WHAT IS RHEUMATOLOGY?
The field of rheumatology covers all conditions which affect joints, bones, muscles, tendons and immune system.
RA (Rheumatoid arthritis), Inflammatory Myositis, Spondyloarthritis and related diseases, SLE, Scleroderma, Sjogren’s Syndrome and other Collagen tissue disorders, Fibromyalgia, Osteoarthritis, Osteoporosis and other metabolic bone diseases are some of the common Rheumatic disorders
Symptoms can range from simple aches & pains, shoulder stiffness or knee discomfort following unusual exercise, through to low back pain, multiple joint pain and swelling or generalized stiffness that can acute or long standing (chronic).Even symptoms like fever, weight loss, weakness, rashes, hair fall, oral ulcers could be due to Rheumatic diseases.
Whatever the condition, it has become clear that early diagnosis and treatment can greatly improve the outcome. For example, in some of the more persistent conditions such as rheumatoid arthritis, SLE, gout and osteoporosis, modern treatment has proved so effective that these diseases can be brought completely under control. The advances in rheumatology have been made possible not just with new drugs, improved radiology and scanning techniques but with evolved evidence based strategies to treat these conditions with better outcome.
RHEUMATOLOGY DIAGNOSIS
There are many inflammatory, degenerative or autoimmune rheumatic diseases with predominant symptoms of joint and muscle aches & pains. Trained rheumatologists differentiate most rheumatic conditions from the history and clinical examination
However, advances in x-ray and scanning techniques have, over the past decade, proved extremely valuable in the diagnosis of rheumatic conditions. For example while simple x-rays detect bone conditions such as fractures , bone damage or bone deformities and osteoarthritis. They are less effective in imaging “soft tissues” such as tendons.
CT scanning and MRI (magnetic scanning) now give clear pictures of muscles, ligaments and tendons, for example in painful shoulder conditions such as ‘frozen shoulder’, in joint conditions and in low back pain.
The machines themselves have also become more ‘user-friendly’ – for example, we now have ‘extremity MRI’ machines, allowing a look at, for example, arm or leg lesions without having to immerse the whole patient in an MRI scanner.
Another advance has been in the use of ‘DEXA' scanning in the diagnosis and management of osteoporosis. Also known as Dual Energy x-ray Absorptiometry, no x-rays are involved. Dexa Scanning instead uses bone mineral densitometry technology to measure and monitor changes in bone density.
Some patients will require other investigations such as blood tests to identify inflammatory and autoimmune diseases like RA, SLE, other collagen tissue disorders etc
Some patients may also need opinion from other specialists like haematologists, spine surgeons, knee surgeons, chest physicians etc
RHEUMATOLOGY TREATMENT
The medicine used in rheumatology have made huge strides. Newer anti-inflammatory and disease modifying medicines have replaced the older drugs with vastly improved efficacy, safety profile and lesser adverse events.
New medicines and Biological drugs are being introduced in the treatment of RA, Spondyloarthritis, Osteoporosis,Lupus and other collagen tissue disorders with improved safety and efficacy