Rheumatologist what treats? What does a rheumatologist treat in adults?
Rheumatology is a branch of practical medicine, in which specialists are engaged in the study and treatment of rheumatological diseases. Their share in the overall incidence is gradually increasing, which requires the development of effective methods of diagnosis and treatment. The same is necessary to prevent early disability of patients and to improve the quality of life of the sick.
General characteristics of rheumatology
In rheumatology, degenerative, inflammatory and dystrophic joint diseases are studied. They are also complemented by systemic vasculitis, the so-called collagenosis. As tasks, it is worth optimizing their diagnostics and thoroughly studying the predisposing factors. In case of successful implementation of the main rheumatological tasks, the possibility of stopping the pathology in the early stages of detection is practically guaranteed.
And yet, what diseases does a rheumatologist treat? A doctor with this specialization treats diseases of the joints and vessels of the body and heart disease of rheumatological etiology. Patients who are prone to this kind of disease can be isolated from the population in advance. Effective prevention will lead to the fact that the disease does not develop. However, this is only a promising task that requires study.
Classification of rheumatological diseases
Rheumatic diseases are called systemic or local lesions of the connective tissue associated with degeneration, inflammation or dystrophy. The rheumatologist that treats these pathologies must competently understand the types and characteristics of the lesion in a particular pathology. Therefore, all diseases must be classified.
In accordance with the characteristics of the lesion, systemic diseases, diseases of the joints of the axial skeleton, joint pathology of the accessory skeleton, heart disease, systemic vasculitis, and autoimmune skin lesions are distinguished. Systemic diseases tend to affect the entire connective tissue, while local diseases are limited to certain sites.
List of rheumatological diseases
Asking what a rheumatologist treats in adults, many people assume that there are only a few clinical diagnoses. In fact, the whole complexity of rheumatology is that there are a lot of diagnoses. At the same time, symptomatically and clinically different diseases can occur similarly. Often the treatment also has similarities. In general, rheumatological diseases are represented by the following list:
- acute rheumatic fever;
- ankylosing spondylitis;
- rheumatoid arthritis;
- gouty arthritis;
- juvenile (juvenile) arthritis;
- systemic lupus erythematosus;
- Raynaud's syndrome;
- rheumatic acquired heart defects;
- diseases combined in the vasculitis group.
These diseases that the rheumatologist treats in adults have many similarities. The most obvious is the defeat of the connective tissue. At the same time, there are even more diseases in the vasculitis group that are difficult to diagnose and treat. Moreover, the complexity of rheumatology is that these diseases are similar to many others that are treated by other specialists.Therefore, this industry is distinguished by the need to highlight clear criteria for differential diagnosis.
Diseases of the vasculitis group
Vasculitis is one of those pathologies that a rheumatologist treats. The disease is very diverse. Vasculitis is distinguished by its clinical manifestations, location of the lesion, features of the course, specific immunological or histochemical markers. Very important is the fact that many of them are treated quite successfully with the correct timely diagnosis. The vasculitis group is represented by the following diseases:
- Takayasu arteritis;
- temporal arteritis;
- periarteritis nodosa;
- Kawasaki disease;
- Wegener's disease;
- Churg-Strauss vasculitis;
- polyangiitis microscopic;
- hemorrhagic vasculitis Schönlein-Henoch;
- cryoglobulinemic vasculitis;
- anti-GMB disease;
- urticarial vasculitis (hypocomplimentary);
- Behcet's disease;
- primary angiitis of the central nervous system;
- Kogan syndrome;
- dermal arteritis;
- aorta isolated;
- leukocyte clastic skin angiitis;
- sarcoid vasculitis;
- lupus vasculitis;
- rheumatoid vasculitis.
In addition to the above primary vasculitis, there are specific secondary ones. In particular: cryoglobulinemic vasculitis associated with hepatitis C, vasculitis with hepatitis B, with syphilis, drug immunocomplex and paraneoplastic vasculitis. These diseases are found only in the presence of primary pathology. For example, paraneoplastic syndrome develops in response to the growth of a malignant tumor and is a systemic response of the body to a neoplasm.
Rheumatological diseases of the heart
A cardiologist-rheumatologist who treats heart diseases of a rheumatic nature deals with acquired cardiac pathologies. Among them, stenosis of the valves or their insufficiency (isolated and combined) due to lesions with streptococci are most common. These diseases - due to a sufficiently developed medical service and due to broad antibiotic therapy - develop less frequently than before. However, they are still hard to flow and lead to disabling valve damage.
Diagnosis of diseases such as acute rheumatic fever and chronic rheumatic feverheart disease, as well as their treatment and rehabilitation of patients are within the competence of a rheumatologist-cardiologist. At the same time, there are often no such specialists in multi-profile medical centers. Therefore, these diseases are dealt with by a rheumatologist, who also deals with other rheumatic diseases, including diffuse and systemic lesions of the connective tissue and vascular pathology.
Rheumatic lesions of the joints
Joints and bones are derived from connective tissue. Therefore, their defeat is also considered a rheumatologist. What does this specialist treat? He is engaged in the diagnosis and treatment of primary and secondary osteoarthritis, osteoporosis, arthritis and other articular lesions, excluding traumatic ones. In the same industry there is another specialty - orthopedist. He is engaged in the recovery of skeletal functions lost due to the disease.
A rheumatologist most often deals with osteoarthritis. These diseases develop in old age, and in senile they already greatly reduce the physical activity of a person. Much less common is rheumatoid arthritis. This disease often manifests at a young age and continues to worsen in the elderly.Often, rheumatoid arthritis has some systemic manifestations that can significantly worsen the prognosis for the patient.
Also, a rheumatologist that treats the above mentioned diseases is engaged in the diagnosis, treatment and rehabilitation of patients with Bechterew's disease, psoriatic and gouty arthritis, youthful joint damage, and reactive arthritis. The importance of treating these pathologies is very high, because ankylosis soon develops without inhibiting pathological processes. The result is a complete cessation of joint mobility.
Among all the specialties of rheumatology, there is one more - a children's rheumatologist. What this specialist treats should be sorted out in more detail. So, the children's rheumatologist is engaged in the identification and diagnosis of rheumatic diseases that are specific only to children, or those that develop in childhood. There are very few of them, and they are often covered in a general rheumatology course.
It is noteworthy that children's rheumatic diseases are chronic pathologies requiring lifelong therapy.They proceed aggressively and reach the highest stage of activity rather quickly. Among them, the most frequent are the following pathologies: reactive arthropathy, juvenile rheumatoid arthritis, ankylosing spondylitis, nodular polyarthritis, dermatopolimiositis, scleroderma.
According to the statistics of the Ministry of Health of the Russian Federation, the number of cases of rheumatic diseases, first identified in children, is steadily increasing. Probably, the only thing is that medical care has become more accessible, and the diagnosis is more specific. Therefore, cases that were previously ignored are now successfully treated, even if they require the appointment of lifelong therapy. Diseases that the rheumatologist and orthopedic surgeon treats should be studied in more detail, which will make it possible to work out effective prevention and treatment measures.
Systemic collagen diseases are another group of diseases that rheumatologists deal with. These pathologies, in contrast to articular lesions, develop rapidly, but do not lead to a loss of working ability so soon. However, the polymorphism of their manifestations makes it necessary to study them more actively, since during their development they affect many organs.Vessels, skin, all connective tissue, heart valves and myocardium, kidneys and joints are somehow affected by systemic vasculitis.
The most studied, but therefore no less dangerous, collagenoses are systemic lupus erythematosus and scleroderma. The rheumatologist that treats these diseases must have a good understanding of diagnostic criteria. It is also important to determine the clinical course of the disease, which will allow to prescribe an adequate therapy. The goal of treatment is to prevent complications of the disease and eliminate the current severity of the condition.
Despite the presence of modern cytostatics, glucocorticoids and nonsteroidal anti-inflammatory drugs, these diseases are difficult to cure. Also the difficulty is dermatomyositis. These diseases, which the rheumatologist treats in children and adults, are accompanied by a host of systemic reactions. Therefore, the therapy should be started as quickly as possible.
Vasculitis in rheumatology
Any rheumatologist that treats vasculitis is well aware of the main features of their course. However, every expert is convinced that much more about these pathologies is unknown to medicine.In particular, the causes of the appearance of diseases remain poorly understood. Found only general patterns. Sometimes they are not enough to differentiate one vasculitis from another. Moreover, a number of diseases in this category develop along with other diseases. Therefore, this branch of medicine is really important. Hopefully, after reading the article, the reader will become clear who the rheumatologist is, who he is and what he heals.