What is a Rheumatologist︖

What does a Rheumatologist do︖

Rheumatic diseases are complex and develop over time due to which they are difficult to diagnose. A rheumatologist will look into your medical history, and would conduct a physical examination for any signs of rheumatology condition. Family history can be an obvious reason for arthritis and other rheumatology conditions in some cases.

Laboratory tests such as blood tests, antibody tests, X-Rays, ultrasound, CT scan, or MRI are prescribed by a rheumatologist for disease identification. During follow-up appointments, a rheumatologist may discuss the diagnosis and various treatment options available for treating the condition and preventing the disease from spreading which would help to prevent any future disability and limitations.

Rheumatoid arthritis and other inflammatory arthritis

Rheumatoid arthritis is a common joint condition that affects hands, wrists, elbows, ankles, feet, and hips. It causes inflammation in the joints causing pain and stiffness.

Symptoms of Rheumatoid Arthritis are joint stiffness and back stiffness. You may feel more pain in your joints and back after some period of rest and it would improve with activity. There may be swellings around the joints or a feeling of warmth over the joints with or without redness.

Early diagnosis is crucial for preventing any damage in joints. A study revealed if rheumatoid arthritis is left untreated for 12 weeks, the bones start developing some damage That may not be reversible. Various disease modifying treatments are available which can stop the progression of the disease. Those patients who have severe or resistant arthritis can have option for latest medications called Biologicals.

Some common types of Arthritis are

• Ankylosing spondylitis (mainly involving joints in the spine)
• Osteoarthritis
• Gouty arthritis (Arthritis due to uric acid)
• Psoriatic arthritis (Arthritis associated with skin psoriasis)

Osteoarthritis is the most common type of arthritis usually affecting middle-aged. It usually causes pain in large joints including knees, hips, shoulders and back. Women are more likely to develop osteoarthritis than men. Osteoarthritis develops slowly and is a result of bone rubbing on bone. Osteoarthritis can also affect hands especially the thumb joint. An early diagnosis by a rheumatologist is required to help in slowing down the progression of this condition

What is spondylitis?

Spondylitis is a rare inflammatory disease that causes the fusion of small bones in your spine with time. The patient will feel pain and early morning stiffness in his back which will improve after some activity but stiffness would return on resting. If left untreated, this type of arthritis leaves your spine fused and making it impossible to bend. This results in extensive pain and stiffness. It usually starts from the lower back spreading up to the neck and other joints of the body.

The most commonly affected areas are the lower back but it can gradually affect the whole spine. In some cases, this can extend to other joints of the body like hands, feet, hips, shoulder joints, tendons and ligaments. Other severe complications raised due to ankylosing spondylitis are compression fractures, heart problems, and uveitis (eye inflammation).

Early diagnosis by a rheumatologist can help in stopping the progression of the disease. Rheumatologist will prescribe the special medications for this condition and physiotherapy which can prevent future damage and disability.

Gouty Arthritis

Gouty Arthritis is a very painful inflammation of a joint, mostly starting from a big toe. This is caused by high uric acid content in the joint which causes severe inflammation of the joint. In most of the cases high uric acid in blood can also be seen. There are several risk factors like dehydration, excess alcohol consumption, kidney dysfunction, diabetes, and metabolism disorder which can increase uric acid in the body.

Your rheumatologist will prescribe some blood tests including uric acid tests and X-Rays to determine the condition of joints. If gouty arthritis is left untreated it can eventually lead to permanent damage in joints. There are special medications that can lower down uric acid levels in blood and joints.

Osteomalacia and Osteoporosis

As we age our bones deteriorate and becomes thin and weak. They tend to become brittle and fracture easily. Osteoporosis, also called as brittle bone disease, results in fracture of the bones and spine with mild injury. There are various reasons for osteoporosis, most common being the vitamin D and calcium deficiency. Other reasons include lack of dairy products in the diet, lack of female hormones after menopause, very low body weight, intolerances to food. Family history is very important because this condition runs in families.

This condition can result in fractures of multiple bones and spine leading to disability and hunched back.

The rheumatologist will perform tests to find out underlying cause. He will also perform bone density scan to look for bone density. He will plan treatment for re-gaining bone density based on your investigation results. It is usually treatable by medications but in some cases surgery is required to treat the fractures and deformities.

Osteomalacia is a condition that develops due to the severe deficiency of vitamin D in the body. Our bones are made up of calcium and phosphate, inadequate consumption of these minerals in diet causes defect in the bone development process. If left untreated this may result in brittle bones and higher risk of bone breakage and fracture are same thing, particularly ribs, spine, and hip.

Connective tissue diseases- Lupus and Scleroderma

Scleroderma is an immune system disorder in which the immune system starts attacking healthy tissues leading to damaged skin and various organs of the body. Scleroderma mainly presents with thickening of skin and blue discoloration of tips of fingers leading to ulcers. In some cases, this disease can spread to other organs of the body like lungs, kidney, liver, heart and bowel.

Lupus is also an immune mediated disease that affects various organs of the body. It can cause rash in sunlight, mouth ulcers, hair loss, skin rashes, kidney heart and lung problems.

Scleroderma is an overlapping disease in about 20% of patients suffering from lupus.