What is Rheumatology?
Rheumatology is the medical specialty that is concerned with arthritis and other diseases of inflammation. Inflammation can occur anywhere in the body, but it is most common in the joints and connective tissues. Arthritis, which occurs in the joints, is also a very common condition, so rheumatology is strongly associated with joint care. But rheumatology is about more that just arthritis. Other conditions that a rheumatologist might treat include:
Lupus, a chronic inflammatory disease
Ankylosing spondylitis, inflammation at the base of the spine
Sjogren’s syndrome, an autoimmune disorder that stops production of tears and saliva
Fibromyalgia, a disorder causing widespread, chronic pain and fatigue
Pediatric rheumatologists are doctors that specialize in treating inflammatory diseases in children. Rheumatoid arthritis, lupus, and other inflammatory diseases can begin even in childhood, and can cause a unique set of problems for active and growing children.
Rheumatologists use patient symptoms as well as lab tests and imaging tests such as MRIs to diagnose disease. Treatment varies widely depending on the diagnosis, but it may include physiotherapy (to improve motion, ability, and function) or medications. Commonly prescribed medications include anti-inflammatories such as NSAIDS (e.g. Tylenol, Ibuprofen) and steroids, or immune system suppressants such as methotrexate and TNF inhibitor medications (e.g. Enbrel, Humira). The goal is always to increase the patient’s ability to move without pain and to reduce the need for future treatment.
Orthopedic surgeons, sometimes just called orthopedists, are surgical doctors of the musculoskeletal system. They work to keep your body active and in motion by treating problems with your bones, joints, tendons and muscles. The most frequently treated disorder seen by orthopedic surgeons is osteoarthritis, a common “wear-and-tear” problem where the cartilage that cushions the ends of the bones wears down, causing friction and pain. Orthopedic surgeons might also see patients for bone and joint deformities, amputation, infections of the bone and joint, overuse injuries, or nerve compression.
Orthopedic surgeons can order tests such as blood work and x-rays to get a clearer picture of the issue. Depending on the illness or injury, more than one different form of treatment may be used. Treatment may include:
Surgery, such as fusing bones together to increase stability, or replacing a joint
Medication, such as pain medication or steroids to promote healing
Casts, splints, or orthotics (devices such as braces or shoe inserts to support the body)
Physical therapy, a kind of treatment using exercise, stretching, heat, and massage to heal the body
Exercise, stretching, movement, and use of the affected part
Orthopedic surgeons also work to prevent injuries and slow the progression of disease in their patients. They educate patients on ways to prevent future injuries, and they treat illness in order to prevent further damage to bones or joints that may be affected by disease. The goal of an orthopedic surgeon is to help their patients restore movement and regain an active life.
Geriatrics is the subspecialty of internal medicine that provides primary care to older adults. Physical health tends to decline with age, and geriatricians work to manage such age-related concerns as chronic illness, frailty, multiple medications, and declining mental health to keep seniors as active and independent as possible.
Some of the most common concerns seen by a geriatrician include:
Mobility issues, including the need for canes and walkers, as well as preventing falls
Osteoporosis, a weakening of the bones, which affects as many as a quarter of all men and half of all women over fifty
Loss of hearing or vision
Incontinence, or the inability to control one’s bladder
Memory loss, including dementia and Alzheimer’s disease
A geriatrician may also provide their patients with comprehensive care that includes checking on their social health. Seniors are at increased risk for poverty, loneliness, abuse, and injuries in the home. As part of their health care, a geriatrician may inquire about family support, living conditions, or the ability of a patient to perform daily self-care tasks.
In some cases, a geriatrician may serve as an advisor to other physicians on a specific case or condition. However, most of the time geriatrics is a primary care specialty, and geriatricians provide routine health care to the older patients they work with.