Rheumatologist in Belgrade

When to see a rheumatologist

A rheumatologist deals with diseases of the joints, spine, muscles and connective tissue, including conditions in which the immune system attacks the body's own tissues. Rheumatic diseases are not limited to older age: inflammatory diseases of the joints and spine often begin in young and middle adulthood. A consultation is worthwhile if you have:

• pain and swelling in one or more joints, especially the small joints of the hands and feet
• morning stiffness in the joints that lasts longer than half an hour
• lower back pain that is worse at night and in the morning and eases with movement
• sudden, severe pain, redness and swelling of a single joint, for example the joint of the big toe
• a rash on the face, increased sensitivity of the skin to the sun, a dry mouth and dry eyes
• fingers that turn pale or bluish in the cold
• raised CRP and sedimentation rate or uric acid in your results, together with joint complaints

Long-lasting joint pain should not be put down only to age or strain. With inflammatory rheumatic diseases it is important for the diagnosis to be made early, so that treatment can start in good time.

Conditions a rheumatologist treats

• Rheumatoid arthritis and psoriatic arthritis
• Ankylosing spondylitis and other spondyloarthritides
• Osteoarthritis of the knees, hips, shoulders and hands
• Gout and other metabolic joint diseases
• Lupus, scleroderma, Sjögren's syndrome and other systemic connective tissue diseases

What a rheumatology consultation at Miren Medic is like

The consultation is carried out by Dr Marko Vorkapić, specialist in internal medicine and subspecialist in rheumatology. It begins with a conversation about which joints hurt and since when, whether there is morning stiffness, how the symptoms change during the day and whether anyone in your family has a rheumatic or autoimmune disease. A clinical examination of the joints, spine and soft tissues follows, including an assessment of mobility.

Where needed, an ultrasound of the joints and tendons is done in the same appointment. Ultrasound shows whether there is fluid in a joint, thickening of the joint lining or changes in the tendons, which helps to assess the symptoms more precisely. The rheumatologist also reviews your laboratory and imaging results and recommends additional tests if needed.

Based on the findings, the rheumatologist makes a diagnosis or a plan for further investigation and proposes treatment. The plan may include medication, advice on diet and physical activity, and referral for targeted exercises and physical therapy.

Preparing for your consultation and follow-up care

Bring all your previous results: blood count, CRP and sedimentation rate, uric acid, immunology tests if you have had them, X-rays and MRI reports, as well as reports from doctors who have treated you before. Write down a list of the medication you take, including painkillers and supplements.

Wear clothes that are easy to take off or roll up, because the rheumatologist examines the joints and spine. It helps to note when the symptoms began, which joints have been affected and what eases or worsens them. If swelling comes in episodes, a photo of the swollen joint can help, as the swelling has often gone down by the time of the consultation.

Chronic rheumatic diseases are generally followed long term. At check-ups the rheumatologist assesses disease activity, reviews your results and how you tolerate the medication, and adjusts the therapy where needed. Some medicines require regular laboratory monitoring, so always bring your latest results to the consultation. Alongside therapy, regular physical activity suited to the condition of your joints and maintaining a healthy body weight help to control many rheumatic diseases.

When you need emergency care

A rheumatology consultation is booked in advance and is not a substitute for emergency care. Go to the emergency department straight away or call an ambulance (194) if you have:

• a suddenly swollen, warm and very painful joint with a fever, as this may be a joint infection
• back pain with weakness in the legs, loss of bladder or bowel control, or numbness in the groin area
• sudden weakness or numbness in an arm or leg
• sudden loss or blurring of vision, especially with a new, severe headache
• difficulty breathing or chest pain

If you already have a rheumatic disease and take therapy that lowers immunity, do not put off a high temperature or signs of infection: contact a doctor the same day.

Frequently asked questions

Related: Physical medicine · Orthopedics · Laboratory · Physiotherapy at home

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