Changing Scenario In Rheumatology - For Better Joint Care
(If treated at this stage by modern drugs, further damage can be halted/ or delayed. If not treated at this stage effectively, damage will continue leading to the severe deformity as below.)
Deformed hand joints due to Rheumatoid Arthritis (RA)
Only a few years back, whenever somebody developed persistent joint pains and swelling, it was thought that there is no remedy except few pain killers to relieve the pain and inflammation, patient was doomed to suffer. There was no concept of halting the ongoing march of arthritis, which usually resulted in progressive damage to the joints ultimately resulting a crippling bed ridden/ chair bound state. With the frame of mind of helplessness on part of patients as well as clinicians, these disorders were being managed by multiple agencies by unproven medications and therapies.
In the last decade or so, to deal with medical disorders of the joints not requiring surgery, a new superspeciality called Rheumatology has emerged on the horizon of internal medicine. Modern drugs used in rheumatology have proved their effectiveness in halting the damaging effect of various arthritides especially Autoimmune diseases which include Rheumatoid arthritis (commonly known as Gathiya affecting mainly young females in child bearing age), Systemic lupus erythematosus (Multisystem inflammatory disease with skin rashes, fever and arthritis which can prove life threatening if not treated with urgency), Dermatomyositis ( Skin & muscle inflammation), Polymyositis (Muscle inflammation with severe proximal muscle weakness) and Sjogren’s syndrome (dryness of mouth & eyes and may be associated with joint pains) and of course Osteoarthritis ( Arthritis associated with age, obesity or weak musculoskeleton) to name a few. Rheumatology has developed considerably in recent years with the advent of better understanding of these diseases with modern diagnostic methods and better management with novel therapeutic modalities. A physician who deal with the whole spectrum of causes of Rheumatic deseases is called Rheumatologist. He is specially trained physican who has received specialized advanced training after obtaining MBBS & MD (Medicine) qualification to find out & treat the exact cause of arthritides by proven, scientific, modern rheumatic interventional techniques with the aim to halt the course of the disease and to save the joint from being deformed.
We’ve come a long way in the world of rheumatism and one of the most important things we’ve learned in recent years is that early and aggressive treatment is key to getting arthritides under control and preventing disability. But what is happening in the real world, all joint diseases are being dumped in one basket called arthritis and being treated by all and sundry by all sorts of ingredients and practices. What happens in the mean time, precious time is lost and arthritis continue to march to damage the joint structures to limits of no return. A layman does not understand where to go, whom to seek the scientific, effective treatment. Patients go wherever their friends, relatives and medical practitioner of multiple discipline advices them to go.
Lack of awareness about the meaning of the rheumatologic terms is so acute that, what to talk about lay people, even few doctors, well educated doctors in their field are not aware about the meaning of Rheumatology & Rheumatologist. Very often patient reach to the rheumatologist after having developed multiple disabilities and deformities. With this in mind we are giving below the self explainatory table so that everyone can decide for themselves where to go after developing the musculoskeletal pain in back or limb joints.
|
Symptom |
Medical aspect (Surgery not required) |
Surgical aspect (Surgery required) |
|
Chest pain |
Physician/ Cardiologist |
Cardiac surgeon |
|
Neurological symptoms |
Physician/ Neurologist |
Neurosurgeon |
|
Abdominal |
Physician/ gastroenterologist |
Surgeon/ Gastrosurgeon |
|
Joint pains |
Physician/ Rheumatologist |
Orthopaedic surgeon |
About rheumatism, it is a nonspecific term used by lay persons for various conditions with pain or other symptoms arising from joints (including those in spine ) or related to other elements of musculoskeletal system ( i.e. muscles , tendons, ligaments, cartilage and bone). Rheumatology includes over 120 diseases wherein arthritis and joint-symptoms are commonly present.
With the advent of Rheumatology, battlelines between patients in a partnership with their rheumatologist on one side and disorders we fight on the other have been drawn, and the scientific gauntlet has been thrown. In response to this, the clinical and tectonic plates of rheumatology have shifted in a profound manner, all for the good of our patients. Though a combination of explosions in our knowledge about basic mechanisms of disease, advances in our appreciation of the clinical “personalities” of autoimmune and musculoskeletal disorders, and the rapidity with which basic scientific wisdom is catapulted into therapeutic advances at the bedside, our patients are living better and longer lives. Today,s rheumatologist uses the multiple effective weapons in his armamentarium to detect and intervene the disease process in its budding stage before it causes irreparable damage. He uses advanced immunological tests, imaging techniques (Musculoskeletal ultrasound, C-arm, video capillaroscopy) for this purpose. In other words, we can say that scene has changed in rheumatology for the great advantage to the patients. The need is to spread the awareness about this fact so that everyone can reap the benefit of knowledge of rheumatology and save their joints, the basic transport of human and keep the wheels (joints) of nation moving.
