Rheumatology


Rheumatology is a sub-specialty in internal medicine and pediatrics, devoted to diagnosis and therapy of rheumatic diseases. Clinicians who specialize in rheumatology are called rheumatologists. Rheumatologists deal mainly with clinical problems involving joints, soft tissues, autoimmune diseases, vasculitis, and heritable connective tissue disorders.

Many of these diseases are now known to be disorders of the immune system, and rheumatology is increasingly the study of immunology. One of the major changes in modern rheumatology is the development of new drugs called biologics, or disease modifying agents, which can control severe disease more effectively.

Rheumatologists treat arthritis, autoimmune diseases, pain disorders affecting joints, and osteoporosis. There are more than 200 types of these diseases, including rheumatoid arthritis, osteoarthritis, gout, lupus, back pain, osteoporosis, and tendinitis. Some of these are very serious diseases that can be difficult to diagnose and treat. They treat soft tissue problems related to musculoskeletal system sports related soft tissue disorders and the specialty is also interrelated with physiotherapy and physical medicine and rehabilitation. Patient education programs and occupational therapy also go hand in hand with this specialty.

Most rheumatic diseases are treated with analgesics, NSAIDs (Non-Steroid Anti-Inflammatory Drugs), steroids (in serious cases), DMARDs (Disease-Modifying Anti-Rheumatic Drugs), monoclonal antibodies, such as infliximab and adalimumab, and the soluble TNF receptor etanercept and Methotrexate for moderate to severe Rheumatoid arthritis. Biologic agent Rituximab (Anti-B-Cell Therapy) is now licensed for use in refractory Rheumatoid Arthritis. Physiotherapy is vital in the treatment of many rheumatological disorders.


Occupational therapy can help patients finding alternative ways for common movements which would otherwise be restricted by their disease. Patients with rheumatoid arthritis often need a long term, coordinated and a multidisciplinary team approach towards management of individual patients, treatment is often tailored according to the individual needs of the individual patient which is also dependent on the response and the tolerability of medications. Diseases diagnosed or managed by the rheumatologist include:

  • Degenerative arthropathies
  • Osteoarthritis
  • Inflammatory arthropathies
  • Rheumatoid arthritis
  • Spondyloarthropathies
  • Ankylosing spondylitis
  • Reactive arthritis (reactive arthropathy)
  • Psoriatic arthropathy
  • Enteropathic spondylitis
  • Juvenile Idiopathic Arthritis (JIA)
  • Crystal arthropathies: gout, pseudogout
  • Septic arthritis

Systemic Conditions and Connective Tissue Diseases

  • Lupus
  • Sjögren’s syndrome
  • Scleroderma (systemic sclerosis)
  • Polymyositis
  • Dermatomyositis
  • Polymyalgia rheumatica
  • Mixed connective tissue disease
  • Relapsing Polychondritis
  • Sarcoidosis
  • Fibromyalgia
  • Vasculitis
  • Microscopic Polyangiitis
  • Eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss Syndrome)
  • Granulomatosis with polyangiitis (formerly known as Wegener’s granulomatosis)
  • Polyarteritis nodosa
  • Henoch-Schönlein purpura
  • Serum sickness
  • Giant cell arteritis, Temporal arteritis
  • Takayasu’s arteritis
  • Behçet’s syndrome
  • Kawasaki’s disease (mucocutaneous lymph node syndrome)
  • Buerger’s disease (thromboangiitis obliterans)

Soft Tissue Rheumatism

Local diseases and lesions affecting the joints and structures around the joints including tendons, ligaments capsules, bursae, stress fractures, muscles, nerve entrapment, vascular lesions, and ganglia. For example:

  • Low back pain
  • Tennis elbow
  • Golfer’s elbow
  • Olecranon bursitis

INTERESTING FACT
RECENTLY, A LARGE BODY OF SCIENTIFIC RESEARCH DEALS WITH THE BACKGROUND OF AUTOIMMUNE DISEASE, THE CAUSE OF MANY RHEUMATIC DISORDERS. ALSO, THE FIELD OF OSTEOIMMUNOLOGY HAS EMERGED TO FURTHER EXAMINE THE INTERACTIONS BETWEEN THE IMMUNE SYSTEM, JOINTS AND BONES. EPIDEMIOLOGICAL STUDIES AND MEDICATION TRIALS ARE ALSO BEING CONDUCTED. SCIENTIFIC RESEARCH ON BIOLOGICS AND CLINICAL TRIALS ON MONOCLONAL ANTIBODY THERAPIES HAVE ADDED A NEW DIMENSION TO THE MEDICAL TREATMENT OF ARTHRITIC DISORDERS....Read More