A doctor who specializes in arthritis is called a rheumatologist. Rheumatologists are internists or pediatricians who completed additional years of fellowship training focused on diagnosing and treating diseases of the joints, muscles, bones, and immune system. If you or your primary care doctor suspects arthritis, a rheumatologist is typically the specialist you’ll be referred to.
What a Rheumatologist Does
Rheumatologists manage more than 100 different musculoskeletal and autoimmune conditions. Arthritis is the most common reason people end up in their office, but the scope is broader than joints alone. Autoimmune diseases can affect the skin, eyes, nervous system, and internal organs, and rheumatologists treat those too.
Some of the most common conditions they handle include:
- Rheumatoid arthritis: an immune system disorder that attacks multiple joints, causing pain, swelling, stiffness, and fatigue
- Osteoarthritis: wear-and-tear damage to the cartilage cushioning your joints, leading to bone-on-bone friction and pain
- Gout: a form of arthritis caused by uric acid crystals building up in a joint
- Lupus: an autoimmune disease where the body’s defense system attacks healthy tissues throughout the body
- Scleroderma: a condition that hardens and tightens the skin and can damage blood vessels and organs
- Polymyalgia rheumatica: an inflammatory condition causing muscle pain and stiffness in the shoulders, hips, and neck
Children get arthritis too. Pediatric rheumatologists specialize in juvenile idiopathic arthritis and other childhood conditions involving the joints, bones, muscles, and immune system. Treatment for kids typically involves a team approach with several providers working together.
How Rheumatologists Differ From Orthopedic Surgeons
Both rheumatologists and orthopedic surgeons deal with joint problems, but they come at them from different directions. Rheumatologists train in inflammatory and autoimmune conditions and treat them primarily with medication. Orthopedic surgeons train in injuries and structural problems of the skeleton and sometimes use surgery to fix them.
If your joint pain stems from inflammation or an immune system problem, like rheumatoid arthritis or lupus, a rheumatologist is the right fit. If you have a fracture, torn ligament, or torn meniscus, that’s orthopedic territory. There’s overlap with osteoarthritis: both types of doctors can manage it, and an orthopedic surgeon may step in when a joint is damaged enough to need replacement. A rheumatologist can treat arthritis of the knee, for example, but won’t handle a sports injury in that same knee.
Training and Qualifications
Becoming a rheumatologist takes a long time. After four years of medical school, they complete a three-year residency in internal medicine (or pediatrics, for those who treat children). Then comes a fellowship in rheumatology lasting two to three years, which includes rotations through specialty clinics for conditions like lupus, vasculitis, and other inflammatory diseases, plus dedicated time for research. All told, that’s at least nine years of training after college before they’re board-certified.
What Happens at Your First Appointment
A first visit to a rheumatologist is thorough. Expect a detailed review of your medical history, your symptoms, and your family history of autoimmune or joint diseases. The physical exam is systematic: the doctor works through your joints from hands and wrists to shoulders, then hips, knees, ankles, and feet. They check each joint for three things: swelling, tenderness, and how much range of motion you’ve lost. They’ll also watch you stand and walk to assess your gait and posture.
Blood tests are a key part of the workup. For rheumatoid arthritis, doctors look at markers of inflammation in the blood and test for specific antibodies that signal autoimmune activity. Imaging often follows. X-rays can track joint damage over time, while MRI and ultrasound give a more detailed picture of how far the disease has progressed. No single test confirms most types of arthritis, so rheumatologists piece together your symptoms, exam findings, bloodwork, and imaging to reach a diagnosis.
The Broader Care Team
Rheumatologists are the lead specialists, but arthritis care often involves a wider team. Physical therapists help you maintain joint mobility and build strength around affected joints. Pharmacists play a role because many rheumatic disease medications require careful monitoring. Social workers can help navigate the practical challenges of living with a chronic condition. For patients receiving certain medications through infusion, specialized infusion nurses manage those sessions. In many practices, nurse practitioners or physician assistants handle follow-up visits and help coordinate care between appointments.
Your primary care doctor remains involved too, especially for managing other health conditions alongside your arthritis. But when it comes to the arthritis itself, the rheumatologist is the one driving the treatment plan.