Definition and Overview
A rheumatology consultation is an appointment with a rheumatologist, a medical professional who specializes in the diagnosis and treatment of rheumatoid arthritis and other related diseases. This consultation usually follows a referral from a general physician or family doctor after the patient experiences some symptoms of arthritis. The procedure is essentially a discussion and evaluation of the patient’s symptoms to diagnose the condition and begin the necessary treatment.
Who Should Undergo and Expected Results
A rheumatology consultation is beneficial for those who are suffering symptoms of rheumatoid arthritis, which include the following:
- Stiffness in the joints
- Joint pain
- Limited range of motion affecting any joint in the body
- Redness around the affected area
- A warm sensation around the affected area
- Visible deformities in the joint
A patient who suspects that his symptoms may be related to arthritis may consult with his primary care provider first, such as a family physician. If the physician sees that symptoms are the same with those of arthritis, he will make a referral to a rheumatologist.
There are over a hundred different types of arthritis and even more problems related to them, so a consultation with a medical professional specializing in these conditions is a must.
After the consultation, the patient can expect to receive a diagnosis, an assessment of how the disease has progressed so far, and a brief explanation of available treatment options. If, for some reason, an accurate diagnosis is not possible during the initial consultation, diagnostic tests such as imaging scans and blood tests will be conducted. The results of which will assist the rheumatologist in making a final diagnosis.
How Does the Procedure Work?
During a rheumatology consultation, the consulting specialist may ask about:
- Symptoms and related details, such as when they were first experienced, how intense they feel, and how long the patient has been experiencing them
- The specific type of pain being experienced, i.e. dull, throbbing, sharp, burning, or pain that radiates to other nearby body parts
- How the pain affects the patient’s life and activities, i.e. is it keeping the patient from performing daily tasks, doing his job, or sleeping soundly?
- Medical history
- Family history of arthritis
- Background information, such as any recent injury, what triggers the pain, when does it usually start, when is it the worst, and how long the symptoms last before they subside
The rheumatologist will then perform a physical exam to check the affected area where the symptoms are felt. He will also check the patient’s eyes, mouth, and skin for any signs of redness, swelling, or rashes. The affected area will then be examined by asking the patient to bend and stretch the joints; doing so may be painful for the patient. If the pain is too intense, patients should inform the rheumatologist right away.
If the information gathered during the rheumatology consultation is not sufficient, the rheumatologist will order some tests, some of which are generalized while others are specialized or used specifically to diagnose arthritis. Generalized tests include chemistry panels and a CBC (complete blood count), whereas specialized tests for evaluating arthritis include:
- RF or rheumatoid factor test
- ANA or antinuclear antibody
- CRP or C-reactive protein test
- LE or lupus erythematosus test
- ESR or erythrocyte sedimentation rate test
These tests will help the rheumatologist arrive at a more definite conclusion regarding the patient’s condition. Once a diagnosis is confirmed, the patient may begin treatment. In most cases, the initial form of treatment is the administration of medications, such as methotrexate or corticosteroids, which are most helpful for mild arthritis. If the disease has progressed to an advanced stage, stronger medications such as biologic response modifiers may be required. The rheumatologist may also prescribe pain relievers such as ibuprofen or aspirin to help with the pain.
The patient will also be given some advice on lifestyle changes or activities that may help improve his condition. These may include physical and occupational therapy.
Possible Risks and Complications
Since the patient is only going in for a consultation, there are no risks involved. However, the information exchanged and discussed during this appointment will play a significant role in any treatment, if found necessary.
Thus, in order to avoid risks and complications during the treatment process, it is important that the patient provides complete and accurate information during the consultation. The information should include any allergies to medications the patient may have, as well as any medications, herbal supplements, and nutritional supplements of any kind that the patient is taking. The patient should also disclose the dosage of each medication or supplement, as well as when and how often they are being taken. Doing so will fully acquaint the doctor with the patient’s condition, allowing him to make safe and appropriate treatment recommendations.
- American College of Rheumatology
- The American Society of Clinical Rheumatologists