There is no field of medicine more broad and fascinating than rheumatology. Our field is, after all, the in vivo expression of immunology. Rheumatology is the sum of all symptoms, the accumulation of all physical findings, the full expression of all laboratory abnormalities, the library of all radiological manifestations, and the catalogue of all pathological features that can occur when the immune system goes awry – whatever the cause. Rheumatology is also the litany of local insults to joints, muscles, bones, and tendons that develop either acutely or as the result of wear, tear, overuse, aging, and other processes of life. Finally, rheumatology is the emotional impact of these disorders on the lives of human beings.
There is no field of medicine in which the “hands-on” approach to the patient is more vital to making the correct diagnosis than in rheumatology. The time devoted to a careful history and an insightful physical examination is immensely reassuring to the patient – “Someone is listening. Someone knows what this is!”. Time spent with the patient guides the remainder of the evaluation, if indeed more is needed, and dictates treatment.
Finally, there is no field of medicine in which therapies have advanced more dramatically since the start of this century than in rheumatology. Our growing ability to treat rheumatological problems and transform patients’ lives is a gift to patients, and a privilege for those who love this field.