Approach to rheumatic diseases.
Rheumatic diseases are the most prevalent of the chronic painful disorders in the world today. The specialty of rheumatology is one of the most clinically orientated. Hence the approach to rheumatic diseases must be clinical. Proper history taking and physical examination including that of the musculoskeletal system cannot be overemphasized. Special attention must be paid to the skin, mucous membrane, the eyes, the gastrointestinal and genitourinary systems. Laboratory tests are meant to supplement a thorough history and physical examination and never in place of them. Because there is so much overlap in the clinical manifestations of the different rheumatic diseases, a precise diagnosis may be difficult in the early stages. Management goals must therefore be bipartite. Short term goal is aimed at symptomatic relief, gaining the patient's confidence and preventing disability. Long term goal requires the physician's attention to diagnosis and prognosis, drug toxicity, negotiating with the patient regarding an acceptable life-style and degree of relief and finally prolonging or protecting life. In fact the modern approach to health care delivery in rheumatic diseases must be based on the team concept. The team should consist of the physician/rheumatologist, the orthopaedic surgeon and a spectrum of arthritis health professionals composed of physical therapists, occupational therapists, nurses, psychologists, social workers, dietitians, bioengineers and administrators.
Feng
P H
PH
Department of Medicine, Tan Tock Seng Hospital, Singapore.
D006301:Health Services Needs and Demand; D006801:Humans; D012216:Rheumatic Diseases / Q000175:diagnosis / Q000628:therapy