When To See a Rheumatologist

A rheumatologist is an internist or pediatrician who has received further training in the diagnosis and treatment of diseases such as arthritis and autoimmune disease. Autoimmune diseases are simply diseases that occur when your body mistakenly attacks itself. The diseases can involve any organ system, including the skin, lungs, kidney, GI tract, muscles, and even eyes, and can also affect muscles, bones, or joints.

So, when is it important to get a rheumatology referral? We always recommend speaking to your healthcare team if you think a rheumatology evaluation is necessary.

Signs and Symptoms

Recurrent fevers, joint swelling, fatigue, rash, anemia, weakness, and/or unexplained weight loss are signs and symptoms that may warrant a referral to rheumatology if no other explanation is found. Since many different diseases can cause the symptoms above, it is important to first communicate with your primary care provider. They may order initial lab tests that help in establishing a diagnosis.

Joint Pain

If you have been having joint pain, such as stiffness in the morning that lasts for more than 30 minutes, you may want to seek a rheumatology referral for evaluation for inflammatory arthritis. In addition, recurring joint swelling, especially in the knuckles, wrists, ankles, and feet, would be another reason to reach out for a rheumatology referral.

Skin Changes

Some types of rashes may be associated with rheumatic disease, so it is recommended to see a rheumatologist if you or your primary care provider suspect an autoimmune etiology, especially if you have other symptoms. Hair loss, oral ulcers, and genital ulcers are other changes that may indicate a rheumatic condition.

Vision Changes

Patients with systemic autoimmune disease may have changes in their vision. You should see an ophthalmologist if you have sudden vision loss, blurry vision, double vision, or red/painful eyes. If the ophthalmology evaluation suspects a rheumatic condition, then that would be another reason to see a rheumatologist.

Abnormal Lab Tests

Keeping the patient’s history and other symptoms in mind, some abnormal lab tests, especially if they are of high value, would warrant a rheumatology workup. These may include labs that are positive or raise suspicion for diseases such as systemic lupus erythematosus, rheumatoid arthritis, vasculitis, scleroderma, gout, polymyalgia rheumatica, giant cell arteritis, just to name a few. Since the rate of false positives can be high for some of these labs, they should only be measured in the right clinical setting.

If you are experiencing unexplained systems that are repeating, it’s a good idea to talk to your primary care doctor about a referral to rheumatology. There are over 100 rheumatic diseases, and rheumatologists have dedicated their careers to the study and treatment of these unique conditions. Early diagnosis and treatment can help prevent permanent damage and prevent symptoms from worsening over time.