1. Who Is a Rheumatologist?

A rheumatologist is a physician who diagnose and treats musculoskeletal diseases and autoimmune conditions also known as rheumatic diseases. To become a rheumatologist, after graduating from medical school, a doctor needs to complete a residency program in internal medicine or pediatrics, followed by fellowship training in rheumatology.

Rheumatologists manage complex systemic disorders that affect the musculoskeletal system (joints, bones, tendons, ligaments, muscles), and also other organs or systems. Common conditions treated by a rheumatologist include osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus (SLE or lupus), gout, psoriatic arthritis, vasculitis, myositis, Paget disease, sarcoidosis, tendinitis, bursitis, ankylosing spondylitis, scleroderma, Sjögren’s syndrome, and fibromyalgia.

A primary care doctor will usually refer you to a consultant rheumatologist. Rheumatologists work closely with other specialists including physiotherapists, occupational therapists, orthopedists, nephrologists, or dermatologists.

2. When Should I See a Rheumatologist?

Symptoms that indicate you may need to see a rheumatologist or consult an online rheumatologist include:

• Joint pain
• Joint stiffness, redness, or swelling
• Limited mobility or inability to move a joint
• Chronic neck or back pain
• Dry mouth, dry eyes
• Dry skin or skin rashes
• Fever and fatigue
• Muscle pain and flu-like symptoms
• Loss of appetite
• Weight loss

You may also want to see a rheumatologist if you have a family history of autoimmune diseases.

3. What Kinds of Tests Does a Rheumatologist Perform or Recommend?

Your rheumatologist may request or perform tests including:

• Imaging including x-rays, CT, MRI, ultrasound
• Complete blood count, metabolic panel
• Urine tests
• Erythrocyte sedimentation rate
• Inflammatory markers including acute phase reactants (such as C-reactive protein, fibrinogen, or serum amyloid), cytokines (such as interleukins, TNF, interferon), and others
• Auto-antibodies (such as rheumatoid factor, anti-CCP, anti-nuclear antibody, and others)
• Kidney and liver function tests
• Uric acid
• Synovial fluid analysis
• Biopsies such as synovial, skin, or muscle

4. What Questions Should I Ask a Rheumatologist?

You may want to ask a rheumatologist online or in person about these kinds of questions:

• What is my condition? What are the complications of this condition?
• What is the recommended treatment? Are there any alternative treatments available?
• Are there any risks involved with taking or not taking the treatment?
• Will the treatment affect my work or other activities?
• Will I need surgeries in the future?
• Do you recommend physical therapy for my condition? Will that help?
• Should I continue taking my other medicines?
• How should I treat pain and fatigue?
• Will I have to take these medicines for the rest of my life?
• Do I need any special diet or supplements?
• What exercises can I perform at home?
• Are there any restrictions in traveling, work, sex, or exercise?
• Is it okay to get pregnant with this condition?
• Are other people in my family at risk of getting this disease?
• Are there any support groups for this disease? How should I find one?
• How often should I have follow up visits or lab tests?