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Rheumatology
Rheumatology is the medical specialty dedicated to studying, diagnosing, and treating diseases that affect the musculoskeletal system, including bones, joints, muscles, tendons, and ligaments.
It is not normal to experience pain. The rheumatologist’s role is to identify the cause of pain and other symptoms (swelling, warmth, redness, weakness) that affect the joints, muscles, or bones. The aim is to reach the diagnosis of one of the more than 100 known rheumatic diseases.
When to consult a rheumatologist?
Pain in the spine, hands, knees, shoulders, feet, or other joints
Morning stiffness or difficulty moving after periods of rest
Swelling, warmth, or redness in the joints
Weakness or limited movement
Difficulty performing daily tasks due to pain
Fever with no apparent cause
Persistent, unexplained fatigue
Osteoarthritis
Osteoporosis
Tendinitis
Fibromyalgia
Gout
Rheumatoid arthritis
Lupus
Sjögren’s syndrome
Polymyalgia rheumatica
Course of the visit
CLINICAL ASSESSMENT: This is the most important step of the consultation. The doctor will ask detailed questions about the pain, its location, duration, intensity, and triggers. A thorough analysis of all musculoskeletal symptoms is carried out to help determine the cause. Other symptoms that may point to rheumatic diseases are also explored. The physical examination allows the doctor to confirm or rule out inflammation of joints or tendons, muscle weakness, movement limitation, or gait abnormalities. Other organ signs (skin, mouth, circulation) may suggest a specific rheumatic disease.
DIAGNOSIS: To confirm the suspected diagnosis, the rheumatologist may request laboratory tests (including autoimmune markers), X-rays, or ultrasounds. Sometimes, further tests such as bone densitometry, CT scan, MRI, or capillaroscopy (to examine circulation in the fingers) may be needed. Joint aspiration may also be performed to analyse the synovial fluid. Some conditions, such as fibromyalgia, do not show any abnormalities on tests.
TREATMENT PLAN: Once the diagnosis is confirmed, the rheumatologist explains the condition and what to expect. A treatment plan is then established, focusing on healthy lifestyle measures, balanced diet, good sleep, regular exercise, and stress management. Painkillers or anti-inflammatory drugs can help relieve pain and inflammation. For inflammatory rheumatic diseases, corticosteroids or immunosuppressive drugs may be required to control the disease’s progression. In some cases, corticosteroid injections may be indicated to resolve local inflammation. Physiotherapy and rehabilitation play an essential role in relieving pain, maintaining mobility, and strengthening muscles. Referral to orthopaedic surgery may be considered in severe cases with significant disability.
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