A rheumatologist is a medicine physician or paediatrician, who is qualified by additional training and experience in the diagnosis and treatment of arthritis and other diseases of the joints, muscles and bones. Many rheumatologists conduct research to determine the cause and better treatments for these disabling and sometimes fatal diseases.
What kind of training do rheumatologists Have?
In South Africa, rheumatologists must first complete an MB ChB (six years followed by an internship of two years), then four years specialising to be a general physician and a further two years of training to become a rheumalogist.
What do rheumatologists treat?
Rheumatologists treat arthritis, certain autoimmune diseases, musculoskeletal pain disorders and osteoporosis. There are more than 100 types of these diseases, including rheumatoid arthritis, osteoarthritis, gout, systemic lupus erythematosus (SLE), back pain, osteoporosis, fibromyalgia and tendonitis. Some of these are very serious diseases that can be difficult to diagnose and treat.
When should you see a rheumatologist?
If musculoskeletal pains are not severe or disabling and last just a few days, it makes sense to give the problem a reasonable chance to be resolved. But sometimes, pain in the joints, muscles or bones is severe or persists for more than a few days. At that point, you should see your physician.
Many types of rheumatic diseases are not easily identified in the early stages. Rheumatologists are specially trained to do the detective work necessary to discover the cause of swelling and pain. It’s important to determine a correct diagnosis early so that appropriate treatment can begin early. Some musculoskeletal disorders respond best to treatment in the early stages of the disease.
Because some rheumatic diseases are complex, one visit to a rheumatologist may not be enough to determine a diagnosis and course of treatment. These diseases often change or evolve over time. Rheumatologists work closely with patients to identify the problem and design an individualised treatment program.
In South Africa there is a great shortage of rheumatologists, and according to the Arthritis Foundation, not more than 40 or 50 in the country as a whole. According to the World Health Organisation, there should be one for every 180 000 people, so the shortage is obvious in South Africa. Most of them are also attached to the training hospitals in urban areas.
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(Susan Erasmus, Health24, updated April 2010)
(Sources: Health24, Arthritis Foundation)