Women are diagnosed with autoimmune diseases at a rate of about 2 to 1 compared to men. These diseases can affect the joints, muscles, and blood vessels, causing pain, swelling, stiffness, and deformity.
Conditions treated by rheumatologists include rheumatoid arthritis , lupus , scleroderma, and spondyloarthritis. Subspecialties in the field of rheumatology include:.
Rheumatologists can treat autoimmune and inflammatory conditions that affect the joints, tendons, ligaments, bones, muscles, and blood vessels vasculitis. Rheumatologists perform examinations and procedures that help them diagnose and treat rheumatic conditions. 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. Rheumatologists diagnose systemic inflammatory diseases and musculoskeletal conditions. A rheumatologist can also diagnose conditions that cause bone or cartilage loss, including osteoporosis and osteoarthritis. A primary care doctor or rheumatologist can use different imaging tests to look for signs of joint damage.
Some imaging tests they may conduct include:. Laboratory testing involves taking samples of blood, urine, or joint fluid and sending these samples to a laboratory for further analysis. A rheumatologist can use lab test results to identify signs of inflammation and infections, such as higher-than-normal levels of inflammatory compounds, antibodies, or white blood cells. In recent years, researchers have also discovered several genetic markers associated with ankylosing spondylitis.
Rheumatologists can suggest and provide treatments for many rheumatic conditions. They can also offer consultation on many cases. 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.
Some rheumatologists are trained in both internal medicine and pediatrics. However, both types of doctors receive similar training, and both are similar in their expertise and care.
After residency, they must participate in a rheumatology fellowship for two to three years to specialize in diagnosing and treating musculoskeletal and autoimmune conditions.
Most rheumatologists then take an examination that tests their knowledge of rheumatology called a board examination. Physicians who participate in this program do so to show that they are pursuing better healthcare for their patients, demonstrating advanced knowledge, and committing to lifelong learning in the specialty of rheumatology.
Note, a rheumatologist is not required to be board certified nor to participate in MOC to practice medicine as a rheumatologist. To maintain a medical license, rheumatologists must participate in classes or studies that cover current medical practices. These courses are called continuing medical education or CME for short. Other countries have their own, unique professional designations. Rheumatologists work mainly in outpatient clinics.
Primary care providers or other physicians can refer you to a rheumatologist for evaluation. Many rheumatologists do not require a referral from another physician for appointments to be made.
Some rheumatologists are affiliated with a hospital and evaluate patients who are hospitalized for rheumatologic problems. Most everyone experiences muscle, bone, or joint pain from time to time.
When the pain does not resolve as one would expect, additional evaluation may be needed. Typically, a primary care, urgent care, or an emergency room provider physician, nurse practitioner, or physician assistant is seen for the first evaluation. Besides rheumatoid arthritis RA , these doctors treat a wide variety of autoimmune and inflammatory diseases that may affect the joints such as gout and lupus , as well as other muscle or bone problems or injuries that can make your joints hurt and limit your function.
They also treat other conditions that you might be unaware of, such as osteoporosis, fibromyalgia, and Lyme disease. We have to take into consideration every system of the body, not just one organ. Marchetta says. Some specialists consult on your diagnosis and treatment plan, then send you back to your primary care doctor for most follow-up care.
Not true for rheumatologists. Some people require less frequent follow-up, but we typically see patients more than their primary care doctors. The diagnosis your primary care doctor has in mind may not be what your rheumatologist determines. According to a survey, if rheumatologists had it to do over again, four out of five them would choose to be a doctor and three out of four would choose the same specialty. There are about 5, practicing rheumatologists in America, with about half working independently and half in academic settings or working with industry to improve drug treatments.
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