A rheumatologist is a medical doctor who specializes in internal medicine. They receive advanced training in rheumatology, a field which focuses on musculoskeletal, autoimmune and inflammatory conditions.
So, even though rheumatologists are commonly associated with the treatment and management of arthritis, they can also help with other issues like muscular injuries, tendon problems and even rare inherited disorders. Keep reading to find out more.
What Symptoms does a Rheumatologist look for?
Your primary doctor may recommend an appointment with a rheumatologist in Singapore if you’ve reported joint pains or symptoms they suspect could be due to arthritis or autoimmune conditions like rheumatoid arthritis. The appointment with the specialist here will be key for further evaluation. During an assessment with a rheumatologist, here are some of the symptoms they may look for;
- Fatigue: In rheumatology, fatigue can hint at underlying conditions like rheumatoid arthritis (RA), lupus, or fibromyalgia. So, persistent tiredness beyond normal exhaustion should not be ignored. It may indicate inflammation or an autoimmune response that is interfering with your energy levels.
- Itching: Itching is most often associated with skin conditions. However, it can also be a symptom of certain rheumatic diseases like psoriatic arthritis or systemic lupus erythematosus (SLE). You may experience the itching either due to inflammation that is affecting your skin or as a side effect of medications you have been using to manage these conditions.
- Swollen Lymph Nodes: Swollen lymph nodes typically indicate an immune response to an infection or inflammation nearby. In rheumatology, persistent swelling might relate to an underlying autoimmune disease. For example, it might be due to rheumatoid arthritis or systemic sclerosis which explains why your GP may refer you to a rheumatologist in Singapore for further investigation if you report swollen lymph nodes.
- Dry Mouth: This condition is also known as Xerostomia. A dry mouth can be a sign of Sjögren’s syndrome. This is an autoimmune condition where the body attacks its moisture-producing glands. This symptom often coexists with dry eyes and other systemic manifestations.
- Inflammation in the Lining of the Lungs: Pleurisy or inflammation of the lining around the lungs may manifest as chest pain. It may also make you experience breathing difficulties and can accompany conditions such as rheumatoid arthritis or systemic lupus erythematosus.
- Dermatitis: Skin involvement is common in many rheumatic diseases. Dermatitis or skin inflammation might be linked to conditions like psoriatic arthritis or systemic sclerosis. It can manifest in the form of rashes, redness, or irritation.
- Stiffness: Joint stiffness, especially in the morning or after prolonged inactivity shouldn’t be ignored, especially if it seems to persist. This condition could indicate various rheumatic conditions ranging from osteoarthritis, to rheumatoid arthritis, and even ankylosing spondylitis. This stiffness often accompanies pain and reduced joint mobility.
- Muscle Weakness: Weakness in muscles can result from conditions like polymyositis or dermatomyositis, inflammatory myopathies that affect the muscles. It leads to progressive muscle weakness and fatigue.
- Dry Eyes: Dry eyes are frequently seen in Sjögren’s syndrome. As earlier explained, this condition causes the immune system to attack moisture-producing glands and this may lead to dryness and irritation. It may also occur in other rheumatic conditions.
- Hair Loss (Alopecia): Hair loss can occur in certain rheumatic diseases. Most notably it can come with lupus. Alopecia can also come as a side effect of medications you’ve been put on to manage these conditions. In lupus, it can present in patches or more diffusely across the scalp.
- Swelling: Joint swelling is a hallmark symptom of many rheumatic diseases. This is particularly true for rheumatoid arthritis. It results from inflammation in the synovium and can cause not just pain, but also stiffness, and limited joint movement.
How does a Rheumatologist examine you?
It is natural to feel a little nervous when visiting a rheumatologist in Singapore for the first time. Actually, that’s why many people ask; how does a rheumatologist examine you?
Now, when you’re in the rheumatologist clinic, their evaluation involves several crucial steps, which are aimed at not only understanding your medical history but also conducting a comprehensive physical examination and potentially even making use of imaging tests or a lab to get to the underlying issue. That said, here are the four things that the rheumatologist will do when examining you;
- Asking about your Medical History: To ensure an accurate diagnosis, the rheumatologist may begin by asking that you share your medical history. This includes past illnesses, surgeries, allergies, medications you take, and details about your family’s health. Genetic factors also play a role in certain types of arthritis. So, you will also want to have accurate information about your family’s health in the days leading to the appointment. To streamline the process, inquire if you can access and complete medical history forms before your appointment. This cannot only help you save time but also allow for a thorough review of your medical records.
- Physical Examination: The physical examination is a pivotal aspect of your consultation. For this part, the rheumatologist will take time to carefully examine your joints. Here, they will be looking for indicators like swelling, tenderness, or signs of inflammation. Being able to accurately identify specific areas of discomfort is crucial as different types of arthritis affect various parts of the body. As earlier explained, they may also be accompanied by other symptoms such as rashes or eye inflammation.
- Lab Tests: Blood tests are also key in the diagnosis of arthritis. These tests search for inflammation markers and antibodies present in certain types of arthritis. For instance, the presence of anti-cyclic citrullinated peptide (anti-CCP) in the blood is common in individuals with rheumatoid arthritis (RA). Also, anti-nuclear antibodies (ANA) might suggest lupus, although they can appear in healthy individuals as well. In cases where gout is suspected, your doctor may check uric acid levels and analyze joint fluid.
- Imaging Tests: X-rays are the primary imaging tool for arthritis. They’re used to identify structural changes like bone erosions or cartilage damage. However, in the early stages before visible damage, X-rays might not provide conclusive evidence. So, ultrasound, which is a non-invasive and cost-effective test, may be used in the assessment of early inflammatory changes in joints. In specific situations, more advanced imaging like MRI or CT scans might be necessary. The only downside is that they tend to be more expensive.
In Closing
There is a wide range of symptoms that a knowledgeable rheumatologist in Singapore may look for to ensure an accurate diagnosis. Other than the symptoms, there are also several other assessments that can be used to ensure accurate diagnosis. If you’re worried about any rheumatoid condition, seek the help of a specialist today to detect the condition early and have it managed.
Are you looking to schedule an appointment with a rheumatologist in Singapore but still unsure where to find one? Get in touch with Dr. Annie Law of Asia Arthritis and Rheumatology Center for a thorough assessment and a tailored treatment plan. To schedule your consultation, call or visit Dr. Annie at;
Asia Arthritis and Rheumatology Center
Mt Elizabeth Hospital (Orchard)
3 Mt Elizabeth, #05-03
Mt Elizabeth Medical Centre
Singapore 228510
