Rheumatology and Rheumatologist

Rheumatology is the field of medicine that is concerned with the evaluation and treatment of people with autoimmune conditions and joint diseases, including arthritis. Branches of rheumatology include basic research and clinical research, as well as clinical diagnosis, treatment, and long-term management of patients with these illnesses. Rheumatologists diagnose and treat many rheumatic conditions that are caused by the body's immune system attacking its own tissues, which affects the musculoskeletal system including joints, bones, tendons, and muscles.

Rheumatologist exams and treats a female patient.

A rheumatologist is a subspecialist in the nonsurgical treatment of rheumatic illnesses, including autoimmune diseases and especially the many forms of arthritis and joint disease.

What training does a rheumatologist receive?

Classical adult rheumatology training includes four years of medical school, one year of internship in internal medicine, two years of internal medicine residency, and two years of rheumatology fellowship training. There is a subspecialty board for rheumatology certification, offered by the American Board of Internal Medicine, which can provide board certification to approved rheumatologists.

Pediatric rheumatologists are physicians who specialize in providing comprehensive care to children (as well as their families) with rheumatic diseases, including autoimmune diseases, and particularly arthritis. Pediatric rheumatologists are pediatricians who have completed an additional two to three years of specialized training in pediatric rheumatology and are usually board certified in pediatric rheumatology.

Rheumatologists have special interests in an unexplained rashes, fever, arthritis, anemia, weakness, weight loss, fatigue, joint or muscle pain, autoimmune disease, and anorexia. They often serve as consultants, acting like medical detectives for other doctors.

Rheumatologists treat autoimmune diseases including arthritis, lupus, psoriasis, celiac disease, dermatomyositis, Addison disease, Graves disease, and multiple sclerosis.

Rheumatologists have particular skills in the evaluation of the over 100 forms of arthritis and have a special interest in rheumatoid arthritis, spondylitis, psoriatic arthritis, systemic lupus erythematosus, antiphospholipid antibody syndrome, Still's disease, dermatomyositis, Sjögren's syndrome, vasculitis, scleroderma, mixed connective tissue disease, sarcoidosis, Lyme disease, osteomyelitis, osteoarthritis, back pain, gout, pseudogout, relapsing polychondritis, Henoch-Schönlein purpura, serum sickness, reactive arthritis, Kawasaki disease, erythromelalgia, Raynaud's disease, growing pains, iritis, osteoporosis, reflex sympathetic dystrophy, as well as soft tissue rheumatism (such as tendonitis, muscle pain, and fibromyalgia), and others.

Be prepared for questions about your health history for your visit with the rheumatologist. They will want to know about the history of your main complaint, including

• How long the symptoms and signs have been occurring?
• What situations or actions make the symptoms and signs better or worse?
• How intense the symptoms and signs are, what functions are impaired by the symptoms and signs, stiffness, pain, swelling, warmth, tenderness, fever, chills, weight loss or gain, sweats, tremors, tingling, numbness, breathing impairments, palpitations, and more?
• They will need to know what particular home remedies, medications, and therapies you have already tried and how they affected you.
• They will want to know your family history and past medical history, as well as underlying medical diseases and conditions.
• They also will need to know the names of each of your treating doctors. Bring all of your past testing results with you.

After your medical history is reviewed with the doctor, be prepared to have a thorough examination. You may still require further blood testing, X-rays, scans, or even additional surgical and/or medical consultants and rheumatology follow-up visits to get to a proper diagnosis and optimal treatment plan.

It can be helpful to bring a family member along. Because many rheumatic conditions can be complex medically, may require serious medicines that can have side effects and need monitoring testing, and because the conditions can affect the day-to-day functioning of the patient in the family environment, doctors will generally welcome the presence of the family member. By being present when the condition is explained, the required tests are described, and the treatment options and side effects are reviewed, the family member can assist the patient in understanding the game plan while they are permitted their own optimal understanding of the situation that will be confronting the family.