Rheumatology Clinic

What is a Rheumatologist?
A rheumatologist is an internist or paediatrician who is qualified by additional training and experience in the diagnosis and treatment of arthritis and other diseases of the joints, muscles and bones. Many rheumatologists conduct research to determine the cause and better treatments for these disabling and sometimes fatal diseases.
What Kind of Training Do Rheumatologists Have?
After four years of medical school and three years of training in either internal medicine or paediatrics, rheumatologists devote an additional two to three years in specialized rheumatology training. Most rheumatologists who plan to treat patients choose to become board certified. Upon completion of their training, they must be certified by the Kenya Medical and Dentist Practioners Board.
What Do Rheumatologists Treat?
Rheumatologists treat arthritis, certain autoimmune diseases, musculoskeletal pain disorders and osteoporosis. There are more than 100 types of these diseases, including rheumatoid arthritis, osteoarthritis, gout, lupus, back pain, osteoporosis, fibromyalgia and tendonitis. Some of these are very serious diseases that can be difficult to diagnose and treat.
When Should You See A Rheumatologist?
If musculoskeletal pains are not severe or disabling and last just a few days, it makes sense to give the problem a reasonable chance to be resolved. But sometimes, pain in the joints, muscles or bones is severe or persists for more than a few days. At that point, you should see your physician.
Many types of rheumatic diseases are not easily identified in the early stages. Rheumatologists are specially trained to do the detective work necessary to discover the cause of swelling and pain. It’s important to determine a correct diagnosis early so that appropriate treatment can begin early. Some musculoskeletal disorders respond best to treatment in the early stages of the disease.
Because some rheumatic diseases are complex, one visit to a rheumatologist may not be enough to determine a diagnosis and course of treatment. These diseases often change or evolve over time. Rheumatologists work closely with patients to identify the problem and design an individualized treatment program.
How Does the Rheumatologist Work with Other Health Care Professionals?
The role the rheumatologist plays in health care depends on several factors and needs. Typically the rheumatologist works with other physicians, sometimes acting as a consultant to advise another physician about a specific diagnosis and treatment plan. In other situations, the rheumatologists acts as a manager, relying upon the help of many skilled professionals including nurses, physical and occupational therapists, psychologists and social workers. Teamwork is important, since musculoskeletal disorders are chronic. Health care professionals can help people with musculoskeletal diseases and their families cope with the changes the diseases cause in their lives.
Is Specialty Care More Expensive?
You may be surprised to learn that specialized care may save time and money and reduce the severity of disease. A rheumatologist is specially trained to spot clues in the medical history and physical examination. The proper tests done early may save money in the long run. Prompt diagnosis and specially tailored treatment often save money and buy time in treating the disease.

Adapted from the American College of Rheumatology
Rheumatological conditions

We have expertise in all rheumatic disorders including:

• all kinds of arthritis, such as osteoarthritis, gout, and inflammatory arthritis such as rheumatoid arthritis and psoriatic arthritis
• ankylosing spondylitis
• spinal pain
• connective tissue diseases (autoimmune diseases) such as systemic lupus erythematosus (SLE), polymyositis, Sjögren’s syndrome and systemic sclerosis
  polymyalgia rheumatica, giant cell arteritis and other forms of vasculitis
• metabolic bone disorders such as osteoporosis and Paget’s disease
• soft tissue rheumatism, such as tendon and ligament problems, “frozen shoulder”, carpal tunnel syndrome
• complex regional pain syndromes and fibromyalgia
• sports and exercise medicine

What will happen when I see the rheumatologist?
The Diagnosis
Rheumatologists in Australia undertake at least six years of specialist training after completing their medical degree and hospital. This includes physician training and specialist training in rheumatology. Your rheumatologist is specially trained to do the detective work necessary to discover the cause of your symptoms. He or she will usually ask you to explain the history of the problem and will undertake a physical examination. Additional investigations such as blood tests, X-rays and scans may also be needed.
Information and Advice
Once a diagnosis is made, your rheumatologist will explain the nature of your illness and what you might expect in the future. This is an important step, particularly for illnesses that might affect you over a long period.
Treatment
Your rheumatologist is an expert in the comprehensive and holistic management of the whole person. With an accurate diagnosis and a shared understanding of your illness, you and your rheumatologist can work together to design a treatment program aimed at managing pain, reducing inflammation and ensuring your quality of life.
Ongoing Management
Depending on the nature of your illness, you may need to see your rheumatologist regularly for ongoing management. Some specialised medications can only be prescribed by a rheumatologist. Alternatively you may be treated by your general doctor, with the rheumatologist on hand for specialist advice.
So how will my condition be treated?
As your rheumatologist will explain, there are a number of treatment options available including:

• Physical therapy
• Medications
• Surgery

He or she will advise you on the different options and what may be best for you. This will depend on the exact nature of your illness, your circumstances and preferences, and any other individual needs or problems. It is important that you share your concerns with your rheumatologist so that together you can agree on the best approach for you.
In treating and managing your illness, your rheumatologist will work closely with your General Practitioner, to ensure that you receive the best possible care. Other skilled professionals may also share in your care:
The physiotherapist is trained in the physical treatment of arthritis and musculoskeletal conditions and uses a combination of education and advice, exercise and special treatment techniques.
The exercise physiologist is trained in delivery of exercise programs.
The occupational therapist provides advice on how to get on with day-to-day activities such as working, dressing and getting out and about.
The psychologist or social worker offers advice and support to help patients and families cope with the changes that illness might bring.
Nurses, podiatrists and dietitians may also form part of the team involved in your treatment.
If you need surgery for your condition, your rheumatologist will involve an orthopedic surgeon or sometimes other types of surgeons depending upon the problem.
Advice for your first visit with a Rheumatologist
You will need to make an appointment with the rheumatology clinic nurse. Please bring a copy of the referral, a health summary, your list of medications, your family history (including information about relatives with rheumatologic/autoimmune conditions), and previous relevant tests and X-rays or other imaging tests if available. A supportive friend or relative would be welcome, as many issues may be discussed.

Adapted from Australian Rheumatology Association