Background & Scope
Rheumatology is a branch of medicine that focuses on the diagnosis and treatment of musculoskeletal diseases and systemic autoimmune conditions. This specialty is concerned with the diagnosis and management of diseases that affect the joints, muscles, and bones, including gout, rheumatoid arthritis, osteoarthritis, psoriatic arthritis, and lupus. It also involves the study of the effects of these conditions on other organs of the body, such as the cardiovascular system, lungs, and skin.
The scope of rheumatology is wide-ranging and includes the study of physical disabilities or impairments caused by musculoskeletal conditions. It also involves how to prevent these conditions from occurring in the first place. Additionally, rheumatology addresses a range of topics related to musculoskeletal health such as exercise physiology, nutrition, ergonomics, and pain management.
Rheumatologists are trained to diagnose and treat complex musculoskeletal conditions using a variety of treatments including medications, physical therapy, lifestyle modifications, and referral for surgery. They also provide education about disease prevention and management to patients and their families. Rheumatologists focus on helping patients maintain an active lifestyle with minimal disruption caused by their condition.
Qualifications, Training, and Certifications
Becoming a rheumatologist requires a great deal of training: after four years of medical school, a three-year residency in internal medicine is required following by an additional two-year fellowship in rheumatology.
During the fellowship, trainees learn about the diagnosis, management, and prevention of musculoskeletal conditions, as well as techniques for physical examinations and imaging studies. They also become familiar with treatments such as medication, physical therapy, lifestyle modifications, and surgery.
The American Board of Internal Medicine offers certification in rheumatology.
Conditions, Diseases, Treatments, and Procedures
Again, rheumatologists are trained to diagnose and treat a wide range of conditions that affect the joints, muscles, and bones. These conditions include gout, rheumatoid arthritis, osteoarthritis, psoriatic arthritis, lupus, and other autoimmune diseases. Additionally, rheumatology also addresses physical disabilities or impairments caused by musculoskeletal conditions.
Rheumatologists use medications, physical therapy, lifestyle modifications such as exercise and nutrition, and referral for surgery. Additionally, rheumatologists provide education about disease prevention and management. Rheumatologists may also perform procedures such as joint injections and aspirations to diagnose or treat specific conditions. Joint injections are used to reduce inflammation in the joint and relieve pain. Aspirations are used to drain fluid from the joint or to obtain fluid samples for diagnostic testing.
Related Medical Specialties
Although rheumatology is a distinct field of medicine, there are several related medical specialties that overlap with rheumatology. These related specialties include orthopedics, physical medicine and rehabilitation, neurology, and immunology.
Orthopedics is a branch of medicine that focuses on treating diseases and injuries of the musculoskeletal system both surgically and nonsurgically. Orthopedic surgeons diagnose and treat conditions such as fractures, strains, sprains, arthritis, and other joint-related issues.
Physical medicine and rehabilitation, otherwise known as physiatry, is a specialty that focuses on the diagnosis and treatment of musculoskeletal conditions and injuries. This specialty also addresses physical disabilities or impairments caused by these conditions. Additionally, physical medicine and rehabilitation specialists help patients restore movement, strength, and function to their affected limbs or muscles through exercise and physical therapy.
Neurology is a branch of medicine that focuses on the diagnosis and treatment of diseases and disorders of the nervous system. Neurologists diagnose and treat conditions such as stroke, multiple sclerosis, Parkinson’s disease, and epilepsy.
Immunology is a branch of medicine that deals with the study of the immune system. Immunologists diagnose and treat autoimmune diseases such as lupus, as well as allergies and other immune-related disorders.
Medical-Legal Cases Involving Rheumatology
Medical-legal cases involving rheumatology include disputes over the diagnosis, treatment, and management of musculoskeletal diseases and systemic autoimmune conditions. Typically, these cases involve failure to diagnose and/or treat a rheumatologic condition, treating a rheumatologic condition that does not in fact exist, or a failure to respond to a reaction to a drug (for example, a sulfa drug like Bactrim causing Stevens-Johnson syndrome). Other cases involve capacity to be employed which present in various contexts including divorce cases. Another kind of case involves an insurance company dispute over the medical necessity for treatment of a rheumatologic diagnosis.