Rheumatology
System | Musculoskeletal, Immune |
---|---|
Significant diseases | Autoimmune disease Inflammation, Rheumatoid arthritis, Lupus, Osteoarthritis, Psoriatic arthritis, Ankylosing spondylitis, Gout, Osteoporosis |
Significant tests | Joint aspirate, Musculoskeletal exam, X-ray |
Specialist | Rheumatologist |
Rheumatology (Greek ῥεῦμα, rheûma, flowing current) is a branch of medicine devoted to the diagnosis and management of disorders whose common feature is inflammation in the bones, muscles, joints, and internal organs.[1] Rheumatology covers more than 100 different complex diseases, collectively known as rheumatic diseases, which includes many forms of arthritis as well as lupus and Sjögren's syndrome.[1] Doctors who have undergone formal training in rheumatology are called rheumatologists.
Many of these diseases are now known to be disorders of the immune system, and rheumatology has significant overlap with immunology, the branch of medicine that studies the immune system.
Rheumatologist
Occupation | |
---|---|
Names | Doctor, Medical Specialist |
Occupation type | Specialty |
Activity sectors | Medicine |
Description | |
Education required |
|
Fields of employment | Hospitals, Clinics |
A rheumatologist is a
Rheumatologists treat
Diseases
Diseases diagnosed or managed by rheumatologists include:
Degenerative arthropathies
Inflammatory arthropathies
- Rheumatoid arthritis
- Spondyloarthropathies
- Ankylosing spondylitis
- reactive arthropathy)
- Psoriatic arthropathy
- Enteropathic arthropathy
- Juvenile Idiopathic Arthritis(JIA)
- Crystal arthropathies: pseudogout
- Septic arthritis
Systemic conditions and connective tissue diseases
- Lupus
- Ehlers-Danlos syndrome
- Sjögren's syndrome
- Scleroderma (systemic sclerosis)
- Polymyositis
- Dermatomyositis
- Polymyalgia rheumatica
- Mixed connective tissue disease
- Relapsing polychondritis
- Adult-onset Still's disease
- Sarcoidosis
- Fibromyalgia
- Myofascial pain syndrome
- Vasculitis
- Microscopic polyangiitis
- Eosinophilic granulomatosis with polyangiitis
- Granulomatosis with polyangiitis
- Polyarteritis nodosa
- Henoch–Schönlein purpura
- Serum sickness
- Temporal arteritis
- Takayasu's arteritis
- Behçet's disease
- Kawasaki disease (mucocutaneous lymph node syndrome)
- Thromboangiitis obliterans
- Hereditary periodic fever syndromes
Soft tissue rheumatism
Local diseases and
Diagnosis
Type | WBC (per mm3) | % neutrophils | Viscosity | Appearance |
---|---|---|---|---|
Normal | <200 | 0 | High | Transparent |
Osteoarthritis | <5000 | <25 | High | Clear yellow |
Trauma | <10,000 | <50 | Variable | Bloody |
Inflammatory | 2,000–50,000 | 50–80 | Low | Cloudy yellow |
Septic arthritis | >50,000 | >75 | Low | Cloudy yellow |
Gonorrhea | ~10,000 | 60 | Low | Cloudy yellow |
Tuberculosis | ~20,000 | 70 | Low | Cloudy yellow |
Inflammatory: Arthritis, gout, rheumatoid arthritis, rheumatic fever |
Physical examination
Following are examples of methods of diagnosis able to be performed in a normal physical examination.
- lower back.
- Multiple joint inspection
- Musculoskeletal Examination
- Screening Musculoskeletal Exam (SMSE) - a rapid assessment of structure and function
- General Musculoskeletal Exam (GMSE) - a comprehensive assessment of joint inflammation
- Regional Musculoskeletal Exam (RMSE) - focused assessments of structure, function and inflammation combined with special testing
Specialized
- ANA (Anti-Nuclear Antibody))
- X-rays, Ultrasounds, and other imaging methods of affected joints
- Cytopathology and chemical pathology of fluid aspirated from affected joints (e.g. to differentiate between septic arthritis and gout)
Treatment
Most rheumatic diseases are treated with
Beginning in the 2000s, the incorporation of
Rheumasurgery
Rheumasurgery (or rheumatoid surgery) is a subfield of
Rheumasurgical interventions can be divided in two groups. The one is early
Research directions
Recently, a large body of scientific research deals with the background of autoimmune disease, the cause of many rheumatic disorders. Also, the field of osteoimmunology has emerged to further examine the interactions between the immune system, joints, and bones. Epidemiological studies and medication trials are also being conducted. The Rheumatology Research Foundation is the largest private funding source of rheumatology research and training in the United States.[citation needed]
History
Rheumasurgery emerged in the cooperation of rheumatologists and orthopedic surgeons in Heinola, Finland, during the 1950s.[13]
In 1970 a Norwegian investigation estimated that at least 50% of patients with rheumatic symptoms needed rheumasurgery as an integrated part of their treatment.[14]
The European Rheumatoid Arthritis Surgical Society (ERASS) was founded in 1979.[15]
Around the turn of the 21st century, focus for treatment of patients with rheumatic disease shifted, and pharmacological treatment became dominant, while surgical interventions became rarer.[16][17]
References
- ^ a b "Explore Rheumatology". www.rheumatology.org. Retrieved 2022-09-28.
- ^ "What is a Rheumatologist?". www.rheumatology.org.
- ^ "Rheumatology Specialty Description". American Medical Association.
- ISBN 978-0-19-991494-4.
- PMID 30725799. Retrieved 2019-12-19.
- ^ "Methotrexate for rheumatoid arthritis". Arthritis.about.com. Retrieved 2013-06-24.
- PMID 15201414.
- PMID 23221584.
- ^ "Norsk forening for revmakirurgi - Med hovedbase på Diakonhjemmet" LB Johannessen Tidsskr Nor Lægeforen 2004; 124:3110 Nr. 23 – 2. December 2004
- ^ Rheumakirurgi Archived 2016-01-18 at the Wayback Machine. Arne Skredderstuen November 2000
- ^ Den sykehusmessige revmatikeromsorgen i Norge (Kåss and Stene 1970), page 24.
- ^ "Surgery for Rheumatic Diseases" Cedars Sinai (http://www.cedars-sinai.edu)
- ^ Revmatisme: Gamle plager - ny viten (Munthe and Larsen 1987), page 49.
- ^ Den sykehusmessige revmatikeromsorgen i Norge (Kåss and Stene 1970), pages 24-25.
- ^ Rydholm, U "Reumakirurgiens uppgång, stabilisering og nedgång ur ett sydsvenskt perspektiv" 2013
- ^ Trender i revmakirurgisk behandling av pasienter med leddgikt og andre kronisk inflammatoriske leddsykdommer Archived 2016-01-29 at the Wayback Machine, Norsk Rheumabulletin 4/2012, pages 16-17.
- S2CID 25813985.)
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External links
- Association des medecins rhumatologues du Quebec
- American College of Rheumatology
- European League Against Rheumatism
- Consortium of Rheumatology Researchers of North America, Inc.
- British Society for Rheumatology
- Canadian Rheumatology Association
- Association of Rheumatology Health Professionals
- German Society for Rheumatology