Talk:Rheumatology

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Thanks, Nunh-huh, for adding all those yucky vasculitides. Frankly, I hadn't taken the time to properly expand on that list. I'm on the lookout for a good review article on Wegener's granulomatosis before I have a go at that disease... JFW | T@lk 09:23, 20 May 2004 (UTC)


Introduction doesn't explain anything[edit]

"Rheumatology is a sub-specialty in internal medicine and pediatrics, devoted to diagnosis and therapy of rheumatic diseases"

If you don't know what rheumatic is, you can't understand this sentence. If you do know what rheumatic is, you don't need to read this sentence. — Preceding unsigned comment added by 2.106.159.190 (talk) 14:33, 15 October 2012 (UTC)

Merge with Rheumatism[edit]

I suggest this article be merged with Rheumatism, because they cover the same subject basically. What do you think? Mikael Häggström 19:23, 22 June 2007 (UTC)

.............

Thank you very much in deed regarding the suggestion to merge two pages. Rheumatology is a medical specialty, where as rheumatism is a lay term. It is very difficult to merge them. We can always explain and define these terms in different sites. Rheumatology is a rapidly expanding medical specialty which needs regular updates. Two sites can be highlighted in each page and they can be linked in order to click and find more information regarding each category. It is important to maintain a site on rheumatism as well, as it is also a commonly used term. Readers can be guided and diverted from the page rheumatism to that of the rheumatology in order to obtain more scientific information on this topic.

Rheumatism is an archaic, colloquial word that has nothing to do with the actual medical field of rheumatology. They should not be merged or referenced together. The term itself arose prior to the modern understanding of many diseases that symptomatically were thought to be related but in the modern era are now know to be nothing related and are treated by vastly different specialities. Nuclearzenfire (talk) 01:25, 7 January 2015 (UTC)

70% 'cure' of rheumatoid arthritis?[edit]

A citation is needed for this, I think, inprecise and misleading statement. Controlling a disease is not the same as curing it, and the new treatments will not help those in whom the disease is already well established. These pages are often a first hit for newly diagnosed patients, so it's important to make them correct and verifiable. —Preceding unsigned comment added by 24.161.97.249 (talk) 02:03, 12 December 2007 (UTC)

Patient outcomes[edit]

The article omits entirely to discuss the experiences of patients, or the clinical outcomes from treatment by Rheumatologists. While it may be true that some patients are helped, it is also true that many are not and some are severely harmed. The article is thus inaccurate and biassed. Rheumatologists' habitual practice of deliberately causing patients extreme pain- by applying pressure onto inflamed, sore joints- is identical to common assault, and should be mentioned; if only to warn new patients of what they face. Rheumatology cannot demonstrate its utility at all without reference to patients' experiences. Wiki should allow such perspectives space, instead of censoring them. There are more patients than doctors, and the content of Wiki should reflect the interests of this majority. —Preceding unsigned comment added by Snonsk (talkcontribs) 11:30, 17 February 2009 (UTC)

System: Immune System?[edit]

For some reason, "Immune System" is listed as the system. While rheumatology does have a lot of involvement with the immune system, that's more descriptive of immunology. Correct me if I'm wrong, despite rheumatology covering broad things such as vasculitis and systemic diseases (lupus), its main system is musculoskeletal -- and most of those other conditions are often treated due to their predominance of arthritic (and consequently, inflammatory and often auto-immune) conditions. CouchTomato (talk) 01:52, 8 April 2014 (UTC)

I can see how you are confused, but immune system is the correct category. In (clinical) medicine, immunology tends to deal with diseases in which the immune system is too weak and thus patients with such diseases are more susceptible to infections, whereas in rheumatology the immune system is too strong/misguided and attacks the body leading to damage. Many of the rheumatological disease have nothing to do with the joints or muscles, symptomatically, and even when the symptoms are primarily in the joints, it is not the joint that is the problem but the immune system. The treatments modify/suppress the immune system. Problems with the joints/muscles proper are mechanical in nature and primarily managed by orthopedists and physiatrists. This is a very common misunderstanding as most people are unfamiliar with the medical (rather than colloquial) use of words such as "arthritis". Nuclearzenfire (talk) 01:23, 7 January 2015 (UTC)

I see your point, and I believe it would make sense to label it as both the immune system and musculoskeletal system. Many rheum conditions are indeed immune-based, and a similar reason explains why hematology and oncology are so intertwined. Many hematologic conditions are proliferative or neoplastic diseases, and a hematologist needs to be well trained in anti-neoplastic medications. Likewise, most rheumatologic and diseases that affect the joints are autoimmune in nature, and therefore a rheumatologist needs to be well trained in immunosuppresive medications. With that said, it is still very much a MSK-centric field.
First, look at the ACR's definition of a rheumatologist: "The role of the rheumatologist is to diagnose (detect), treat and medically manage patients with arthritis and other rheumatic diseases. These health problems affect the joints, muscles, bones and sometimes other internal organs (e.g., kidneys, lungs, blood vessels, brain)."[1] Second, the musculoskeletal exam is a key component of the rheumatologist's physical exam, and no other branch of internal medicine shares that expertise aside from Sports Medicine. Third, you say that many rheum diseases have nothing to do with the joints and muscles but have to do with autoimmune disease... but that doesn't explain the conditions that do and are NOT. Septic arthritis, crystal arthropathies, bursitis & other joint inflammatory issues, and even simple osteoarthritis (although rheumatologists don't really like treating that as there's not much you can do) are examples of arthritis. Non-autoimmune myopathies are muscular conditions that the rheumatologist has to work with. And finally, for skeletal, there is also osteoporosis. And many of the autoimmune conditions do have significant joint involvement -- the most notorious rheumatologic disease, lupus, often has significant joint manifestations. RA, spondyloarthropathies, and poly/dermatomyositis are no-brainers for their MSK involvement. Only the vasculitidies are more oddballs.
IF rheumatology was truly just a catch-all for autoimmune disorders, then conditions like multiple sclerosis, type I diabetes, autoimmune hepatitis, inflammatory bowel disease, vitiligo, and so on would be rheumatology. There is also a very common misunderstanding in whose role is what with regards to "joints/muscle proper." You are correct that joint problems that are mechanical in nature are managed by orthopedists, but mainly in the surgical and interventional setting. Non-surgical joint issues that are mechanical can be medically and therapeutically managed by sports medicine doctors (although that is very specialized), and non-surgical joint issues that are inflammatory in nature are managed by rheumatologists. All three are MSK specialists, and many times their treatment and range of expertise can easily overlap. CouchTomato (talk) 22:23, 27 January 2015 (UTC)