A rheumatologist is a doctor who diagnoses, treats and prevents rheumatic diseases.
A rheumatologist treats a wide variety of joint diseases, among which the well-known gout, arthritis and osteoarthritis are just the tip of the iceberg of many possible problems.
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- When is it necessary to see a rheumatologist?
- What diseases does a rheumatologist treat?
- Reception of a rheumatologist and basic diagnostic methods
- Pediatric rheumatologist
- Appointment to a rheumatologist
When is it necessary to see a rheumatologist?
A referral to a rheumatologist is received by patients with complaints of pain of any nature, which is concentrated around one or more joints. In addition, the need to visit this specialist is indicated by their changed form, structure and performance. Usually ignored by many people, but it is recommended to check with a rheumatologist if there are relatives with joint diseases (which indicates a hereditary predisposition).
The field of activity of rheumatology mainly includes systemic, dystrophic and inflammatory diseases that are provoked by viral and bacterial infectious agents and affect joints and connective tissue. Therefore, in addition to the above reasons, an indication for visiting a rheumatologist is frequent infectious diseases such as tonsillitis. The list of symptoms of some rheumatic diseases also includes crunching and swelling of the joints of the extremities and spine, which are familiar to most people.
What diseases does a rheumatologist treat?
The modern rheumatologist has one of the largest "working front" among medical specialties. His professional interests include a huge number of diseases of various organ systems, the symptoms or general consequences of which are damage to bones, muscles and joints.
Rheumatic diseases, especially in the later stages of development with complications, pose a serious danger to the patient. When all types of supporting connective tissue (cartilage, bones, ligaments) are involved in the pathological process, it becomes difficult to avoid such consequences as limited body mobility in the affected areas up to the patient's disability. If a patient gets an appointment with a rheumatologist with a complicated form of the disease, then the doctor is able to improve his condition only to the extent that his working capacity is lost, but there is still an opportunity for a person to leave the house without assistance. In this case, the disease also affects the patient's state of mind, affecting family relationships, the ability to socialize and mental activity.
Most often, rheumatic diseases are chronic with regular exacerbations. According to the spectrum of tissue damage, these diseases can be divided into two general sections.
- Rheumatoid arthritis;
- Juvenile arthritis is idiopathic;
- Reiter's syndrome, or reactive arthritis;
- Ankylosing spondylitis, or ankylosing spondylitis;
- Infectious arthritis;
- Background arthritis of intestinal inflammation.
- Gout and pseudogout.
- Still's disease.
Connective tissue diseases (diffuse):
- Lupus erythematosus;
- Systemic scleroderma;
- Sjogren's disease.
Diseases that can affect both connective tissues and muscle fibers, blood vessels and internal organs are also rheumatic.
These include such well-known diseases as:
- Rheumatic fever (acute);
- Recurrent polychondritis;
- Polymyalgia rheumatica;
- Behcet's disease;
- Osteoporosis, etc.
Systemic vasculitis, vasculopathies and some other disorders are classified into a separate group of rheumatic pathologies:
- Vasculitis is microscopic;
- Cryoglobulinemic vasculitis;
- Polyarteritis nodosa;
- Horton's arteritis;
- Purpura Shenlein-Genoch;
- Kawasaki disease;
- Hypereosinophilic angiitis;
- Antiphospholipid syndrome, etc.
Reception of a rheumatologist and basic diagnostic methods
Few people, having felt the impact of the first symptoms of a rheumatic disease, immediately get an appointment with the right specialist. A referral to him must be written by a therapist or surgeon, to whom patients turn to with appropriate complaints in the first place. Considering how closely rheumatology is connected with other areas in medicine, it is easy to understand why the symptoms of rheumatic diseases are similar to the manifestation of cardiological, hematological, gastroenterological, oncological, infectious and other pathologies.
The doctor referring the patient to a rheumatologist should also order a preliminary x-ray. An X-ray is the key to working as a rheumatologist. It sufficiently displays all the details of pathological changes in the connective tissue. The doctor fixes them and enters them in the outpatient card as the initial diagnosis. It is radiography that is the simplest and most informative diagnostic procedure for rheumatic diseases. At the first stages of their development, on the information received by the rheumatologist from the X-ray, the diagnosis and consultation of the doctor ends and the appointment of the appropriate therapeutic and preventive procedures is performed.
In more complex situations, several other diagnostic procedures are possible.
MRI (magnetic resonance imaging) is a layer-by-layer scan of a specific area or the entire body of a patient with pulsating magnetic fields and radio waves. In terms of rheumatic diseases, MRI scans are necessary to clarify the condition of the soft tissues surrounding the focus of the disease. It is carried out to clarify the diagnosis and details of the treatment plan for rheumatic pathologies of intervertebral discs, vascular ligaments and nerve fibers.
- CT (computed tomography) is an analogue of MRI, but is produced by X-rays, which give information about the physical properties of the pathology under study. A K-tomogram is a collection of X-rays, which is significantly better than a simple X-ray. However, in most cases, one image is sufficient, so the cost of tomography is unreasonable. However, in recent years, in osteoporosis, information obtained with its help is increasingly used, since it is from CT scans that densitometry can be performed - determination of tissue density.
- An auxiliary diagnostic method is a universal blood test, the results of which help to determine the presence of inflammatory processes in the body, which can significantly affect the course, and, consequently, the treatment of the disease.
Most rheumatic diseases appear only in adulthood, although it is known that the prerequisites for their development often appear as early as childhood. In addition, some diseases (especially those that are hereditary, like many diffuse connective tissue diseases) begin to bother children from an early age. And if the problem is not solved in time, the future adult risks being incapacitated or disabled.
Therefore, a pediatric rheumatologist is a doctor with a very high level of personal responsibility, who must have extensive experience in the study and treatment of rheumatic diseases, both in adults and children.
It is believed that angina is one of the main factors in the development of rheumatic diseases at an early age. In addition to her, some researchers attribute this blame to the pathological activity of streptococci. In any case, antibiotic therapy for childhood illnesses is based on this knowledge. Studies show that rheumatic fever, transferred in childhood without antibiotics, provokes the development of heart defects.
The treatment of rheumatic diseases in children is complicated by contraindications to the use of many effective drugs. Experienced rheumatologists are able to draw up a treatment plan with such drugs, taking into account the total body area and low weight of the child.
The work of rheumatologists is difficult to overestimate, since thanks to it, many people with rheumatic diseases have a chance to live to a ripe old age, leading an active lifestyle.