Do You Require Rheumatologist Services or an Orthopaedic Surgeon?
Although the overall focus of rheumatologist services and those of an orthopaedic specialist are both directed at problems with the musculoskeletal system, the specific aspects of that system that form the basis of the individual specialities for these two healthcare professionals, differ significantly. The guidelines that follow should prove of value to anyone who may have a joint problem and who might be wondering which of these musculoskeletal specialists it would be best to consult.
Let’s compare the type of treatment undertaken by each of them. In addition to his or her role as a physician, which might require performing manipulative procedures to correct postural problems and prescribing exercise and medication, about half of all treatments administered by the average orthopaedic specialist will involve some form of surgical intervention. By contrast, rheumatologists are primarily physicians, so their services do not normally include surgery.
When in the operating room, an orthopaedic specialist is required to deal both with trauma cases, such as fractures arising from sports injuries or motor vehicle accidents, and elective procedures, such as hip, knee, and shoulder replacements in which damaged bone is removed and replaced by a prosthesis. A replacement is mostly required to assist patients with osteoarthritis that has left them with painful, swollen joints that are no longer responsive to prescription painkillers or steroids, and has resulted in some degree of diminished mobility.
A variant of this condition, which is known as rheumatoid arthritis, is clearly reflected in the title given to rheumatologists. Not surprisingly, its treatment is among the services provided by this type of specialist. While both of these conditions cause joint pain, in this instance, the pain and swelling tend to be more generalised, affecting all of the major joints rather than just one in isolation, and there is no explanatory injury. More often than not, an isolated joint pain will suggest the appropriate course of action should be to consult an orthopaedic specialist. Either old or recent injuries, as well as osteoarthritis, may present with these symptoms, which tend to worsen when the joint is under pressure.
Among the more common reasons for patients to seek the services of rheumatologists are painful and debilitating autoimmune conditions. These occur when, for some reason, the body’s immune system begins to attack healthy tissue, treating them like invading bacteria and other foreign bodies. Rheumatoid arthritis, lupus, Sjögren’s syndrome, polymyositis, scleroderma, gout, sarcoidosis, antiphospholipid syndrome, and connective tissue disease are all examples of autoimmune disease that fall within the purview of this type of musculoskeletal specialist. The metabolic bone disorders, Paget’s disease and osteoporosis, are also among their interests.
It is apparent that these two specialisms share a fair amount of common ground and, consequently, this will often lead to referrals between the disciplines. Given this overlap between their respective responsibilities, it is not unusual for healthcare professionals to choose to obtain qualifications in both of these fields. On the other hand, it is equally common for an orthopaedic specialist to focus solely on a particular aspect of this discipline, such as hip and knee arthroscopy and arthroplasty.
In general, however, if you describe your symptoms clearly, your GP should be able to recommend the services of a rheumatologist or an orthopaedic specialist, as appropriate.