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ROLE OF A RHEUMATOLOGIST

Rheumatologists treat arthritis, certain autoimmune diseases, musculoskeletal pain disorders and osteoporosis. There are more than 100 types of these diseases, including ankylosing spondylitis (AS), rheumatoid arthritis, and lupus.

What Does a Rheumatologist Do?
The rheumatologist's most important role is to decide on the diagnosis and recommend the right kind of management for the disease. Toward this aim, the rheumatologist advocates for the patient in all aspects of health care, the community, and in the legislative arena. The rheumatologist educates the patient, family, and community, teaching not only medical information, but also techniques for preventing disability, coping mechanisms for chronic disorders, behavioral therapy for improving quality of life, medication, and rehabilitative functions. The rheumatologist is a member of the health care team, referring and receiving referrals from all team members.

The rheumatologist evaluates the following:

  • signs and symptoms of systemic involvement
  • joint disorders
  • need for orthopedic or corrective intervention
  • need for hospitalization for medical management
  • mental well-being
  • level of independence
  • result of advanced laboratory and radiological examinations
  • necessity of referrals to other health care providers

When Should Someone See a Rheumatologist?
Anyone who thinks they may have spondylitis can read the disease signs and symptoms found in the "About Spondylitis" section of this site. With over 100 rheumatic diseases, it is difficult to make generalizations on when a person should seek care from a general practitioner or rheumatologist. The American College of Rheumatology suggests that if musculoskeletal pains are not severe or disabling and last just a few days, people may want to give the problem a chance to be resolved. However, if the pain in the joint, muscles or bones is severe or persists for more than a few days, they should seek medical attention.

Many types of rheumatic diseases are not easily identified in the early stages. Take the example of spondylitis - one of the main diagnostic tools to diagnose AS and its related diseases is through x-ray changes in the sacroiliac joint (buttock area). Yet these changes may not show on x-ray for years in a person with spondylitis, or perhaps never show. The lack of changes could deter some rheumatologists from making the correct diagnosis.

Rheumatologists are specially trained to do the detective work necessary to discover the cause of swelling and pain. It is important to determine a correct diagnosis early in the disease process so that the person can begin appropriate treatment since some musculoskeletal disorders respond best to treatment during this time period. Early diagnosis and treatment may be able to help some people with AS since most of the loss of function in this disease group occurs during the first ten years.

Many people with spondylitis need to be seen by a rheumatologist over an extended period of time rather than being care for by their primary care doctor (general practitioner). Rheumatic diseases often change or evolve over time; therefore, it is recommended that spondylitis patients visit their rheumatologist at least once a year for a regular check-up.

How Does the Rheumatologist Work with Other Health Care Professionals?
Oftentimes, the rheumatologist works with other physicians, sometimes acting as a consultant to advise another physician about a specific diagnosis and treatment plan. In other situations, the rheumatologist acts as a manager, relying upon the help of many skilled professionals including nurses, physical and occupational therapists, psychologists and social workers. Teamwork is important, since musculoskeletal disorders are chronic.

Where Do Rheumatologists Work?
Rheumatologists provide care in a variety of health care settings, including medical, surgical, and rehabilitation hospital units, private office practice, managed care practice, outpatient clinics, and transitional care units.

Training
Rheumatologists must obtain a bachelor's degree (four years of college), medical degree (four years of medical school), training in either internal medicine or pediatrics (three years), and a rheumatology fellowship program. Most rheumatologists who plan to treat patients choose to become board certified. Upon completion of their training, they must pass a rigorous exam conducted by the American Board of Internal Medicine to become certified.

Locating a Rheumatologist
Need help finding a rheumatologist? Then click here for some tips on finding a rheumatologist that is right for you.

Source: American College of Rheumatology

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