Rheumatology

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Catherine Burt Driver, MD
    Catherine Burt Driver, MD

    Catherine Burt Driver, MD

    Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

Symptoms of Rheumatoid Arthritis

What is rheumatology?

Rheumatology is the field of medicine that is concerned with the evaluation and treatment of people with autoimmune conditions and joint diseases, including arthritis. Branches of rheumatology include basic research and clinical research, as well as clinical diagnosis, treatment, and long-term management of patients with these illnesses.

What is a rheumatologist?

A rheumatologist is a subspecialist in the nonsurgical treatment of rheumatic illnesses, including autoimmune diseases and especially the many forms of arthritis and joint disease.

What training does a rheumatologist receive?

Classical adult rheumatology training includes four years of medical school, one year of internship in internal medicine, two years of internal medicine residency, and two years of rheumatology fellowship training. There is a subspecialty board for rheumatology certification, offered by the American Board of Internal Medicine, which can provide board certification to approved rheumatologists.

Pediatric rheumatologists are physicians who specialize in providing comprehensive care to children (as well as their families) with rheumatic diseases, including autoimmune diseases, and particularly arthritis. Pediatric rheumatologists are pediatricians who have completed an additional two to three years of specialized training in pediatric rheumatology and are usually board certified in pediatric rheumatology.

What diseases and conditions do rheumatologists treat?

Rheumatologists have special interests in unexplained rash, fever, arthritis, anemia, weakness, weight loss, fatigue, joint or muscle pain, autoimmune disease, and anorexia. They often serve as consultants, acting like medical detectives for other doctors.

Rheumatologists have particular skills in the evaluation of the over 100 forms of arthritis and have special interest in rheumatoid arthritis, spondylitis, psoriatic arthritis, systemic lupus erythematosus, antiphospholipid antibody syndrome, Still's disease, dermatomyositis, Sjögren's syndrome, vasculitis, scleroderma, mixed connective tissue disease, sarcoidosis, Lyme disease, osteomyelitis, osteoarthritis, back pain, gout, pseudogout, relapsing polychondritis, Henoch-Schönlein purpura, serum sickness, reactive arthritis, Kawasaki disease, erythromelalgia, Raynaud's disease, growing pains, iritis, osteoporosis, reflex sympathetic dystrophy, as well as soft tissue rheumatism (such as tendinitis, muscle pain, and fibromyalgia), and others.

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Rheumatologists are physicians who specialize in the treatment of arthritic conditions.

Types of Arthritis

Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where two different bones meet. A joint functions to move the body parts connected by its bones. Arthritis literally means inflammation of one or more joints.

Arthritis is frequently accompanied by joint pain. Joint pain is referred to as arthralgia. When four or more joints are involved, the arthritis is referred to as polyarthritis. When two or three joints are involved, it is referred to as oligoarthritis. When only a single joint is involved, it is referred to as monoarthritis.

How many types of arthritis exist?

There are many types of arthritis (over 100 identified, and the number is growing). The types of arthritis range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation resulting from an overactive immune system (such as rheumatoid arthritis). Together, the many types of arthritis make up the most common chronic illness in the United States.

How should patients prepare for their rheumatology visit?

Be prepared for questions about your health history for your visit with the rheumatologist. They will want to know about the history of your main complaint, including how long the symptoms and signs have been occurring, what situations or actions make the symptoms and signs better or worse, how intense the symptoms and signs are, what functions are impaired by the symptoms and signs, stiffness, pain, swelling, warmth, tenderness, fever, chills, weight loss or gain, sweats, tremor, tingling, numbness, breathing impairments, palpitations, and more. They will need to know what particular home remedies, medications, and therapies you have already tried and how they affected you. They will want to know your family history and past medical history, as well as underlying medical diseases and conditions. They also will need to know the names of each of your treating doctors. Bring all of your past testing results with you.

What can patients expect during a visit with a rheumatologist?

After your medical history is reviewed with the doctor, be prepared to have a thorough examination. You may still require further blood testing, X-rays, scans, or even additional surgical and/or medical consultants and rheumatology follow-up visits to get to a proper diagnosis and optimal treatment plan.

It can be helpful to bring a family member along. Because many rheumatic conditions can be complex medically, may require serious medicines that can have side effects and need monitoring testing, and because the conditions can affect the day-to-day functioning of the patient in the family environment, doctors will generally welcome the presence of the family member. By being present when the condition is explained, the required tests are described, and the treatment options and side effects are reviewed, the family member can assist the patient in understanding the game plan while they are permitted their own optimal understanding of the situation that will be confronting the family.

REFERENCE:

Firestein, Gary S., et al. Kelley's Textbook of Rheumatology, 9th Edition. Philadelphia, PA: Saunders, 2013.

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Reviewed on 3/30/2017
References
REFERENCE:

Firestein, Gary S., et al. Kelley's Textbook of Rheumatology, 9th Edition. Philadelphia, PA: Saunders, 2013.

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