Rheumatologist

A rheumatologist is a specialist in the field of study, examination and treatment of rheumatological diseases, as well as the development of measures for their prevention. Rheumatology, as one of the specializations of internal medicine, deals with the diagnosis and treatment of diseases of the joints and connective tissue associated with rheumatism. This branch is closely connected with cardiology, endocrinology, nephrology, hematology, and indirectly with immunology, toxicology, infectology, neurosurgery, so a rheumatologist simply needs specialized knowledge in these areas of medicine. A doctor of such a wide profile is able to correctly establish both the diagnosis and describe a detailed treatment regimen, taking into account all the features of rheumatic diseases.

Doctor-rheumatologist: what does he do

The main field of activity of this doctor is the fight against rheumatological diseases that affect the connective tissues, blood vessels and joints in the human body. A rheumatologist, when receiving a patient, first of all collects an anamnesis of his life and a medical history, finds out all the symptoms that disturb the patient, and prescribes additional studies to make an adequate diagnosis. It is for this reason that a rheumatologist should also be a qualified diagnostician.

Having established what kind of disease the patient is concerned about, the doctor prescribes a treatment regimen in order to reduce the manifestations of symptoms, alleviate the patient’s well-being and overcome degenerative or dystrophic processes in the body that cause a specific disease.

The development of preventive measures, as well as therapy to maintain patients with chronic forms of rheumatological diseases, also belongs to the conduct of rheumatologists.

Body parts and tissues affected by rheumatic diseases

The main lesions in the human body are the articular apparatus, blood vessels and connective tissues. For this reason, a rheumatologist treats almost all parts of the body with symptoms of inflammation or destruction of joints, blood vessels, or a particular type of tissue – it can be the neck, limbs, back, hands, feet, the cardiovascular system of the body.

Diseases treated by a rheumatologist

All diseases with a characteristic rheumatoid nature are classified according to various criteria. So, for example, they distinguish:

• dystrophic and inflammatory joint processes: these include gout, all types of arthritis (idiopathic, reactive, rheumatoid, infectious, juvenile), ankylosing spondylitis, osteoarthritis;
• systemic vasculitis: lesions that differ in etiology, but have the same manifestation – inflammatory processes in the vessels. Among them, Wegener’s granulomatosis, nodular periarteritis, Buerger’s disease are common;
• systemic autoimmune connective tissue diseases: scleroderma, lupus erythematosus, Behcet’s disease;
• acute rheumatic fever: characterized by the development of pathological processes in the membranes of the heart;
• microscopic vasculitis, Horton’s arteritis, hypereosinophilic angiitis are isolated into a separate group of rheumatoid diseases.

Arthritis is a process of inflammation and deformation of the inner layer of the articular bag and cartilage. They can develop as a consequence of psoriasis, past genitourinary and intestinal infections, or as a result of disorders in the immune system. Characterized by limitations in mobility, pain, curvature of the limbs or spine.

Gout is a pathological condition in which uric acid crystals are deposited in the joints.

Bechterew’s disease is an inflammatory process of an autoimmune nature that affects the intervertebral discs.

Osteoarthritis is an inflammatory disease that causes the cartilage tissue to lose substances that give it density.

Vasculitis usually occurs due to disorders in the immune system. Wegener’s granulomatosis is an inflammation of the arteries, arterioles, capillaries and venules of the eyes, kidneys and respiratory tract. At the site of inflammation, a nodule is formed, which dies over time. Periarthritis nodosa is an inflammation of the walls of the arteries with the formation of microaneurysms. Buerger’s disease is characterized by partial or complete occlusion of arterial cavities.

Scleroderma or systemic sclerosis is a process of inflammation of small blood vessels, as a result of which fibrous tissue begins to grow around them and collagen accumulates. At the same time, the walls of the vessels thicken, the lumen of their cavities decreases.

Systemic lupus erythematosus is a disease in which the body’s immune system begins to actively produce antibodies to the DNA of its own cells. A rash appears in the cheekbones, ulcers appear in the mouth, convulsions, pleurisy, psychosis, anemia, pleurisy, and pericarditis are also accompanied by lesions.

Behçet’s disease is an inflammatory process of the vessels of the mucous membranes of the eyes, mouth, gastrointestinal tract and genital organs, and causes the development of ulcerative formations.

Microscopic vasculitis is an inflammation of the vessels of the internal organs, mainly the kidneys and lungs.

Horton’s arteritis affects the temporal artery and leads to narrowing of its lumen.

Actually rheumatism has several forms of manifestations:

• rheumatic heart disease, which negatively affects the membranes of the heart;
• rheumatoid arthritis – inflammatory processes in the joints;
• rheumatic pleurisy – inflammation of the lining of the lungs, which has an autoimmune character;
• skin rheumatism with the formation of erythema and nodules in the subcutaneous tissue.

Who is a rheumatologist-cardiologist, why you need to contact him

Having studied the above classification of diseases, it can be understood that many rheumatological diseases have a direct effect on the heart and blood vessels.

A cardiologist-rheumatologist, in fact, is an adjacent doctor, and can make the most accurate diagnosis in case of manifestations:

• endocarditis;
• myocardial damage;
• violations of the patency of blood vessels;
• development of arrhythmias.

All these symptoms can be caused directly by rheumatism, the treatment of which is mainly directed by the activities of a cardiologist-rheumatologist. Systemic lupus erythematosus, vasculitis and scleroderma are also reasons for consulting a specialist in these related profiles.

When to visit a rheumatologist

The main symptom that should alert a person and force him to make an appointment with a rheumatologist is systematically recurring pain, concentrated around one or more joints. Other reasons for visiting a doctor are a change in the shape and appearance of the joints, a decrease in their mobility.

People with a hereditary predisposition need to be constantly under the supervision of a specialist, and from time to time undergo special examinations.

Frequent viral diseases, such as tonsillitis, are also a reason for consulting a rheumatologist. The fact is that systemic inflammatory diseases that are provoked by viral pathogens affect, among other things, both joints and connective tissues. In addition, any tendencies to sore throats and infectious diseases indicate the features of the functioning of the immune system, which the rheumatologist also pays attention to.

A feeling of stiffness in the back, a crunch in the joints and spine, accompanied by the appearance of inflammation and swelling, also suggests that it is time to make an appointment with a doctor or call a doctor at home.

Constantly elevated body temperature, increased temperature of the skin on the joint, pain, aches and weakness, stiffness in the morning – a sufficient set of symptoms that require consultation with a rheumatologist.

Pediatric rheumatology is a separate area of ​​the healthcare industry

Despite the fact that most rheumatoid diseases appear already in adults, the prerequisites for their appearance can be detected even in childhood. In addition, inflammatory processes in connective tissues, especially those that have hereditary prerequisites, begin to cause concern even in childhood. Such lesions are extremely dangerous, because, not being detected at a very young age, in adulthood they can cause serious inconvenience to a person, and sometimes even cause disability.

It is for this reason that a pediatric rheumatologist should be a highly qualified specialist who is well versed in the problem and characteristics of the child’s body. For example, diseases such as tonsillitis in children are one of the decisive factors in the development of rheumatism, which a pediatrician must know about.

It is not uncommon for a child to be affected by rheumatic fever – such a disease requires the appointment of appropriate antibiotics, otherwise there is a risk of developing heart defects in the form of complications after the disease.

Diagnostic and treatment methods relevant for rheumatological lesions of the body

Often, having felt unusual symptoms and sensations in the body, in particular, in the joints, a person cannot independently determine which specialist should be contacted with this problem. Therefore, first the patient gets to the therapist or surgeon. These doctors, after conducting the primary diagnosis, if necessary, refer to a rheumatologist.

For the most successful diagnosis, the doctor conducts some special activities – a patient survey in order to systematize and study the primary symptoms; study of the hereditary factor, since rheumatological diseases tend to transmit a hereditary predisposition; visual and palpation examination; body temperature measurement; tests (general blood and urine, rheumatic tests, rheumatoid factor, analysis for the presence of uric acid); magnetic resonance imaging (allows you to clarify the condition of the soft tissues around the lesion, helps to make a more accurate diagnosis in rheumatic pathologies of nerve fibers, intervertebral discs and vascular ligaments); CT scan; ultrasound diagnostics of joints, cartilage, muscles, ligaments; X-ray research methods.

The main method of treating rheumatological diseases is medication, although in some cases traditional medicine and methods of extracorporeal hemocorrection are used.

Drug therapy is aimed at inhibiting the process of cell destruction, reducing pain and feeling of stiffness of movements. For these purposes, non-steroidal anti-inflammatory drugs, cytostatics, glucocorticosteroid hormonal agents are used. The action of cytostatics is aimed at suppressing the process of cell division in the body, so they are often used to treat vasculitis. Antibiotics and immunosuppressants may also be prescribed.

In some cases, extracorporeal hemocorrection is prescribed – plasmapheresis, cascade filtration of blood plasma, that is, processes for modifying blood components specially selected from the human body, followed by transfusion of the obtained components to the patient after the purification process.

Rehabilitation of patients is carried out using laser and magnetic therapy, thermotherapy and phototherapy, massage and strengthening physiotherapy exercises.

A rheumatologist is a highly qualified specialist who studies, diagnoses, and treats diseases of rheumatological origin. Given that these diseases affect the joints and blood vessels, and can affect the functioning of the cardiovascular system, both rheumatologists and rheumatologists provide assistance to patients.