Definition and Overview
Rheumatology is the branch of medical science that deals with the diagnosis, treatment, and management of disorders that affect the musculoskeletal system. The majority of these disorders are caused by the systemic degeneration and inflammation of joints and soft tissues, autoimmunity and vasculitis (inflammation of blood vessels). The most common among these rheumatology diseases include osteoarthritis, rheumatoid arthritis and gout.
Osteoarthritis – Of all the types of arthritis, osteoarthritis can be considered the most common because it is caused by the normal wear and tear of the joints. The joints of the body, particularly the knees, hips and lower back, are often the most affected because they bear the weight of the body. They may also be easily damaged because of injury or repetitive action. Most senior adults also fall prey to the disease simply because the body grows old and loses its natural flexibility. In osteoarthritis, it is the cartilage (the soft tissue covering the ends of the bones in the joint) that breaks down. When it becomes thinner, the bones no longer have any protection and they rub against each other causing friction, pain, and swelling. In addition, the disease also prompts the growth of new bone around the joint, especially in hand joints, causing pain.
Rheumatoid arthritis – Rheumatoid arthritis is a rheumatologic autoimmune disease. Ordinarily, the body’s immune system acts as the first line of defense in cases of sickness or infection. The antibodies are the immune system’s way of fighting the disease. However, there are times when the immune system makes a mistake and ends up attacking the healthy cells. This is what happens with autoimmune diseases. Rheumatoid arthritis happens because the immune system attacks the joints of the body. The attack happens to pairs of joints, like in both hands or both wrists, and that is what distinguishes it from common arthritis. When the joints are attacked, they become swollen and inflamed and end up damaging both the cartilage (the tissue covering the bones in a joint) and the bones. Rheumatoid arthritis is a chronic, long-term, systemic disease that needs to be monitored and managed continuously.
Gout – This is another type of disease involving the joints and is caused by the build-up of uric acid in the body. The body naturally produces uric acid and excess amounts of it are expelled through urine. However, there are cases when these excess amounts get stocked up in the body and they end up crystallizing in the joints, causing swelling and sometimes, even debilitating pain. Gout often appears in the big toe and affects men more than women. It is easy to discount because it rarely happens and usually resolves itself after a while. However, if it happens regularly, there is a chance that it will become a long-term problem and may lead to joint damage.
Who Should Undergo and Expected Results
Any follow-up appointment with the doctor is necessary because it allows the doctor to monitor and track any changes that have occurred since the last medical or clinical meeting. This allows him to identify any progress and possibly amend the treatment plan based on these changes. A rheumatology follow-up is essential because most of the rheumatology diseases have a tendency to develop into more serious problems over time.
There are different reasons for a follow-up visit. First, the patient goes back for a follow-up monitoring. This is the usual type of a follow-up visit and it may be to check the effect of medications or to evaluate the progress of a treatment plan. Second, there may be a new complaint or a new symptom that the patient has to refer to the doctor. In such cases, the doctor will conduct a thorough examination and will run tests to diagnose the condition and if necessary, provide treatment.
How Does the Procedure Work?
Follow-up visits to a rheumatologist typically follow the same procedure:
- The medical staff will check and record your vital signs, such as weight and blood pressure.
- Any lab test results will be collated and compared to previous test results
- The doctor, previously briefed about your chief complaint, may choose to review your medical history, medications taken and family history to better understand your condition.
- A general physical examination follows, and the doctor may pay particular attention to affected areas that pose problems.
- A discussion or a question-and-answer portion naturally follows as the doctor tries to listen to your concerns and answers any questions that you may have
- The doctor may recommend medication, an exercise treatment program, physical therapy or occupational therapy and additional tests if necessary.
Possible Complications and Risks
There are normally no risks involved when a patient goes for a follow-up check-up. Complications may only arise if the patient keeps certain information to himself. If the doctor is not fully informed about the patient’s health, he will not be in a position to give the best advice for the patient. He may also misdiagnose a symptom and prescribe the wrong medication and treatment for it.
The risk may be when the patient does not keep to his follow-up schedule. This may result in the treatment regressing or the disease getting worse because it’s not getting the proper medication or treatment. It may also lead to further complications if a symptom is not discovered in time especially because rheumatology diseases are systemic, meaning they may affect the entire body over time.
- American College of Rheumatology