear out because of mechanical damage from years of use.

Osteoporosis is a “silent disease”. It is very common in women over the age of 55 years. Most people who have osteoporosis do not know it

Until they develop a fracture. It is very important to get a bone density scan done in women to detect and treat osteoporosis effectively.

Anybody can get arthritis, although it is more common in females

Not exactly, depends on the genes passed on to your children, if both parents have it then children have it.

Arthritis has types, viral arthritis is self limiting, Rheumatoid arthritis is highly treatable and we can achieve remission free periods.

Low purine diet for gout patients, otherwise eat healthy, drink healthy and maintain optimal body weight and BMI.

Rheumatism is a term used to describe inflammation of joints, ligaments, fascia covering ligaments, tendons, where as arthritis indicates only joint inflammation. But these two terms are often interchangeable.

Other than viral arthritis, and few other soft tissue conditions the treatment is lifelong.

Overuse of any drug is harmful, Steroids are wonderful if used judiciously, Use it according to your rheumatolgist advice.

Biologics are the newer drugs for treatment of rheumatic diseases. They are very effective and give great results in shorter duration. Must be taken under the guidance of your Rheumatologist.