Rheumatology

Rheumatology is the specialty that deals with the diagnosis, assessment and treatment of rheumatic diseases. These involve both non-surgical diseases of the locomotor apparatus (diseases that attack joints, muscles, tendons, and bones) and systemic autoimmune diseases.

Rheumatic diseases are complex and often times multisystemic (affecting other organs in addition to the osteoarticular system), requiring experience and a pluridisciplinary team approach. The purpose is always an early diagnosis because treatments undergone before potentially irreversible modifications provide patients with the best results.

In view of a correct early diagnosis the rheumatologist may recommend specific blood tests, soft tissue ultrasound, osteoarticular X-rays, magnetic resonance imaging (MRI), osteodensitometry, electromyography, articular puncture with examination of synovial liquid, skin biopsy, etc.

Therapies vary depending on the diagnosis and severity, from analgesics, non-steroidal anti-inflammatory drugs or corticosteroid drugs (cortisone-based medication), immunosuppression therapies (synthetic or biologic), intra-articular injections, antiresorptive treatment (in osteoporosis) or non-invasive rehabilitation therapies.

Examples of diseases treated by the rheumatologist:

• degenerative joint disease – Osteoarthritis with its locations (gonarthrosis, coxarthrosis, Spondylosis, etc.)
• autoimmune or anti-inflammatory diseases – rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis, Sjögren’s syndrome, scleroderma, mixed connective tissue disease, juvenile idiopathic arthritis, adult-onset Still’s disease, Behçet’s syndrome, familial Mediterranean fever, primary or secondary systemic vasculitis.
• spondylarthritis – ankylosing spondylitis, psoriatic arthritis, other peripheral spondylarthritis
• steoporosis and osteopenia
• microcrystalline disease (gout, a disease that results from deposits of calcium pyrophosphate crystals, etc.)
• infectious diseases – septic arthritis
• idiopathic inflammatory myopathy