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Diagnosis and Treatments

Patients are usually referred to a rheumatologist when their GP feels that they need some extra testing or more specialised care for a condition affecting their muscles, bones or joints. If you have been advised to see a rheumatologist, your visit will usually begin with a chat about your symptoms and a physical examination.

Learning about your medical history can provide some important clues that will help your doctor to work out exactly what is wrong, so rheumatologists often need to ask a lot of questions. As well as talking about the types of symptoms that you have experienced, when they have occurred, and how severe they have been, the rheumatologist will also need to carry out a physical examination.

This will often involve a series of standard diagnostic techniques that allow the doctor to take a closer look at your joints. The goal will be to look for any signs of inflammation or structural problems affecting the muscles, bones or connective tissues, and to check how well the joints are working. The medical history and physical examination should, together, produce some useful clues as to what might be causing your illness.

However, the doctor will often need to order some extra tests in order to confirm the suspected diagnosis. The tests that rheumatologists are most likely to ask for are imaging tests such as X Rays or ultrasounds and blood tests or laboratory tests of fluids taken from the affected joints.

Once the results have been returned from the lab, a precise diagnosis should be possible, although it can sometimes take a little longer to work out exactly what is wrong. The types of conditions that a rheumatologist typically encounters include problems such as back pain and tendonitis that may have come about as a result of overexertion or injury, osteoporosis, and various forms of arthritis, including osteoarthritis, rheumatoid arthritis, and psoriatic arthritis.

It is also common to see patients with many other inflammatory and autoimmune disorders such as lupus, gout and ankylosing spondylitis. Rheumatologists can also encounter some less common conditions, each of which needs to be treated in a particular way.

Narrowing down the diagnosis to work out exactly what is causing your symptoms will enable your doctor to give you a prognosis of how your condition might progress as well as a treatment plan that will help you to manage the symptoms or to tackle the underlying causes.

Among the treatment options that can be offered by a rheumatologist are various forms of pain relief and medication. Patients are often prescribed a course of tablets to take at home, but rheumatologists can also administer steroid injections directly into affected joints to relieve pain in serious cases. Medications can also be used to treat particular conditions.

For example, there are a selection of different drugs that can be used to treat rheumatoid arthritis, so a rheumatologist might need to decide whether a drug like methotrexate will be the right choice to prevent joint damage in a particular patient, or whether it might be better to try one of the newer biological agents that are becoming available to treat this condition.

Rheumatologists are also likely to refer their patients to other medical professionals for extra treatments. Other therapists who often work with patients affected by rheumatic conditions include podiatrists, occupational therapists, and physiotherapists.

Finding the right combination of therapies can make a significant difference for many people affected by musculoskeletal conditions, but the treatment can often be long term, or even lifelong. This means that many patients develop close relationships with their rheumatologists, who will need to keep a close eye on how the symptoms and treatment are progressing over time.