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scleroderma; polymyositis; dermatomyositis; sarcoidosis; temporal arteritis; Wegener's granulomatosis and other vasculitis rheumatologist assesses: + Signs and symptoms, including systemic involvement When Should a patient See a Rheumatologist? When evaluating patients who present with painful, red, swollen or warm joints, or musculoskeletal pain that is severe or lasts more than a few days, consider referral to a rheumatologist for screening. According to the American College of Rheumatology (ACR), a rheumatologist is specially trained to find rheumatic diseases in the early stages, when some problems respond best to treatment. Correct diagnosis and early treatment are critical to prevent joint damage, for example. Because some rheumatic diseases are complex and serious and can be hard to diagnose and treat, one visit to a rheumatologist may not be enough to determine a diagnosis and formulate a treatment plan. These diseases tend to be chronic and often change over time. They may get worse, or they may go into remission and return after some time. Rheumatologists work closely with patients over time to find the problem and design a treatment plan. "The goal is to catch conditions early," says Praveena Gorantla, M.D., a rheumatologist with Via Christi Clinic who sees patients in two Wichita locations. She cautions: "Diagnosis is based primarily on the physical exam and labs, so it's important that the initial evaluating physician not give corticosteroids that can affect our labs or mask symptoms. If the labs show abnormal antibodies or there are inflammatory findings, we suggest they call us for referral; we typically can see a patient within two weeks." What Does a Rheumatologist Do? Accord ing to t he ACR , t he pRAvEENA goRANTLA, m.D., Via Christi Clinic Rheumatology, busts common + Joint disorders + Bone disorders, including osteopenia (low bone mass); and osteoporosis. arthritiS factS actS act arthritis myths. myth: Arthritis is not a serious + Overall function, including physical and mental well-being, and level of independence health problem. Fact: Arthritis is a serious, painful and debilitating disease that accounts for 44 million outpatient visits and more than + Results of advanced imaging and lab tests 992,000 hospitalizations annually. early diagnosis and management are important to prevent long-term pain and disability. + Treatment options myth: Herbal medications and diet can control rheumatoid arthritis. + The need for more evaluation and treatment, such as referrals to other health care providers; orthopedic aids or corrective surger y; and hospital stay. Fact: They may help relieve symptoms, but only prescriptive, disease-modifying drugs can slow or halt disease progression. myth: people with arthritis should protect their joints by avoiding exercise. Fact: Lack of exercise can decondition R heumatolog ists prov ide highquality care, often at a lower cost, according to the ACR. Proper analysis of a patient's medical history, physical examination and tests, combined with accurate diagnosis and specially tailored treatment, results in improved patient outcomes and better quality care, and is often less costly. and weaken muscles, adding more strain to joints. Arthritis patients benefit from regular exercise, including strength training, flexibility exercises and aerobic activity, as directed. myth: Fibromyalgia is a form of inflammatory arthritis. Fact: Unlike rheumatologic diseases, in which there is inflammation and/ or abnormality of joints, muscles and What Are the Treatments for Rheumatoid Arthritis? RA is an autoimmune disease that causes inflammation in the soft tissue lining of joints. Treatment focuses on controlling joint pain and swelling and preventing joint damage. Nonsteroidal anti-inf lammatory drugs and corticosteroids help reduce pain and swelling quickly. Diseasemodifying drugs and biologics are targeted therapies that help prevent joint destruction. For osteoarthritis? Osteoarthritis (OA) is not an autoimmune disease. It's the result of wear and tear of the joint causing cartilage to become damaged. OA is managed through the following: maintenance of idea l body weight; exercise to strengthen muscles around the joints; bones, fibromyalgia is characterized by lack of inflammation and abnormality of the tissues. it is believed to be caused by abnormal pain perception and can be triggered by emotional stress, depression, anxiety or chronic sleep problems. A rheumatologist's primary role is to rule out rheumatologic diseases and refer back to a primary care physician. physical therapy; joint injections; and topical and oral medications to relieve pain. And osteoporosis? W it h o s t e op oro si s , t re at ment involves identifying and correcting risk factors for bone loss. A rheumatologist may recommend engaging in regular, weight-bearing exercise; taking daily calcium and vitamin D supplements mDNEWS.Com ■ MD News Greater Kansas |7

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