What is a rheumatologist?
A rheumatologist is a physician who has completed a three year internal medicine or four year combined internal medicine – pedicatrics residency followed by additional two or more years of subspecialty training in the care of arthritis, immunologic and musculoskeletal diseases.
Sometimes our role is to ‘solve the riddle’ and determine if there is an underlying immunologic disease causing peoples’ symptoms. Other times the problem is already defined and our job is to integrate medical interventions to control the disease process. Common themes are to reduce pain, maximize function, prevent organ damage (including structural joint damage), as well as maintain physical strength, work and social integration.
We do not always have all the answers. There are times when the best conclusion is a rheumatic disease is ruled out.
In all cases we work to create a balanced treatment plan that emphasizes adaptation, self-management and effective coping. Medical treatments may include: exercise, therapy, pain relievers, oral and intra-articular corticosteroids, and a toolbox of twenty immunomodulators Explore this short video to learn more about the about the domain of rheumatology and our areas of clinical expertise.
Deep Knowledge and Broad Experience Caring
Digital x-rays are an important tool in evaluating and monitoring varied forms of arthritis. They can help differentiate osteoarthritis, pseudogout, gout and rheumatoid arthritis. In patients with osteoporosis spinal compression fractures can only be detected via x-ray as they are often without symptoms. In clinical trials digital xrays of the hands and feet are electronically transfered to research radiologists to compare Sharp Scores – the key measure of progression of structural joint damage in rheumatoid arthritis. Though costly MRI may be needed, usually x-rays of the sacroiliac joints and lumbar spine are sufficient to support the diagnosis of ankylosing spondylits. So having radiology services available at the point of care is efficient and less expensive than hospital associated clinics (no added facility fees).
Having the ability to immediately evaluate a patient on immunosuppressive medications for pneumonia can impact our decision making and increase patient safety. The rheumatologist interpreting x-rays in light of their clinical examination adds another level of sophistication and value for patients.
Clinic Based Infusion Therapy
Rheumatologists have a toolbox of biologic therapies that target and block specific aspects of the immune system with the goal of returning immune regulation closer to normal. At West Michigan Rheumatology we have provided infusions services for our patients since 1998. Infiximab (Remicade), abatacept (Orencia), rituximab (Rituxan), and tocilizumab (Actemra) as well as their related biosimilar preparations are important options in our toolbox of rheumatoid arthritis therapy. In addition Benlysta, rituximab (Rituxan) and IV steroid bursts are used in SLE and tocilizumab (Actemra) in giant cell arteritis. We also administer Reclast for the treatment of osteoporosis.
We believe having a dedicated infusion nurse that knows you who is within arm reach of your physician increases the safety of your care. We specialize in caring for our patients, so you will never be exposed to patients receiving intra-venous antibiotics for drug resistent infections or patients receiving cancer chemotherapy.