Demystifying Rheumatology

Dr.Benzeeta Pinto, Asst. Prof Clin Immunology & Rheumatology, St John’s Med College, Bengaluru

What is rheumatology?

Well, if you don’t know what rheumatology means, don’t fret. You are not the only one! Most of the times, even the patients we treat are not completely sure of what it means. Unlike cardiology (cardio-heart),neurology (neuro-nerves), which directly indicates the meaning, rheumatology has the misfortune of a name that doesn’t really spell out its meaning. Rheumatology is derived from the Greek word ‘rheuma,’ which means flow (Indeed!). Back in the dark ages, joint pains were considered to be caused by body fluids,which were misdirected .Rheumatology currently refers to the branch of medicine that deals with disorders of the musculoskeletal system and soft tissues, autoimmune diseases, vasculitis,and heritable connective tissue disorders. Since these disorders are mostly immune mediated, the study of rheumatology is inseparable from the study of immunology. Hence, in the true sense, rheumatology is the study and practice of medical immunology and, thereby, a subspeciality of internal medicine.

Who is a rheumatologist?

Unfortunately, rheumatology lacks the glamor of cardiology or neurosurgery;hence, I’m yet to see a movie or sitcom that talks of a rheumatologist (Although House MD does have a few episodes thatmention lupus).Just like all the other subspecialities of medicine,becoming a rheumatologistrequires you to train in internal medicine (or general medicine as it is called in India)or paediatrics first. Most rheumatologists train for a varying period of 2–3 years after their MD/DNB. Sinceimmunology and rheumatology walk hand in hand,rheumatologists in India may also identify as clinical immunologists.

What are the diseases treated by a rheumatologist?

Diseases of the immune system are complex and fascinating. A lot of them involve the joints and musculoskeletal structures but are not limited to these. Rheumatoid arthritis, spondyloarthropathy, psoriatic arthritis, and gout are the common ones, to name a few. In addition, we also deal with more serious autoimmune diseases like systemic lupus erythematosus, systemic sclerosis,primary Sjogren’s syndrome and inflammatory myositis. Numerous other complex diseases like vasculitis,relapsing chondritis, sarcoidosis, and autoinflammatory diseasesalso come under the umbrella of rheumatology.

What is auto-immunity?

Auto-immunity refers to your immune system attacking itself. The immune system is an elaborate network of cells and molecules that are involved in protecting the body against infections andcancer. In certain situations,especially when there is a conducive genetic background, the immune system may turn upon itself leading to myriad disease manifestations.

Who can get affected by these diseases?

Although autoimmune diseases more commonly affect women in their child-bearing years, people of any age,gender, race, and region can be affected by these diseases.

Are these diseases curable?

Most rheumatological diseases have no permanent cure. This is similar to most other chronic diseases, such as diabetes mellitus and essential hypertension that currently have no cure. But with the available treatments,most diseases can be effectively controlled and patients can lead a near-normal life. Early diagnosis and treatment are the key to good outcomes.

When should I see a rheumatologist?

If you are experiencing pain in your joints associated with swelling and morning stiffness.
If you have chronic low back pain, which is worse in the morning.
If you have attacks of gout (intermittent bouts of joint pain especially affecting the great toe).
If you have symptoms that affect multiple organs, such as the skin,joints, blood counts, and kidney.
If you have persistent dryness of mouth and eyes.
If you have any other problems that your physician feels can be a symptom of autoimmune disease.


Since it is a superspeciality, it is advisable to first seek opinion of your primary health care giver, discuss with him or her what you fear, and take a referral for a rheumatologist consultation rather than directly going to one!