Rheumatology

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For the journal, see Rheumatology (journal). Rheumatology_sentence_0

Rheumatology_table_infobox_0

RheumatologyRheumatology_table_caption_0
SystemRheumatology_header_cell_0_0_0 Musculoskeletal, ImmuneRheumatology_cell_0_0_1
Significant diseasesRheumatology_header_cell_0_1_0 Autoimmune disease Inflammation Rheumatoid arthritis, lupus, Osteoarthritis, Psoriatic arthritis, Ankylosing spondylitis, Gout, OsteoporosisRheumatology_cell_0_1_1
Significant testsRheumatology_header_cell_0_2_0 Joint aspirate, Musculoskeletal exam, X-rayRheumatology_cell_0_2_1
SpecialistRheumatology_header_cell_0_3_0 RheumatologistRheumatology_cell_0_3_1

Rheumatology (Greek ῥεῦμα, rheûma, flowing current) is a branch of medicine devoted to the diagnosis and therapy of rheumatic diseases. Rheumatology_sentence_1

Physicians who have undergone formal training in rheumatology are called rheumatologists. Rheumatology_sentence_2

Rheumatologists deal mainly with immune-mediated disorders of the musculoskeletal system, soft tissues, autoimmune diseases, vasculitides, and inherited connective tissue disorders. Rheumatology_sentence_3

Many of these diseases are now known to be disorders of the immune system. Rheumatology_sentence_4

Rheumatology is considered to be the study and practice of medical immunology. Rheumatology_sentence_5

Beginning in the 2000s, the incorporation of drugs called the biologics (which include inhibitors of TNF-alpha, certain interleukins, and the JAK-STAT signaling pathway) into standards of care is one of the paramount developments in modern rheumatology. Rheumatology_sentence_6

Rheumatologist Rheumatology_section_0

Rheumatology_table_infobox_1

RheumatologistRheumatology_table_caption_1
OccupationRheumatology_header_cell_1_0_0
NamesRheumatology_header_cell_1_1_0 Doctor, Medical SpecialistRheumatology_cell_1_1_1
Occupation typeRheumatology_header_cell_1_2_0 SpecialtyRheumatology_cell_1_2_1
Activity sectorsRheumatology_header_cell_1_3_0 MedicineRheumatology_cell_1_3_1
DescriptionRheumatology_header_cell_1_4_0
Education requiredRheumatology_header_cell_1_5_0 Rheumatology_cell_1_5_1
Fields of

employmentRheumatology_header_cell_1_6_0

Hospitals, ClinicsRheumatology_cell_1_6_1

A rheumatologist is a physician who specializes in the field of medical sub-specialty called rheumatology. Rheumatology_sentence_7

A rheumatologist holds a board certification after specialized training after attaining a medical degree through fellowship programs in the United States, or specialist registrar positions in the United Kingdom, Pakistan or DM in India or equivalent programs elsewhere in the world. Rheumatology_sentence_8

In the United States, training in this field requires four years undergraduate school, four years of medical school, and then three years of residency, followed by two or three years additional Fellowship training. Rheumatology_sentence_9

The requirements may vary in other countries. Rheumatology_sentence_10

Rheumatologists are internists who are qualified by additional postgraduate training and experience in the diagnosis and treatment of arthritis and other diseases of the joints, muscles and bones. Rheumatology_sentence_11

Many Rheumatologists also conduct research to determine the cause and better treatments for these disabling and sometimes fatal diseases. Rheumatology_sentence_12

Treatment modalities are based on scientific research, currently, practice of rheumatology is largely evidence based. Rheumatology_sentence_13

Rheumatologists treat arthritis, autoimmune diseases, pain disorders affecting joints, and osteoporosis. Rheumatology_sentence_14

There are more than 200 types of these diseases, including rheumatoid arthritis, osteoarthritis, gout, lupus, back pain, osteoporosis, and tendinitis. Rheumatology_sentence_15

Some of these are very serious diseases that can be difficult to diagnose and treat. Rheumatology_sentence_16

They treat soft tissue problems related to musculoskeletal system sports related soft tissue disorders. Rheumatology_sentence_17

Diseases Rheumatology_section_1

Main article: Rheumatism Rheumatology_sentence_18

Diseases diagnosed or managed by rheumatologists include: Rheumatology_sentence_19

Degenerative arthropathies Rheumatology_section_2

Rheumatology_unordered_list_0

Inflammatory arthropathies Rheumatology_section_3

Rheumatology_unordered_list_1

Systemic conditions and connective tissue diseases Rheumatology_section_4

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Soft tissue rheumatism Rheumatology_section_5

Local diseases and lesions affecting the joints and structures around the joints including tendons, ligaments capsules, bursae, stress fractures, muscles, nerve entrapment, vascular lesions, and ganglia. Rheumatology_sentence_20

For example: Rheumatology_sentence_21

Rheumatology_unordered_list_3

Diagnosis Rheumatology_section_6

Physical examination Rheumatology_section_7

Following are examples of methods of diagnosis able to be performed in a normal physical examination. Rheumatology_sentence_22

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  • Schober's test tests the flexion of the lower back.Rheumatology_item_4_40
  • Multiple joint inspectionRheumatology_item_4_41
  • Musculoskeletal ExaminationRheumatology_item_4_42
    • Screening Musculoskeletal Exam (SMSE) - a rapid assessment of structure and functionRheumatology_item_4_43
    • General Musculoskeletal Exam (GMSE) - a comprehensive assessment of joint inflammationRheumatology_item_4_44
    • Regional Musculoskeletal Exam (RMSE) - focused assessments of structure, function and inflammation combined with special testingRheumatology_item_4_45

Specialized Rheumatology_section_8

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Treatment Rheumatology_section_9

Most rheumatic diseases are treated with analgesics, NSAIDs (nonsteroidal anti-inflammatory drug), steroids (in serious cases), DMARDs (disease-modifying antirheumatic drugs), monoclonal antibodies, such as infliximab and adalimumab, the TNF inhibitor etanercept, and methotrexate for moderate to severe rheumatoid arthritis. Rheumatology_sentence_23

The biologic agent rituximab (anti-B cell therapy) is now licensed for use in refractory rheumatoid arthritis. Rheumatology_sentence_24

Physiotherapy is vital in the treatment of many rheumatological disorders. Rheumatology_sentence_25

Occupational therapy can help patients find alternative ways for common movements that would otherwise be restricted by their disease. Rheumatology_sentence_26

Patients with rheumatoid arthritis often need a long term, coordinated and a multidisciplinary team approach towards management of individual patients. Rheumatology_sentence_27

Treatment is often tailored according to the individual needs of each patient which is also dependent on the response and the tolerability of medications. Rheumatology_sentence_28

Rheumasurgery Rheumatology_section_10

Rheumasurgery - sometimes called rheumatoid surgery - is a subfield of orthopedics occupied with the surgical treatment of patients with rheumatic diseases. Rheumatology_sentence_29

The purpose of the interventions is to limit disease activity, soothe pain and improve function. Rheumatology_sentence_30

Rheumasurgical interventions can be divided in two groups. Rheumatology_sentence_31

The one is early synovectomies, that is the removal of the inflamed synovia in order to prevent spreading and stop destruction. Rheumatology_sentence_32

The other group is the so-called corrective intervention, i.e. an intervention done after destruction has taken place. Rheumatology_sentence_33

Among the corrective interventions are joint replacements, removal of loose bone or cartilage fragments, and a variety of interventions aimed at repositioning and/or stabilizing joints, such as arthrodesis. Rheumatology_sentence_34

Research directions Rheumatology_section_11

Recently, a large body of scientific research deals with the background of autoimmune disease, the cause of many rheumatic disorders. Rheumatology_sentence_35

Also, the field of osteoimmunology has emerged to further examine the interactions between the immune system, joints, and bones. Rheumatology_sentence_36

Epidemiological studies and medication trials are also being conducted. Rheumatology_sentence_37

The Rheumatology Research Foundation is the largest private funding source of rheumatology research and training in the United States. Rheumatology_sentence_38

History Rheumatology_section_12

Rheumasurgery emerged in the cooperation of rheumatologists and orthopedic surgeons in Heinola, Finland, during the 1950s. Rheumatology_sentence_39

In 1970 a Norwegian investigation estimated that at least 50% of patients with rheumatic symptoms needed rheumasurgery as an integrated part of their treatment. Rheumatology_sentence_40

The European Rheumatoid Arthritis Surgical Society (ERASS) was founded in 1979. Rheumatology_sentence_41

Around the turn of the century, focus for treatment of patients with rheumatic disease shifted, and pharmacological treatment became dominant, while surgical interventions became rarer. Rheumatology_sentence_42


Credits to the contents of this page go to the authors of the corresponding Wikipedia page: en.wikipedia.org/wiki/Rheumatology.