Rheumatology

Rheumatology is the branch of medicine dedicated to the diagnosis, management, and treatment of disorders affecting the joints, bones, connective tissue, and surrounding structures. These disorders can range from degenerative conditions like osteoporosis to autoimmune and inflammatory diseases such as Rheumatoid arthritis, Lupus, and Sjogren's disease.

Practitioners Medical doctors who specialize in rheumatology are termed rheumatologists. They are trained to diagnose the underlying causes of musculoskeletal pain and provide holistic treatment, which often includes a combination of medication, physical therapy, and lifestyle modifications.

Tests and Procedures

Joint injection

Rheumatologists use a range of diagnostic tests and procedures to identify and monitor the progress of rheumatologic diseases, including:

• Bone scan: An imaging test that identifies bone abnormalities.
• Joint fluid aspiration: Extracting fluid from a joint to analyze it.
• Cortisone shots: Injections that reduce inflammation and pain.
• Dual energy CT scan: Measures bone mineral density to detect osteoporosis.
• Joint CT scan: Detailed imaging of a joint.
• MRI of the joints: Imaging that provides detailed images of joints.
• Synovial fluid analysis: Evaluating the fluid from inside a joint for inflammation and other conditions.
• Ultrasound scan of joints: Using sound waves to visualize joint structures.
• Ultrasound-guided cortisone injections: Precise delivery of cortisone injections using ultrasound.
• Viscosupplementation: Injecting hyaluronic acid into a joint to supplement the viscosity of natural joint fluid.
• X-ray: Standard imaging to view bone and joint structures.

Journals

To stay updated with recent advances, rheumatologists often refer to professional journals. Some prominent journals in the field of rheumatology are:

• The Journal of Rheumatology
• Arthritis & Rheumatology
• Best Practice & Research: Clinical Rheumatology
• Osteoarthritis and Cartilage
• Journal of Clinical Rheumatology
• Nature Reviews Rheumatology
• Rheumatology (journal)

Diseases and Conditions

• Rheumatoid arthritis (RA): A chronic inflammatory disorder affecting multiple joints, including those in the hands and feet. Unlike the wear-and-tear damage of Osteoarthritis, RA affects the lining of the joints, leading to painful swelling and eventually erosion of bone and joint deformity.
• Ankylosing spondylitis: A type of arthritis affecting the spine, typically leading to redness, heat, swelling, and pain where the spine meets the pelvis.
• Arthritis: General term for conditions causing joint inflammation. Although arthritis is a symptom rather than a diagnosis, the term is often used to refer to any disorder affecting the joints.
• Autoimmune diseases: Conditions wherein the body's immune system mistakenly attacks its tissues. This category includes many rheumatologic diseases like lupus and RA.
• Autoinflammatory diseases: Disorders characterized by abnormal inflammation without a clear autoimmune cause. They often result in symptoms like fever, rash, and joint swelling.
• Behçet’s disease: A rare condition leading to inflammation of blood vessels and can cause issues ranging from mouth sores to eye inflammation.
• Bursitis: Inflammation of the bursae, small fluid-filled sacs cushioning bones, tendons, and muscles near the joints.
• Giant cell arteritis: An inflammatory disease affecting the large blood vessels of the scalp, neck, and arms.
• Gout: A form of arthritis caused by excess uric acid in the bloodstream, leading to sharp crystal deposits in joints.
• Juvenile arthritis: Describes various autoimmune and inflammatory conditions in children aged 16 and younger.
• Lupus (Systemic Lupus Erythematosus): An autoimmune disease wherein the immune system attacks its tissues, causing widespread inflammation and tissue damage.
• Osteoarthritis: The most common form of arthritis, it is a degenerative joint disease where the protective cartilage wears down.
• Polymyalgia rheumatica: A disorder causing muscle pain and stiffness, particularly in the shoulders.
• Psoriatic arthritis: A form of arthritis affecting some people with psoriasis, leading to joint pain, stiffness, and swelling.
• Reactive arthritis: A joint inflammation caused by an infection in another part of the body, often the intestines, genitals, or urinary tract.
• Scleroderma: A group of rare diseases causing hardening and tightening of the skin and connective tissues.
• Sjögren’s syndrome: An autoimmune disease targeting the glands responsible for tears and saliva.
• Tendinitis: The inflammation of a tendon, a flexible band of tissue connecting muscles to bones.

Other rheumatologic conditions

Other rheumatologic conditions include Rheumatic fever, Rheumatoid arthritis, Rheumatism, Ankylosing spondylitis, Psoriatic arthritis, Chronic Childhood Arthritis, Vasculitis, Polymyalgia rheumatica, Spondyloarthropathy, Reactive arthritis, Cardiovascular disease, Myositis, Takayasu's arteritis, Adult-onset Still's disease, and Cutaneous small vessel vasculitis.

Frequently Asked Questions

1. What occurs at the first appointment with a rheumatologist? Answer: During your first appointment with a rheumatologist, he or she will likely ask you about your medical history and symptoms, do a physical exam, and may prescribe blood tests or imaging studies to assist identify your illness. They may also discuss potential treatment choices and schedule follow-up sessions with you.
2. How should I prepare for my initial rheumatology visit? Make a list of your symptoms, including when they began and how severe they are, in preparation for your initial rheumatologist consultation. Bring a list of all the medications you are presently taking, including dosages, as well as any past medical documents or test results. Create a list of any questions you wish to ask the rheumatologist.
3. What am I to inform my rheumatologist? Answer: You should be as forthright and specific as possible while explaining your symptoms to your rheumatologist. Mention any additional problems you have, such as diabetes or high blood pressure, as well as the medications and supplements you are taking. Inform the rheumatologist if you have a history of rheumatic disorders in your family or if you have noticed a pattern in your symptoms, such as a worsening in the morning or after activity.
4. What blood examinations do rheumatologists order? Answer These may include tests to measure inflammation (such as erythrocyte sedimentation rate or C-reactive protein), tests to measure the level of certain antibodies (such as rheumatoid factor or anti-CCP), and tests to evaluate for other conditions that can cause similar symptoms to rheumatic disease (such as lupus or Sjogren's syndrome).
5. What are the seven criteria for diagnosing RA? Answer: The seven diagnostic criteria for RA are morning stiffness lasting at least an hour, arthritis of three or more joints, arthritis of the hand joints, symmetric arthritis, rheumatoid nodules, radiographic changes characteristic of RA, and seropositivity for rheumatoid factor or anti-CCP antibodies.
6. What drugs are prescribed by rheumatologists? To treat rheumatic disorders, rheumatologists may prescribe a number of different drugs. These may include nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), biologic agents, corticosteroids, and other pharmaceuticals used to treat symptoms like pain and exhaustion.
7. Are blood tests always able to detect inflammation? Some inflammatory indicators may not be increased in all instances, therefore blood tests might not always reveal inflammation. Blood tests can be useful for assessing inflammation, but they are not always definitive, and additional diagnostic procedures may be necessary.
8. What age range does the average rheumatology patient fall within? Patients of rheumatology can be of any age, but rheumatoid arthritis, the most prevalent form of inflammatory arthritis, often develops between the ages of 30 and 60.
9. Why does my rheumatologist require urine? Your rheumatologist may request a urine test to detect protein or blood in the urine, which can indicate kidney involvement in some rheumatic disorders. They may also examine the urine for the presence of rheumatic disease-treating drugs, such as methotrexate.
10. What do rheumatologists do for fibromyalgia? Rheumatologists may combine medicines, physical therapy, and other therapies to help control the symptoms of fibromyalgia. Analgesics, antidepressants, and anticonvulsants are examples of medications. Flexibility and strength may be enhanced by physical therapy. Additionally, acupuncture, massage, and cognitive-behavioral therapy may be beneficial. For additional treatment, a rheumatologist may send the patient to a pain management expert.

List of Rheumatologists (USA)

• Alabama
• Alaska
• Arizona
• Arkansas
• California
• Colorado
• Connecticut
• Delaware
• Florida
• Georgia
• Hawaii
• Idaho
• Illinois
• Indiana
• Iowa
• Kansas
• Kentucky
• Louisiana
• Maine
• Maryland
• Massachusetts
• Michigan
• Minnesota
• Mississippi
• Missouri
• Montana
• Nebraska
• Nevada
• New Hampshire
• New Jersey
• New Mexico
• New York
• North Carolina
• North Dakota
• Ohio
• Oklahoma
• Oregon
• Pennsylvania
• Rhode Island
• South Carolina
• South Dakota
• Tennessee
• Texas
• Utah
• Vermont
• Virginia
• Washington
• West Virginia
• Wisconsin
• Wyoming

US territories

• American Samoa
• Guam
• Northern Mariana Islands
• Puerto Rico
• U.S. Virgin Islands
• District of Columbia

List of Rheumatology topics

• Glossary of rheumatology
• Dictionary of rheumatology
• Rheumatology diseases

Rheumatology Resources
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Rheumatologic diseases

Arthritis is often used to refer to any disorder that affects the joints. Rheumatic diseases usually affect joints, tendons, ligaments, bones, and muscles. Rheumatologic diseases usually affect joints, tendons, ligaments, bones, and muscles.

Connective Tissue Diseases

Rheumatology and	Connective Tissue Diseases
Ankylosing spondylitis	Arthritis
Arthritis and Rheumatic diseases	Autoimmune diseases
Autoinflammatory diseases	Behçet’s disease
Bursitis	Giant cell arteritis
Gout	Juvenile arthritis
Knee problems	Lupus
Osteoarthritis	Polymyalgia rheumatica
Psoriatic arthritis	Reactive arthritis
Rheumatoid arthritis	Scleroderma
Sjögren’s syndrome	Systemic lupus erythematosus (Lupus)
Tendinitis	Rheumatologic diseases