Rheumatologist vs Orthopedist: What’s the Difference?


Finding the right medical specialist for your needs is hard enough without also having to decide upfront what kind of specialist you should see in the first place.

This is particularly true when two or more medical specialty fields overlap significantly in the symptoms and conditions they treat.

The close relationship between rheumatology and orthopedics is an example of such overlap. Both fields of practice focus on diagnosing and treating various kinds of joint pain.

However, for most layman patients, where the fields diverge and how to know when to see a rheumatologist vs an orthopedist are questions with less clear answers.

In the U.S., an average of 20 million clinically inappropriate referrals to specialists occur annually.

To help you communicate better with your primary care physician, this article explains the main differences between a rheumatologist and an orthopedist, with an added focus on how to know which field is right for your symptoms.

Principle Differences between Rheumatology and Orthopedics

In terms of the scope of their different fields of practice, these are the most notable differences that can guide you to the right specialist.

1. Specialization Focus

Rheumatologists specialize in diagnosing and managing autoimmune diseases and systemic conditions affecting the joints, muscles, and bones, such as:

Their focus pertains to understanding and treating the interplay between the immune system and musculoskeletal health, often involving chronic conditions that require ongoing management.

In contrast, orthopedists concentrate on the musculoskeletal system more broadly, addressing injuries, deformities, and diseases through both surgical and non-surgical means.

Their work includes treating acute injuries like fractures and torn ligaments, as well as performing surgeries for long-term issues such as joint replacement.

2. Treatment Approaches

Owing to their differences in focus, these two fields also diverge in their respective approaches to treatment.

Rheumatologists primarily employ medications, lifestyle modifications, and non-surgical methods to manage and alleviate symptoms of systemic musculoskeletal diseases. 

Their approach aims at controlling disease progression and improving a patient’s quality of life, which often involves long-term treatment plans.

Orthopedists, on the other hand, are trained in both surgical and non-surgical treatments for musculoskeletal issues.

They tend to opt for surgery to correct physical impairments, such as repairing a torn ligament or replacing a damaged joint, alongside prescribing physical therapy and other rehabilitation measures to aid recovery.

3. Conditions Treated

While there is overlap in the conditions both specialists treat, rheumatologists typically manage chronic, systemic autoimmune diseases like:

  • Rheumatoid arthritis
  • Systemic Lupus Erythematosus (SLE)
  • Scleroderma
  • Sjögren’s Syndrome
  • Polymyositis and Dermatomyositis

Orthopedists treat acute injuries, such as fractures and torn ligaments.

Further, orthopedists may also manage chronic conditions requiring surgical intervention like chronic rotator cuff tears and osteoarthritis.

4. Surgical Intervention

Orthopedists are trained to perform surgery as part of treatment — such as joint replacements or repairs of torn ligaments.

Rheumatologists, on the other hand, do not perform surgery; their treatment methods are non-invasive.

5. Training and Education

Both kinds of professionals complete medical school and residency training.

However, their residency and fellowship training focus on different areas. 

Rheumatologists complete a residency in internal medicine or pediatrics followed by a fellowship in rheumatology.

Orthopedists complete a residency in orthopedic surgery, focusing on surgical techniques and treatments for musculoskeletal conditions.

Should You See a Rheumatologist or Orthopedist?

While you should always consult with your primary care physician for a first assessment of your symptoms, there are some helpful factors to consider to help both you and your physician decide on the right referral.

1. Symptoms and Onset Timing

Patients should consider the nature of their symptoms.

Chronic pain, stiffness, or swelling in the joints without a prior traumatic injury and unaccompanied by other systemic symptoms like fatigue, fever, or unexplained weight loss, may suggest an autoimmune or rheumatic condition.

Such symptoms typically indicate the need for a rheumatologist.

However, if the pain or disability is due to an injury, such as a broken bone, a torn ligament, or joint instability, or is localized without systemic symptoms, an orthopedist would be appropriate.

2. Nature of Condition

Patients who have a prior diagnosis of any chronic, systemic autoimmune disease, such as lupus or rheumatoid arthritis, should seek a rheumatologist following the emergence of any new chronic joint pain.

Rheumatologists manage complex multi-system diseases requiring medical therapies to modulate the immune system.

For isolated degenerative joint diseases treatable by surgical intervention, such as severe osteoarthritis or a sports injury needing repair, an orthopedist is the specialist to consult.

3. Referral Patterns

Primary care physicians can be an excellent resource for guidance.

They can help determine whether a patient's symptoms are more likely related to a chronic autoimmune condition or an injury-related issue.

Referral from a primary care physician is often based on initial treatment response.

For instance, if symptoms don't improve with basic care or if the condition appears complex and symptoms persist for weeks to months.

Are You Seeking Help for Rheumatological Symptoms?

At Southwest Florida Rheumatology, our team of rheumatologists will work with you in close dialogue to ensure you receive the right care and treatment.

With three convenient locations in the Florida area, help is just a phone call away.

Contact us today to schedule your first appointment by calling 813-672-2243.


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