Rheumatology at LCMH
What is a rheumatologist?
A rheumatologist is a medical doctor specializing in diagnosing, treating and educating patients who suffer from rheumatic conditions. These conditions usually, but not always, affect the joints.
Which part of the body is the focus for a rheumatologist?
Most rheumatic diseases affect the joints. Joints involved can be anywhere in the body (arms, legs or the spine), small or large. There are mainly two types of arthritis that rheumatologists encounter and distinguish between at the beginning of the diagnosis—this is crucial step as the treatment differs significantly for these two types of arthritis. However, arthritis is not the only condition for which patients end up in the care of a rheumatologist. There are a wide group of rheumatic autoimmune diseases—conditions that not only affect the joints (and sometimes do not at all) but also cause significant inflammation to other parts of the body. These sometimes affect many organ systems, as in the case of systemic lupus erythematosus. In these cases, primary care physicians are the first to suspect these diseases, so they refer patients to the rheumatologist for further evaluation.
What are the most common health problems you assess?
The most commonly encountered rheumatic conditions are:
- inflammatory arthropathies, such as rheumatoid and psoriatic arthritis
- degenerative arthropathy osteoarthritis
- systemic inflammatory conditions, such as systemic lupus erythematosus and Sjogren’s syndrome
- inflammatory muscle diseases and vasculitis (inflammation of the blood vessels)
- more complicated cases of crystal arthritis, such as gout
How does a rheumatologist help patients with arthritis and other rheumatic diseases?
Diagnosis. First, accurate diagnosis is the most important step. Sometimes it does not suffice to talk to and examine the patient. Often further diagnostic steps such as aspiration (tapping) of the joint and assessing the fluid in the laboratory is required. For systemic inflammatory conditions, we test a patient’s blood for an array of inflammatory/autoimmune markers to arrive at the diagnosis.
Treatment. Treatment differs depending on the type of arthritis. For patients with the most common, rheumatoid arthritis, we have so many treatment options today—from oral medications, their combinations, to injectable/infusable biologic agents—that really make life-changing impact for the patients. It’s the reason we rarely see advanced joint deformities that were so common in patients affected by arthritis just decades ago.
At what point should a patient see a rheumatologist?
Any patient suffering from unexplained (without preceding trauma) and/or unremitting joint symptoms—joint pain, swelling, dysfunction—should be evaluating by a rheumatologist. Additionally, patients with non-specific musculoskeletal complaints or “suggestive” blood tests are referred to a rheumatologist by their primary care physician when he or she highly suspects that a patient suffers from a rheumatic condition.