The Rheumatology Department is concerned with the diagnosis and treatment of pain, swelling, limited mobility and loss of function affecting the joints, bones, muscles, connective tissues and soft tissues. Rheumatic diseases are systemic conditions that are not limited to the joints; they can also affect vital organs such as the heart, lungs, kidneys and skin. The goal of early diagnosis and appropriate treatment is to prevent permanent joint damage and organ involvement that may develop as a result of these diseases.
What Is Rheumatology?
Rheumatology is a subspecialty of Internal Medicine that focuses on chronic painful conditions affecting the body's musculoskeletal system, as well as autoimmune diseases. Autoimmunity is a condition in which the immune system mistakenly identifies the body's own cells as foreign and attacks them. Autoimmunity forms the underlying basis of many rheumatologic disorders.
Rheumatology specialists are called rheumatologists. Rheumatologists diagnose rheumatic diseases and develop individualized treatment plans tailored to each patient's specific condition and needs. Since the course of these diseases is often long-term (chronic), close collaboration between the patient and the physician plays a crucial role in improving treatment success.
What Diseases Does Rheumatology Department Treat?
The Rheumatology Clinic deals with a broad spectrum of diseases, including both those resulting from mechanical wear and tear and those caused by inflammatory processes. Main diseases followed-up by rheumatology department are as follows:
- Rheumatoid Arthritis (Inflammatory Joint Rheumatism): It is a chronic inflammatory disease that primarily affects the small joints of the hands and feet and typically follows a symmetrical pattern.
- Ankylosing spondylitis: It is a chronic rheumatic disease that primarily affects the lower back and spine and is characterized by morning stiffness.
- Butterfly Disease (Lupus): It is a systemic connective tissue disease that can affect multiple organs, including the skin, joints, kidneys and blood cells.
- Osteoarthritis (Calcification): It is a mechanical disease that develops as a result of the gradual wear and tear of joint cartilage over time.
- Gout disease: These are sudden and painful attacks that occur as a result of crystal accumulation in the joints due to a disorder in uric acid metabolism.
- Sjögren Syndrome: It is an immune system disorder that targets the exocrine glands and is characterized by dry eyes and dry mouth.
- Psoriatic Arthritis: It is an inflammatory arthritis that can occur in people with psoriasis.
- Behcet's disease: It is a multisystem disease characterized by mouth and genital ulcers, eye inflammation and vascular involvement.
- Vasculitis: It refers to inflammatory conditions that occur in the walls of blood vessels.
- Fibromyalgia: It is a soft tissue rheumatic condition characterized by widespread muscle pain, fatigue and sleep disturbances.
What Are the Diagnostic Methods Used in Rheumatology?
The diagnosis of rheumatologic diseases requires a multidisciplinary approach and is often like putting together the pieces of a puzzle. Clinical examination, the patient’s medical history (anamnesis) and advanced laboratory tests form the basis of the diagnostic process. Rheumatology diagnostic methods include:
- Laboratory Tests: Blood and urine tests are used to measure the level of inflammation in the body and to detect autoantibodies.
- Imaging methods: It is used to observe damage to the joint structure, wear or increased fluid accumulation.
- Joint fluid analysis: The fluid taken from a swollen joint is examined under a microscope to investigate the presence of crystals or infection.
What Are Rheumatology Tests?
Laboratory tests are used to confirm the presence of a rheumatologic disease or to rule out other possible conditions. The most commonly used rheumatology tests are:
- Sedimentation (ESR) and CRP: These are blood tests that indicate the overall level of inflammation (inflammatory activity) in the body.
- Rheumatoid factor (RF) and Anti-CCP: These are specific antibody tests used in the diagnosis of rheumatoid arthritis.
- ANA (Antinuclear antibody) Test: They are critically important for screening lupus and other connective tissue diseases.
- HLA-B27: It is a genetic marker that is checked when ankylosing spondylitis is suspected.
- Uric Acid: It is evaluated for diagnosis and follow-up of gout disease.
- Complete blood count and kidney/liver function tests: It is performed to monitor the systemic effects of the disease and assess suitability for medication use.
Who Should Apply To Rheumatology Department?
Not every joint pain indicates a rheumatic disease but certain specific symptoms suggest that a consultation with a rheumatologist is necessary. It is especially important for individuals with a genetic predisposition to closely monitor their symptoms. It is appropriate for the following individuals to consult the rheumatology department:
- Those who experience stiffness in the joints or lower back lasting longer than 30 minutes upon waking in the morning
- Those who experience redness, swelling and a feeling of increased warmth in the joints
- Those who have lower back and upper back pain that worsens during rest and improves with movement
- Those who develop excessive sensitivity to sunlight or a butterfly-shaped rash on the face
- Those who have unexplained recurrent fever and fatigue
- Those who observe whitening or bluish discoloration of the fingers in response to cold (Raynaud phenomenon)
What are the Treatment Methods of Rheumatological Diseases?
The treatment of rheumatologic diseases varies depending on the type and severity of the disease, as well as the patient’s overall health condition. The primary goals of treatment are to suppress inflammation, relieve pain and improve the patient’s quality of life while preventing joint damage. The main treatment methods used in the management of rheumatologic diseases are as follows:
- Medication therapy: Anti-inflammatory drugs, corticosteroids and disease-modifying antirheumatic drugs (DMARDs) are used.
- Biological methods: In cases that do not respond to conventional treatments, advanced medications targeting specific components of the immune system are preferred.
- Physiotherapy and Rehabilitation: Exercise programs are implemented to maintain joint range of motion and strengthen the muscles.
- Lifestyle adjustments: A Mediterranean-type diet, maintaining an ideal body weight and quitting smoking are factors that support the success of treatment.
Frequently Asked Questions About Rheumatology
Is Rheumatism Seen Only In Elderly People?
No, rheumatic diseases can occur in all age groups, including childhood.
Does Inflammatory Arthritis Heal Completely?
Many rheumatic diseases are chronic but the disease can be kept under control with modern drug therapies.
Can Rheumatism Patients Do Sports?
Yes, it is especially recommended for patients with rheumatic diseases to perform exercises such as swimming, walking, and Pilates that do not place excessive stress on the joints in order to maintain joint health.
Is Hot Spring Therapy Good For Inflammatory Arthritis?
During periods when inflammation is active (when the joint is swollen and warm), heat applications and going to thermal spas may worsen the condition; therefore, a doctor should always be consulted.
Is Genetic Predisposition Important In Rheumatism?
In some rheumatic diseases, genetic predisposition is an important risk factor, but environmental factors also play a triggering role in the development of the disease.
Should You Go To Rheumatology For A Lower Back Hernia?
For lower back hernia, patients should first consult the Department of Neurosurgery; however, if there are accompanying inflammatory conditions, the rheumatology department should be consulted.
