What does a Rheumatologist do?
Rheumatology is the branch of medicine that deals with many of the diseases where the body’s own immune system has started to act against some of its own tissues. These are known as auto-immune or auto-inflammatory diseases. Although some of the causes are becoming better understood, to a large extent the exact reasons why the immune system does this are not understood.
Depending on the specific tissues the immune system is targeting, the diseases will have various manifestations. Many, but not all, of the rheumatological diseases will have arthritis as one of their main manifestations. Arthritis (from the Greek words arthron – meaning joint, and itis - meaning inflammation) means inflammation of a joint. The inflammation may involve the lining tissue of the joints themselves or the tendon sheaths (called the synovium), or the region where a tendon, ligament or muscle inserts into the bone. Inflammation may be evident as warmth, redness and/or swelling of the affected area.
Some confusion often exists about the term arthritis.
Wear-and-tear arthritis, known as osteoarthritis, is due to progressive mechanical wear and damage to the structures within the joint. This is usually what people think of when they hear the word arthritis - it may bring to mind an image of an elderly person with a walking stick or frame, and the need for hip or knee replacements. This type of arthritis is fundamentally different from the inflammatory forms of arthritis.
The distinction between inflammatory arthritis and osteoarthritis is very important. The auto-immune and auto-inflammatory diseases are generally treated by giving medications that suppress the inappropriate activity of the immune system so that the inflammation (and hence the pain and disability) is reduced.
Because the fundamental problem in osteoarthritis is not inflammatory, this approach rarely works in osteoarthritis. Osteoarthritis is treated by painkillers, physiotherapy to strengthen the supporting muscles around an affected joint, and if appropriate, joint replacement surgery.
Many other areas of the body can be affected by the rheumatological diseases. These include the skin, eyes, muscles, lungs, kidneys, nerves, and brain.
Some of the diseases commonly managed by rheumatologists include rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus (systemic lupus erythematosus), Sjogren’s syndrome, polymyositis, dermatomyositis, scleroderma, vasculitis, osteoporosis and fibromyalgia.
Please click here for information on fibromyalgia.