What is rheumatology?

Rheumatology is a subspecialty in internal medicine and pediatrics that deals with the joints, soft tissues, autoimmune diseases and heritable connective tissue disorders. A rheumatologist specializes in the diagnosis, treatment and therapy of the rheumatic diseases.

The rheumatologist

A rheumatologist diagnoses and treats musculoskeletal disease and systemic autoimmune conditions. Unlike an orthopedist, rheumatologists do not perform surgery to treat joint disease. Furthermore, the goal of many rheumatologists is to find the underlying cause of rheumatic disease and conduct research to find better treatment options.

Rheumatologists generally work in outpatient clinics. However, it is typical for a rheumatologist to be affiliated with a hospital and work with patients hospitalized with a rheumatic disease. A referral from a primary care physician is required for an evaluation with a rheumatologist, though some allow appointments without one.

Rheumatologist training

A rheumatologist must first complete 4 years of medical or osteopathic education, followed by 3 years of residency training in internal medicine or pediatrics, though some train in both. An additional 2- to 3-year rheumatology fellowship is required to learn about the causes, risk factors and treatment of chronic musculoskeletal and autoimmune conditions. Board certification is contingent upon passing the board examinations, which are retaken every 10 years.

Conditions rheumatologists treat

Rheumatic diseases are conditions of inflammation and auto-immunity and there are more than 200 diseases that may be treated by a rheumatologist. Some diseases that rheumatologists treat include:

arthritis;
dermatomyositis;
gout;
lupus erythematosus;
Lyme disease;
mixed connective tissue disease;
polychondritis;
polymyositis;
polymyalgia rheumatica;
sarcoidosis;
Sjögren’s syndrome;
scleroderma; and
·vasculitis.

Rheumatology is also associated with soft tissue diseases and rheumatologists treat many of the them, including:

fibromyalgia;
low back pain;
tennis or golfer’s elbow; and
·olecranon bursitis.

A rheumatologist may also treat the diseases of rheumatology that affect bones, including:

fluorosis;
·osteoporosis;
·osteomalacia;
renal osteodystrophy; and
rickets.

Several genetic disorders affecting the joints may be studied by rheumatologists as well, including:

achondroplasia;
Ehlers-Danlos syndrome;
hyperextensible joints; and
Marfan syndrome.

Treatment of rheumatic conditions

Strategies used to manage patients in rheumatology may range from drug treatments, physical and occupational therapy, rehabilitation and even surgery in severe cases. Drug therapies range from anti-inflammatory drugs, to opiates, to antidepressants.

Recent advances in immunology and genealogy of rheumatic diseases have made rheumatology a growing field of study. Rheumatologists are currently exploring the association between immunology and autoimmune disorders. Novel agents known as biologics are emerging as an established treatment for patients with chronic and severe conditions of the locomotor system. Study of these agents and improvement of outcomes among patients with these conditions fall under the umbrella of rheumatology.

Additional information about rheumatology may be found at these websites:

http://rheumatology.oxfordjournals.org/

http://www.rheumatology.org.uk/

http://www.eular.org/

http://www.rheumatology.org/practice/clinical/patients/rheumatologist.asp

http://www.arthritis.org

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002223/

http://www.arthritis.com/

http://www.nlm.nih.gov/medlineplus/arthritis.html

http://jrheum.org/