These complaints include muscle pain and weakness, regional pain syndrome such as back or neck pain, rheumatoid arthritis, gout, ankylosing spondylitis and lupus erythematosus among others. Rheumatologists are specialists in the diagnosis and management of musculoskeletal disorders having completed three years of training in the broad field of internal medicine and a two year fellowship in rheumatology. R heumatoid arthritis is a systemic disorder characterized by female predominance. It is persistent, symmetric and may be associated with systemic features such as fatigue, weight loss and anemia.
Most patients also have an elevated sedimentation rate.
M edications are useful in managing inflammation associated with rheumatoid arthritis. The first compounds employed are either salicylates or other nonsteroidal anti-inflammatory drugs. These medications exert their anti-inflammatory action by modifying prostaglandin metabolism. They are used as initial therapies. All share common toxicities including stomach upset, liver function abnormality, renal dysfunction and fluid retention.