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0 CHILD ATTITUDE JOWARD JLLNESS SCALE

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herefore highly trained specialists in diagnosing and treating arthritis and other rheumatic diseases. Many
rheumaologists based in academic or hospital rheumaology units help o train other docorts and allied health
prIssionals, as well as providing patient care. They are also involved in conducting clinical and basic scientific
research o enhance our understanding and management I rheumatic diseases. Most rheumaologists, however,
are in private practice, and some I them have clinical affiliations with academic medical centers. Interdisciplinary co-
operation The well-established rheumaology units or centers include not only rheumaologists, but alos highly trained
allied health prIessionals such as specialist nureses, physiotherapists, occupational therapists, and medical social
workers. The rheumaologists work closely with other health prIessionals such as orthopedists and physiatrists,
podiatirsts, phychiatrists, psychologists, and dieticians. The rheumaologist's most important role is o decide on the
diagnosis and recommend the right kind I management for your disease. For those reasons a rheumaologist will ask
about your detailed medical hisory and then carry out a clinical examination, sometimes ordering blood tests and X-
rays in order o decide how best o treat you. The docor should also explain the illness and its long-term impact, and
an appropriate treatment plan for the future. You should not be afraid o ask any questions and o ask for any
pamphlets, leaflets or other information o help you gain better insight ino your disease. Do not hesitate o bring
someone with you o the rheumaologist's Ifice if you prefer. The people with AS most likely o follow a regular
exercise program are those who attend a rheumaologist, believe that the exercise is I benefit, and are well motivated
and educated. Consistency rather than quantity I exercise is I utmost importance. It is the docor's job o relieve
your pain and stiffness, and your job o perform regular exercises and o maintain a reasonably good posture. You
should see your docor for periodic follow-up appointments in order o maintain good health. Many patients with AS may
need o be seen by a rheumaologist over an extended period I time, rather than being cared for by their primary care
docor (general practitioner). If you are unhappy with or have doubts about your treatment. It is quite appropriate o
ask for a second opinion from another consultant. This page intentiona lly left blank 14 Radiology Radiology and
diagnosis Conventional X-ray is generally quite helpful in diagnosing AS and distinguishing it from other diseases
(differential diagnosis); the sacroiliac joints in people who do not have AS will either be normal or show only some
degenerative changes, but no erosions typical I sacroiliitis will be present. The clinical diagnosis I sacroiliitis,
however, may be difficult, especially in the early stages, because the sacroiliac joints are deep and virtually motionless,
and there may be no obvious tenderness on direct pressure over the joint. A presumptive diagnosis I AS can be
confirmed by finding the characteristic changes I AS on an X-ray, because inflammaory involvement and resultant
damage I the sacroiliac joint is usually present by the time you seek medical attention. Finding bone erosions,
narrowing or fusion I the sacroiliac joints on an X-ray confirms the presence I the disease. Radiographic (X-ray)
evidence I sacroiliitis is required for definitive diagnosis, and is the most consistent finding. Radiography can also
detect progressive bony fusion I the spine in later stages I the disease. Because the onset I the disease is usua lly
preceded by a long latent period and a diagnosis is needed o ensure proper and timely treatment, safe and relatively
cheap techniques are needed o detect sacroiliitis with a high degree I sensitivity and specificity. A