Rheumatology is the branch of medicine dealing with the causes, pathology, diagnosis, and treatment of rheumatic disorders. In general, rheumatic disorders are characterized by inflammation, degeneration, or metabolic derangement of the connective tissue structures of the body, especially the joints, joint capsules, tendons, bones, and muscles. There are over 150 different forms of rheumatic or musculoskeletal diseases. These conditions may be acute or chronic, and affect people of all ages and races. At Pacific Rheumatology Associates, we specialize in managing all aspects of rheumatic illness.

What is a rheumatologist?

A rheumatologist is an internist or pediatrician who received further training in the diagnosis (detection) and treatment of musculoskeletal disease and systemic autoimmune conditions. After residency, they must enroll in a rheumatology fellowship for two - three years to learn about chronic musculoskeletal and autoimmune conditions and their treatment.

Rheumatologists then take a board examination to become board certified in rheumatology. This certification/exam has to be retaken every ten years. Physicians are also required to participate in a certain amount of continuing medical education on a yearly basis.

When should I see a rheumatologist?

Everyone experiences muscle and joint pain from time to time. When the muscle and joint pain is not resolving as one would expect, additional evaluation may be needed. Typically, the primary care physician is seen for the first evaluation. If there is concern for an underlying rheumatic condition, he/she will refer you to rheumatology for evaluation.

Earlier referral should be made if you have relatives with autoimmune or rheumatic disease (as these conditions run in families) or if the symptoms are significantly worsening over a short period of time. Some of the signs and symptoms can improve or temporarily resolve when initially treated but can return once the medication is stopped. If the symptoms continue to return, a rheumatology evaluation may be needed. Although treatment should not be delayed while awaiting a rheumatology appointment, certain medications can improve symptoms and make a diagnosis more difficult.

Joint damage can occur if the symptoms of joint pain are ignored or not treated properly over a period of time. This damage cannot always be reversed with treatment and may be permanent. Do not delay appropriate evaluation.

What should I bring to my first rheumatology visit?

Please bring the following to your first rheumatology visit at Pacific Rheumatology Associates:

  • Any previous lab and/or radiographic X-ray/ultrasound/MRI tests results for review (medical records are typically sent by the referring physician, but occasionally – despite best intentions – are not present. Sometimes tests need to be repeated to confirm the result)

  • An up-to-date medication list with the specific dosages you are taking (include a list of medications you have already tried to reduce duplication of prior treatments)

  • A list of allergies to medications

  • Your family history, including any known relatives with rheumatologic/autoimmune disease

  • Your insurance card

Is specialty care more expensive?

Typically, the insurance co-pay is higher to see a specialist than a primary care physician. You may be surprised to learn that specialized care may save time and money in the long-term, as well as reduce severity of the disease. A rheumatologist has special training to spot clues in the history and physical exam that can lead to earlier diagnosis and is knowledgeable about testing that may reduce unnecessary procedures and save you money.

 Adapted from the American College of Rheumatology website (www.rheumatology.org)