Rheumatology

Rheumatology is a branch of medicine devoted to the diagnosis and therapy of rheumatic diseases. Physicians who have undergone formal training in rheumatology are called rheumatologists.

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Rheumatologists are medical professionals who diagnose and treat conditions that affect the joints, tendons, ligaments, bones, and muscles.

People may need to see a rheumatologist if they experience persistent joint pain or stiffness.

In this article, we discuss what rheumatologists do, the types of conditions they treat, the procedures they perform, and why someone would need to see one.
 

What is a rheumatologist?

A rheumatologist is an internal medicine doctor who specializes in diagnosing and treating inflammatory conditions that affect the joints, tendons, ligaments, bones, and muscles.
 

Rheumatologists diagnose and treat musculoskeletal conditions, but they do not perform surgery.
 

Before they can start treating these conditions, a rheumatologist must fulfill the following education and training requirements, according to the College of

Rheumatology:

| graduate from a medical school
| complete a residency program
| participate in a rheumatology fellowship

After a person finishes a rheumatology fellowship program, they must pass a board examination and receive their certificate to practice rheumatology. Rheumatologists must participate in continuing education courses throughout their careers.

 

A rheumatologist can choose to treat specific rheumatic conditions, or they can narrow their focus to a particular area, or subspecialty, within rheumatology.

 

Subspecialties under the Trusted Source in the field of rheumatology include:

| autoimmune and inflammatory conditions
| noninflammatory degenerative joint conditions
| soft tissue diseases
| chronic pain
| metabolic disorders that affect the bone
| pediatric or juvenile rheumatic conditions


What conditions do they diagnose and treat?
Rheumatologists can treat autoimmune and inflammatory conditions that affect the joints, tendons, ligaments, bones, muscles, and blood vessels (vasculitis).

 

These conditions include:

| inflammatory arthritis of the knees, hips, or shoulders
| tendinitis
| rheumatoid arthritis
| osteoarthritis
| psoriatic arthritis
| osteoporosis
| systemic lupus erythematosus (lupus)
| bursitis
| giant cell arteritis
| Behcet’s disease
| scleroderma
| polymyalgia rheumatica
| polymyositis
| dermatomyositis
| Paget’s disease
| ankylosing spondylitis
| Reiter’s syndrome
| reactive arthropathies (secondary to bowel disorders, skin disease, or infections)
| gout
| Sjogren’s syndrome
| idiopathic juvenile arthritis
| sarcoidosis


 

Rheumatologists perform examinations and procedures that help them diagnose and treat rheumatic conditions.

These procedures include:| Physical exams
| A rheumatologist usually performs a complete physical exam when they see a person for the first time, or when they want to monitor the effects of a current treatment program.

They will spend extra time examining areas where people report feeling pain or stiffness. They might ask a person to bend, flex, or stretch these areas. They will also examine joints on both sides of the body to compare size, intensity of inflammation, range of motion, and function.

 

People with arthritis can experience symptoms in one or more joints on one side of the body, while others may notice pain and stiffness in one or more joints on both sides of the body.

 

A rheumatologist will also review a person’s medical history, current medical conditions, and family history during this comprehensive interview.

 

Diagnostic testing
Rheumatologists diagnose systemic inflammatory diseases and musculoskeletal conditions. They use a variety of tests to identify the underlying cause of a person’s symptoms.
 

Some potential causes of inflammation include:

| environmental exposures
| genetics
| infections
| autoimmune conditions
| abnormal uric acid metabolism


A rheumatologist can also diagnose conditions that cause bone or cartilage loss, including osteoporosis and osteoarthritis.

 

Treating rheumatic conditions

Rheumatologists can suggest and provide treatments for many rheumatic conditions. They can also offer consultation on many cases.
 

Treatments they may recommend include:

| Joint injections and aspirations


A rheumatologist can treat joint inflammation and pain by either injecting an anti-inflammatory medication, such as corticosteroid, directly into the affected joint or by aspirating the joint.
 

When a rheumatologist aspirates a joint, they use a needle attached to a syringe to remove excess joint fluid. They use joint aspiration to reduce patients’ joint swelling and pain and to analyze the joint fluid as a part of the diagnostic protocol.
 

Medications

A rheumatologist might prescribe disease modifying antirheumatic drugs, which lower immune system activity or slow down the progress of rheumatic conditions.

Nonsteroidal anti-inflammatory drugs — such as ibuprofen, naproxen, meloxicam, and aspirin — can also help relieve joint inflammation and reduce pain in the joints.