A rheumatologist is a doctor who specializes in the treatment of diseases of the musculoskeletal system such as joints, bones, muscles and tendons. What is his role ? When to see it?
rheumatology is a medical specialty that is dedicated to the diagnosis and treatment “diseases of the musculoskeletal systemthat is to say all the organs that allow movement, such as bones, joints, spine, tendons, muscles, nerves“, explains Pr Aleth Perdriger, head of the Rheumatology department at the University Hospital of Rennes and president of the National Professional Rheumatology Council. Thus, the rheumatologist is the doctor specializing in pathologies that affect the bones, muscles, tendons and jointss.
What is the role of the rheumatologist?
The rheumatologist intervenes “if there is pain or reduced mobility, without an obvious traumatic cause“, emphasizes Professor Aleth Perdriger, who adds: “the origin of the pain can be a local joint disease (osteoarthritis) or a general disease (such as polyarthritis or fibromyalgia pain).“If he cannot treat the condition you have, your GP will refer you to a rheumatologist.
For which diseases should you see a rheumatologist?
The rheumatologist should be consulted before pain or decreased mobility which affects part or all of the joints, especially if the pain resists analgesics or if it comes back often (lumbar blockage, joint swelling, difficulty walking or picking up objects). “Rheumatology is not just about pain associated with aging joints. This specialty is concerned diseases of the bones, joints, tendons. So many diseases that can be linked to inflammation, such as an infection, an autoimmune disease such as rheumatoid arthritis or a bone tumor. Diseases can be related to movement and joint or bone fragility, such as fibromyalgia, osteoporosis or osteoarthritis“, specifies Pr Aleth Perdriger,. All these diseases are the subject of specific management by the rheumatologist. We distinguish pain treatments from specific treatments of the disease. Most often additional examinations are necessary to make the diagnosis or judge the severity or otherwise of the damage.In the case of osteoporosis, the rheumatologist will decide on the therapeutic strategy to adopt after analyzing the results of a bone densitometry.
For example, you can consult a rheumatologist in case of:
- Diseases of the bones, joints, tendons…
- Rheumatoid arthritis,
- Fibromyalgia,
- Osteoporosis,
- Osteoarthritis…
“For a rheumatologist, it is important to know you in order to understand the cause of a disease. He will therefore ask you about the circumstances of the onset of pain or discomfort, but he will also ask you to mention any family history of joint or bone diseases. He will also ask you about all your treatments and your possible rheumatological or non-rheumatological medical problems.“, develops Pr Aleth Perdriger. Then, he will carry out a clinical examination and will possibly prescribe additional examinations.
Before a consultation, do not forget to look for any family history. Also read the medications you are taking and don’t forget to bring any x-rays or test results you have already taken.
What tests does a rheumatologist do?
The rheumatologist often needs, after his clinical examination, to carry out biological examinations to guide a diagnosis, in particular for inflammatory diseases. He can practice x-rays, CT scan, MRI, bone densitometry to assess bone strength. For about 10 years, the rheumatologist has been using a lot of joint ultrasound, an examination which is carried out in many rheumatologists’ offices. Depending on the patient’s pathology, the rheumatologist may be required to perform joint punctures, joint infiltrations and lavages or ultrasound-guided interventions.
What studies to become a rheumatologist?
In total, it takes 10 years of study to become a rheumatologist in France. After a scientific baccalaureate (S), you must follow (and pass) the first two years of medicine – First Cycle of Medical Studies. There is then a Second Cycle of Medical Studies, which lasts four years (including three externships). At the end of the 6th year, students can choose rheumatology as a specialty for their internship, which lasts four years. This course leads to a diploma of specialized studies (DES) in rheumatology.
The rheumatologist works in a hospital and/or in private practice. Do not hesitate to ask your attending physician to advise you on one. You can also consult the Health Insurance website to find contacts based on location and rates charged.
What is the price of a consultation? Is it reimbursed?
The consultation with the rheumatologist costs around 35 euros (sector 1). It is covered by health insurance up to 70% if you follow the course of care. If the fees are exceeded, check with your health insurance fund.
Thank you to Pr Aleth Perdriger, head of the Rheumatology department at the University Hospital of Rennes and president of the National Professional Rheumatology Council.