What is rheumatism?
Rheumatism is an old term for the inflammation of muscles, joints, tendons, and bones. Under this umbrella term, there are at least 200 different conditions; some have the characteristics of autoimmunity, i.e., uncontrolled activation of the immune system against healthy body cells.
Rheumatic diseases can be classified in many ways, but a simple classification is based on their nature. Rheumatic disorders include a broad spectrum of anomalies that predominantly involve the musculoskeletal system. These medical conditions are autoimmune, autoinflammatory, and degenerative/metabolic disorders.
What is the role of a rheumatologist?
Medical practitioners specializing in studying and treating rheumatic diseases are called rheumatologists. Most medical specialties focus on one part of the body. However, rheumatic disorders can affect the entire human body since connective tissue problems and autoimmune diseases can spread to different organ systems if not treated early. Hence, rheumatologists are trained in holistic treatment.
Rheumatic diseases usually require lifelong treatment, so practitioners stay in long-term contact with their patients. Therefore, it is crucial to choose the right rheumatologist near you.
How to become a rheumatologist?
Aspiring medical students undergo a traditional bachelor's degree and four years of training in medical school. After graduating from medical school, students earn a Doctor of Medicine degree (MD).
After medical school, doctors must complete a mandatory three-year residency focusing on internal medicine or pediatrics. During their residency, doctors are exposed to a broad range of diseases. Physicians must pass the internal medicine or pediatric board examination for superspecialization in the future.
Doctors then obtain a two—to three-year fellowship that provides super-specialty training to become rheumatologists. This fellowship gives them in-depth training in musculoskeletal and autoimmune diseases. Rheumatologists get board-certified after passing a rigorous exam that the American Board of Internal Medicine conducts to present themselves as subject-matter experts. All rheumatologists stay updated on the latest technologies and retake their exams every ten years.
Rheumatologists and other medical specialties
Rheumatology gives a holistic perspective of several aspects of the human body. Hence, rheumatologists often work together with other medical specialties. They are often sought after by specialists who want a deeper diagnosis of persistent musculoskeletal or autoimmune diseases.
Alternatively, rheumatic experts may seek assistance from other skilled professionals, including nurses, physical and occupational therapists, psychologists, etc. Often, musculoskeletal disorders are chronic and need a team of medical practitioners with different skill sets to provide a long-term remedy.
What are some of the common and rare rheumatic diseases?
Some of the common rheumatic diseases include:
- Arthritis
- Osteoarthritis
- Osteoporosis
- Rheumatoid Arthritis
- Gout
- Fibromyalgia
- Vasculitis
- Ankylosing Spondylitis
Relatively rare rheumatic disorders include:
- Patellar tendonitis: This painful tendonitis affects the tendon joining the kneecap to the shinbone.
- Glomerular disorder: It affects the kidneys in systemic connective tissue disease
- Granulomatosis with polyangiitis: This inflammatory condition can damage critical organs like the kidney, lungs, throat, nose, and ears.
- Microscopic polyangiitis: An uncommon variant of vasculitis, it affects the small blood vessels.
- Takayasu disease: Another rare form of vasculitis that causes inflammation in the blood vessels.
- Juvenile dermatomyositis: It is an inflammatory disorder affecting children's muscles, blood vessels, and skin. About three in a million get diagnosed with this rare form of myositis.
What is rheumatoid arthritis?
Rheumatoid arthritis (RA) is a chronic (ongoing) autoimmune disease. Unlike other types of arthritis, it develops in the joints of both sides of the body. Pain and inflammation in fingers, hands, wrists, knees, ankles, feet, and toes are common symptoms of RA. Uncontrolled inflammation damages cartilage, which cushions the joints. This can cause joint deformation over time. Your bone will eventually deteriorate, resulting in joint fusion, which is your body's attempt to defend itself from persistent irritation.
Certain immune system cells in your immune system aid this process. These compounds are generated in your joints but circulate throughout your body, causing discomfort. Moreover, rheumatoid arthritis can affect body parts other than joints, including skin, eyes, mouth, lungs, and heart.
RA affects about 1.3 million people in the United States. Females are 2.5 times more prone to it than males. Although anyone can get rheumatoid arthritis, it often starts to develop in people between the ages of 30 and 60. Young-onset rheumatoid arthritis (YORA) affects children and young adults, usually between 16 and 40. Later-onset rheumatoid arthritis (LORA) affects adults aged 60 and above.
Though the exact cause is unknown, researchers believe a mix of genetics, hormones, and environmental factors may cause this condition.
What kind of lifestyle changes help with rheumatoid arthritis?
While you cannot control certain aspects of RA, lifestyle changes like the following may help:
- Enough rest: Inflamed joints increase the risk of injury to them and nearby soft tissue structures. Hence, giving your inflamed joints the proper rest is essential. However, working out is still important. Maintaining a decent range of motion in your joints and general fitness is vital when dealing with RA.
- Regular exercise: Pain and stiffness might make it difficult to move. People with RA may become inactive, resulting in a loss of joint mobility and muscle strength. This, in turn, causes more pain and fatigue. With regular exercise, you can prevent and reverse these effects. Consulting a physical or occupational therapist for advice on how to exercise safely is also advisable.
- Diet: Although not much evidence suggests a direct relation between special diets and RA, it is always wise to eat a balanced, healthy diet. It helps reduce inflammation, which may be helpful with RA. Fish like trout, tuna, salmon, and sardines are rich in omega-3 fatty acids that control cytokines, the inflammation-causing chemicals. Research indicates that omega-3s may alleviate joint pain and shorten morning stiffness. Colorful fruits and veggies are also good options as they contain antioxidants that fight harmful free-radical molecules in the body. Apart from this, whole grains like oatmeal, brown rice, and barley may also help as they tend to lower C-reactive protein levels, which is a sign of inflammation.
- Manage stress: Managing RA can be stressful, which may worsen your overall health. Thus, it is vital to manage stress. You can do deep breathing exercises, yoga, and meditation, seek support from family, friends, and co-workers, or get counseling from a professional.
- Limit alcohol consumption: Certain medications for rheumatoid arthritis can raise the risk of liver damage in people who regularly consume alcohol. So, if you drink and are taking these medications, consulting your doctor about your alcohol habits is essential.
- Quit smoking: Smoking is injurious to overall health and is a major risk factor for RA. Quitting smoking can potentially improve your symptoms. If you are finding it hard to quit, you can get help from a professional.
When to consult a rheumatologist near you?
We often ignore mild or sudden pain in our joints, muscles, etc. However, if the pain doesn't subside after several days or aggravates, you should consult a specialist. Many types of rheumatic diseases are not severe in the initial stages. Certain musculoskeletal conditions evolve slowly and may spread to other body parts from the primary affected area.
Early diagnosis and treatment help prevent long-term consequences. Rheumatologists evaluate and decide specific treatment plans for each individual as per their medical history and presenting complaints.
What should I expect from a rheumatologist?
Since several autoimmune diseases are hereditary, your rheumatologist may want to understand your family history and lifestyle. To help determine the root cause of the medical issue, the rheumatologist may perform multiple diagnostic tests, including:
- Blood tests or urine analysis.
- Biopsy to look for signs of autoimmunity in the tissues.
- Liver function tests or kidney function tests.
- Bone density scan.
- CT scan, MRI, or USG to visualize organs and structures.
- Chest X-ray to assess lung anomalies.
- Heart tests, such as an ECG.
- Electromyogram for assessing nerve and muscle functioning.
- Endoscopy to evaluate gastrointestinal issues.
What happens at a rheumatologist visit?
Rheumatic diseases may be complex and challenging to diagnose at times. Thus, rheumatologists gather your complete medical history first. Then, they look for signs and symptoms to identify the cause of your condition. Family history can be crucial in determining the cause of rheumatic diseases. Your rheumatologist will request the most information possible about your family history.
The rheumatologist will then review the results of any earlier tests. To look for additional potential hints to the probable cause of your musculoskeletal problem, the rheumatologist may order further laboratory tests, imaging studies (X-ray, ultrasound, CT scan, or MRI), or other tests.
The doctor will then combine the results to assess the source of the patient's symptoms and develop a customized treatment plan. It may take several visits with your rheumatologist to diagnose some rheumatic diseases. Treatment suggestions could be as follows:
- Medications
- Referral to physical or occupational therapy
- Referral to other specialists
- Joint and tendon injections
Rheumatologists may treat recurring conditions during follow-up visits or consult with patients about medications, coping mechanisms, avoiding chances of disability or regaining function, and ways to enhance their quality of life.
What should you bring to your initial appointment with a rheumatologist?
You should bring the following with you for your first rheumatology appointment:
- Any prior laboratory results, radiographic X-ray, ultrasound, MRI test results, and medical notes for review. Sometimes, the referring physician may send your medical records, too. Giving the rheumatologist as much information as possible during your initial appointment is critical.
- A list of current medications, such as your precise dosages. To avoid repeating previous treatments, list the medicines you have already tried.
- A list of medication allergies and intolerances.
- Your family history, including any rheumatologic or autoimmune disease-affected kin. Despite how insignificant you may feel it is, you must try to share your family's medical history as accurately as possible.
- A list of all previous health issues, surgeries, travel experiences, sleep patterns, dietary habits, physical activity history, and social history (such as employment, education, sports participation, and illicit drug use, among other things).
Care for rheumatic patients during COVID-19
Often, patients require immunosuppressant drugs for severe rheumatic conditions. Such immunocompromised patients are at a higher risk of developing COVID-19. Rheumatology practices during the pandemic have faced myriad challenges. The medicines must be regularly monitored and altered based on the patient's immune status, making it necessary to stay in touch with your practitioner.
How to find the best rheumatologist near you in Philadelphia?
We often delay visiting a doctor because we need to know whom to consult. Your search for the best rheumatologist in Philadelphia, PA, ends with us. At Zocdoc, we have a list of rheumatologists practicing various subspecialties.
On Zocdoc, you can search for the healthcare provider you need, your preferred date and time, and your location. The search filters on the website also allow you to search providers based on your insurance plan. Besides, adding an image of your medical insurance card can help you easily select your insurance plan on Zocdoc. However, it is not mandatory. If you want to skip the upload and instead want to do it manually by picking your plan from a list, then you have that option as well. For any insurance-related queries, you can refer to Zocdoc's patient help center.
Each doctor's profile on Zocdoc showcases their specialty and testimonials from past patients. Some doctors also provide video consultations. You can review the individual profiles and select the doctor who best fits your requirements.
All Zocdoc bookings are quick, secure, and free!
A statistical study of rheumatology
As per the Centers for Disease Control and Prevention estimate, approximately one in every three Americans, or about 91 million people, are likely to suffer from rheumatic diseases in the United States. The number of doctor-diagnosed cases could be around 54 million.
About 1.5 million people in America are estimated to suffer from rheumatoid arthritis. Women are around three times more prone than men to acquire this condition.
According to a study by the Lupus Foundation of America, about 1.5 million people suffer from some form of lupus, with children and teenagers most affected.
The Great Lakes region has about 957 adult rheumatologists and around 50 pediatric rheumatologists. The ratio between people and physicians for adults is ~41,424.2; for children, it's ~252,673.7.
Sources
Cleveland Clinic[1]
WebMD[1]
WebMD[2]
American College of Rheumatology
ScienceDirect
Hospital for Special Surgery
Cleveland Clinic[2]
NYU Langone Health
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