What is Rheumatology?
Rheumatology specializes in diagnosing and treating autoimmune diseases and systemic conditions that affect the joints, muscles, and bones. Common conditions include rheumatoid arthritis, lupus, and gout. Their focus is on managing chronic inflammatory conditions that often require long-term treatment.
What does a rheumatologist treat?
Common Diseases Treated
- Rheumatoid arthritis
- Ankylosing spondylitis
- Psoriatic arthritis
- Gout
- Osteoporosis
- Osteoarthritis
Rare diseases Treated
- SLE (Systemic lupus erythematosus/Lupus)
- Myositis
- Systemic sclerosis/Mixed connective tissue disease
- Sjogren’s syndrome
- Vasculitis (eg: Takayasu’s arteritis, ANCA vasculitis etc.)
- Anti-phospholipid syndrome
- Interstitial Lung disease – autoimmune mediated
What is the difference between a rheumatology vs. an orthopedics?
Rheumatology: Treatment is primarily non-surgical and may involve medications, lifestyle changes, and physical therapy to manage symptoms and control disease progression. Rheumatologists aim to alleviate chronic pain and improve the quality of life.
Orthopedics: Orthopedic treatment can include both surgical and non-surgical options. While they may perform surgeries to correct physical impairments, they also provide non-surgical treatments like physical therapy and injections.
What are reasons to see a rheumatologist?
- Rheumatoid arthritis: Joint pain and morning stiffness
- Spondyloarthritis: Low back pain and morning stiffness
- Bone/joint pain: Non-traumatic bone or joint pain
- Gout: Joint pain with high uric acid
- Osteoporosis: Fracture after minor fall
- Lupus: Fever, joint pain, oral ulcers, hair loss in young females
- Vasculitis: Non-healing leg ulcers
- Eye inflammation: Recurrent red eye or inflammation
- Sjogren’s: Dry mouth and eye
- Raynaud’s: Color change in fingers with cold
- Anti-phospholipid syndrome: Recurrent miscarriages, blood clots
Investigations available for managing rheumatic diseases
- Rheumatoid factor & Anti-CCP: Autoantibodies
- ANA by IIF: Antinuclear antibody
- ANA Profile (25 Abs); Myositis Profile – by Line Immunoassay: Autoantibody profiles
- ANCA by ELISA & IIF: Anti-neutrophil cytoplasmic antibodies
- HLA-B27/HLA-B51: Genetic markers
- Anti-Cardiolipin, Anti-Beta 2 Glycoprotein, Lupus anticoagulant: Antiphospholipid antibodies
- Serum ACE levels/Serum Ferritin, Serum-IL 6: Inflammatory markers
- Routine hematology and biochemical tests (CRP, Uric acid, Vitamin D): Blood tests
- X-ray/Ultrasound/CT/MRI/DXA SCAN: Imaging
Speciality Clinics in rheumatology
Lupus Clinic
Lupus is a chronic autoimmune disease that causes inflammation and damage to various parts of the body. It can affect the skin, joints, kidneys, heart, lungs, and brain. The most common type is systemic lupus erythematosus (SLE), but there are other forms, including cutaneous lupus, drug-induced lupus, and neonatal lupus.
- Joint Pain and Swelling: Arthritis causing painful, swollen joints, often accompanied by morning stiffness.
- Fatigue: Persistent tiredness or fatigue that does not improve with rest.
- Fever: Low-grade fevers without an apparent cause.
- Skin Rash : A distinctive butterfly-shaped rash across the cheeks and nose, as well as other rashes that may worsen with sun exposure.
- Chest Pain: Pain when taking deep breaths, often due to inflammation of the lining around the lungs (pleurisy).
- Hair Loss: Thinning hair or bald spots, which can be associated with inflammation.
- Raynaud’s Phenomenon: Pale or purple fingers and toes in response to cold or stress.
- Mouth Ulcers: Sores in the mouth or nose.
- Swelling: Swelling in the legs or around the eyes.
- Neurological Symptoms: Headaches, confusion, memory problems, and dizziness.
- Antinuclear antibody (ANA) testing
- ANA Profile, Complete blood count (CBC)
- Kidney function tests
- Tests for anti-phospholipid syndrome.
Develop individualized treatment plans based on disease severity, organ involvement, and patient preferences. This may include medications ,lifestyle modifications and patient education.
Osteoporosis Clinic
Osteoporosis is a chronic condition characterized by decreased bone density, leading to weakened bones and an increased risk of fractures. It is often referred to as a “silent disease” because it typically does not present noticeable symptoms until significant bone loss has occurred.
- Fractures: The most common symptom is a bone fracture that occurs from a fall or even minor movements, such as bending over or coughing. Fractures often occur in the hip, wrist, or spine.
- Loss of Height: Over time, individuals may experience a noticeable decrease in height due to compression fractures in the spine.
- Stooped Posture: A hunched or stooped posture, known as kyphosis, can develop as a result of vertebral fractures.
- Back Pain: Pain in the back or neck may arise from fractured or collapsed vertebrae, which can pinch nerves and lead to discomfort.
- Receding Gums: In some cases, osteoporosis can affect oral health, leading to receding gums.
- Weak Grip Strength: A decrease in grip strength can also be associated with osteoporosis.
- Bone Density Testing
- Laboratory Tests (calcium, vitamin D levels, serum PTH)
- Relevant blood tests to assess secondary causes of osteoporosis.
Develop personalized treatment plans considering BMD results, fracture risk, comorbidities, and patient preferences. This may include lifestyle modifications, pharmacotherapy and calcium/vitamin D supplementation.
Rheumatology – Team of Experts
Book an Appointment
Preparation for an appointment with a rheumatologist
Organize Your Records: Rheumatologist will need to review notes from your previous healthcare providers. It’s also helpful to obtain copies of any lab and imaging test results.
Document Your Medical History: Include a list of any medications you are currently taking for other health conditions, as well as any vitamins or supplements you use.
Keep a Symptom Journal: Since your symptoms may vary and can change rapidly, recording your symptoms and their frequency will help you remember important details for your appointment.
Multidisciplinary Approach
Multidisciplinary Collaboration
- Lupus clinic: Collaborating with nephrologists, dermatologists, neurologists and other specialists as needed for comprehensive care.
- Osteoporosis Clinic: Coordinate referrals to spine surgeons, orthopedic surgeons, physiotherapists, and nutritionists as needed.
Patient Education and Support
Educational Materials
Provide trustworthy information about lupus, including:
- Symptoms
- Treatment options
- Self-management strategies
Support Groups
Offer resources for patients to connect with others, including:
- Support groups
- Online communities
Follow-up and Monitoring
Scheduled Visits
Establish a regular follow-up schedule to:
- Monitor disease progression
- Assess treatment effectiveness
- Identify potential side effects of medications
Clinical Pathways
Implement standardized protocols for managing the disease to ensure consistent care quality