Rheumatology

Rheumatology, a subspecialty of internal medicine, is devoted to the diagnosis and treatment of rheumatic diseases. Rheumatologists mainly deal with problems involving the muscles and/or joints.

Diseases

Diseases diagnosed or managed by the rheumatologist include:

• rheumatoid arthritis
• lupus erythematosus
• Sjögren's syndrome
• scleroderma (systemic sclerosis)
• dermatomyositis
• polymyositis
• polymyalgia rheumatica
• osteoarthritis
• septic arthritis
• gout, pseudogout
• spondyloarthropathies
  • ankylosing spondylitis
  • Reiter's syndrome
  • psoriatic arthropathy
  • enteropathic spondylitis
  • reactive arthropathy
• vasculitis
  • polyarteritis nodosa
  • Henoch-Schönlein purpura
  • serum sickness
  • Wegener's granulomatosis
  • giant cell arteritis
  • temporal arteritis
  • Takayasu's arteritis
  • Behçet's syndrome
  • Kawasaki's disease (mucocutaneous lymph node syndrome)
  • Buerger's disease (thromboangiitis obliterans)

Diagnosis

Apart from an extensive medical history and physical examination, a rheumatologist may apply the following diagnostic methods:

• Laboratory tests (e.g. erythrocyte sedimentation rate, rheumatoid factor)
• X-rays of affected joints and other imaging methods
• Cytology and chemical pathology of fluid aspirated from affected joints (e.g. to differentiate between septic arthritis and gout)

Treatment

Most rheumatic diseases are treated with analgetics, NSAIDs (anti-inflammatory drugs), steroids (in serious cases), DMARDs ("steroid-sparing" agents) and monoclonal antibodies, such as the recently introduced infliximab and etanercept.

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.

Scientific research

A large body of recent scientific research treats the background of autoimmune disease, the cause of many rheumatic disorders. Epidemiological studies and medication trials are also conducted.