3 things I wish people knew about Rheumatology
rheu·ma·tol·o·gy ˌro͞oməˈtäləjē/ noun MEDICINE the study of rheumatism (systemic autoimmune conditions), arthritis, and other disorders of the joints, muscles, and ligaments.
- 1.Rheumatoid Arthritis (RA) is not Osteoarthritis (OA).When I ask patients about a personal or family history of arthritis, it usually takes several minutes to tease out what the diagnosis actually is/was. This is because very few understand the difference between these two! RA is an autoimmune condition that requires lifelong immunosuppressive medications and can be horribly disfiguring, while OA is regular "wear and tear" type of arthritis. OA usually comes with age, whereas RA is usually diagnosed in the 3rd-5th decades of life.
- 2.A positive blood test doesn't mean you have the diagnosis.Unfortunately in medicine, nothing is certain. I have the hardest time explaining to patients that a blood test may not be the be-all and end-all for making a diagnosis. A rheumatoid factor should diagnose rheumatoid arthritis, right? I wish! Some tests are more sensitive (pick up more true positives but also have many false positives) and some are more specific (fewer true positives but may have many false negatives). Talk to your rheumatologist about the true significance of the tests.
- 3.While some of our medications can seem scary, the diseases can be much more devastating if left untreated.We have come to a time in rheumatology, where we have done such a great job of coming up with life-changing medications to treat our diseases that most people have no idea how bad their disease could be. The only downside to this is having patients understand why they might need treatment. Don't get me wrong, side effects can be scary too! But we have many ways to monitor for and to prevent these, and as always, you should have a discussion with your doctor about risks and benefits.