Rheumatology is a subspecialty with major specialisation in paediatrics and internal medicine. Autoimmune conditions occur when the immune system produces inflammation in the areas where it is unnecessary resulting in damage to the body. The study generally deals with soft tissues, joints, vasculitis, heritable connective tissue disorders and autoimmune diseases. The rheumatologist specialises in the treatment, diagnosis and therapy of the rheumatic diseases. The field is multidisciplinary. This refers to the fact that the field relies on close relationships with certain other specialities.

There has been a lot of noteworthy advances in this field in recent years, considering the development of state-of-the-art biological drugs with better targeting capabilities. This is mostly because imaging techniques have improved and there have been rapid advances in the basic science of musculoskeletal diseases.

What are the key aspects of modern rheumatology?

Over the last two decades, rheumatology has changed significantly. It had been an inpatient speciality and the treatment methods were not very effective. Now, outpatient services are offered and the specialities are science-based and targeted. However, a fundamental problem that still causes problems is defining the range of illnesses that come under this field, owing to its multidisciplinary views.

The development of new drugs have results with a proper understanding of the pathophysiological processes that are associated with rheumatic diseases. Along with the novel biological drugs available to the physicians today, there are specific registries that evaluate the real-life usage of these agents. Their optimal role in treatment protocols has brought about great changes in the field.

How rheumatology can be beneficial to the patients?

Rheumatology offers diverse prospects for scientific research and clinical treatments. The field is advanced and is expected to develop further in the near future. There would be improved science and better assessment of diseases. Drug usage is being optimised and new biomarkers are being developed which would address the challenges in the field.

What do rheumatologists do?

Rheumatologists work in outpatient clinics. Other physicians or primary care providers might refer you to a rheumatologist if they decide that you need an evaluation. There are rheumatologists whom you can visit with reference from other physicians. Most rheumatologists are affiliated to hospitals and treat patients who might be hospitalised for a rheumatic disorder.

When is it time for you to visit a rheumatologist?

People often suffer from muscle ache and pain in the joint. However, if the pain does not resolve, there might be a need for additional evaluation. If the primary caregiver discovers that there might be an underlying rheumatic condition, you might need a rheumatologic evaluation.

If you have relatives who are known to suffer from autoimmune conditions, referrals would be made very soon. Similar cases would arise if the symptoms worsen over time. There might be signs and symptoms which might resolve through initial treatment but resurface when medication is discontinued. This is when a rheumatology evaluation would be needed.

Treatments relating to the rheumatology evaluation should not be delayed. In the meantime, medications to alleviate the symptoms can be used.

Authored By Dr.V.Sivakumar (M.B.B.S., M.D., FIPM)

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