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A Message from Dr. Wilson
I graduated from medical school over 35 years ago, and the field of rheumatology has changed dramatically since then. Back then, it would have been fair to call rheumatology "medical orthopedics." Painful arthritic conditions which could not be helped by the orthopedic surgeon were sent to the rheumatologist for management of symptoms. The emphasis at that time was on the treatment of pain and discomfort because we had little else to offer. We would use anti-inflammatories, muscle relaxers, antidepressants, and pain medications because we could not change the process that was affecting the patient. A rheumatology practice was full of degenerative osteoarthritis, tendinitis, bursitis, and fibrositis. Sure, there were rudimentary therapies to try to control some diseases. Rheumatoid arthritis patients would receive weekly injections of liquid gold salts, and many disorders were treated with prednisone.
Today, rheumatology is a completely different field. Our knowledge of the complexities of immune and inflammatory mechanisms has transformed rheumatology into a specialty focused on autoimmune and systemic inflammatory diseases. For our treatments, we have borrowed multiple medications from cancer chemotherapy, and we employ injections and infusions of monoclonal antibody proteins. We can suppress and control previous crippling and debilitating diseases such as rheumatoid arthritis, psoriatic arthritis, systemic lupus, osteoporosis, and tophaceous gout. Training in multiple disorders is unique to rheumatology, and only a rheumatologist knows best how to diagnose and treat those disorders. Our focus now is on distinguishing those disorders, and those patients, from common arthritis maladies. That separation allows us to do what we are best trained for: the diagnosis and treatment of systemic rheumatic diseases.
When we encounter a new patient in our practice today, our investigation centers on whether that patient has a rheumatic disorder which is best managed by a rheumatologist. Many patients do not have rheumatic disorders, and some are disappointed that we do not possess a treatment which will change their condition. Sometimes, we can suggest other therapies or evaluations that may be of benefit. In all cases, we strive to reach an honest, compassionate assessment, and do our best to treat those systemic rheumatic disorders which we uncover.
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