Emily Myers, MD is a Rheumatologist at Sinai Hospital in Baltimore, MD. Rheumatologists deal with diseases that affect the muscles, joints, ligaments, tendons as well as diseases that affect the immune system such as lupus and rheumatoid arthritis. In many cases, orthopedists and rheumatologists work together to give patients the best care and treatment options possible.
Background and Training: Dr.. Myers completed training in internal medicine, a fellowship in Rheumatology and she passed a Board Exam in Rheumatology. According to Dr. Myers, “medical school exposes you to different areas of medicine and I found Rheumatology particularly interesting in my second year when I took an elective class in Rheumatology.” There is currently no cure for autoimmune diseases, so doctors help patients manage their conditions long-term. Dr. Myers stated that she “ enjoyed developing long-term relationships with patients” and she also liked the fact that she could do outpatient work which allowed her to have a good work-life balance.
Common Conditions:
Lupus: Dr. Myers specializes in the treatment of Lupus. Lupus is an autoimmune disease that causes inflammation and pain in organs, muscles, and joints. Dr. Myers stated that “ Lupus causes the immune system to fight healthy tissue in the body instead of fighting infections and it affects the skin, nervous system, brain, kidneys and other systems of the body.” There is no known cause for this disease but it is believed that some people have a genetic predisposition to the disease that is triggered by external factors such as stress and sickness. Lupus is treated with medication that reduces the inflammation in the body and immunosuppressants. Exercise is known to be effective in reducing the stiffness and swelling of joints caused by the disease.
Arthritis: There are two types of arthritis, inflammatory arthritis and non-inflammatory arthritis, the most common of which is osteoarthritis. Osteoarthritis affects joints where the bones meet and move. It occurs when the cartilage that cushions the bones degenerates over time. The condition is very common in older people but it is also common in athletes. It can be treated surgically if needed. As an athlete, I understand that in order to prevent osteoarthritis, it is important to keep a healthy body weight as extra weight stresses the joints which can lead to further wear and tear. Although exercise as an athlete is good, it’s best not to exercise the same muscles on consecutive days in order to avoid over use and wear and tear. Osteoarthritis can be treated with pain and anti-inflammatory medication, physical therapy and surgery, if needed.
Cartilage Damage: Cartilage is connective tissue used to cushion the joints and prevent bone friction. Cartilage is avascular, meaning that there is very little blood supply and minimal blood vessels between cells. This avascularity means that cartilage cannot heal due to the inability to access vital nutrients to regenerate. Athletes participating in sports face the risk of wearing down the cartilage in their joints over a long period of time. When cartilage is worn down or completely lost, surgery is required to relieve pain and restore the function of the joints. In cases where athletes require knee replacements, the damaged cartilage and bone are removed and replaced with an artificial joint.
New Developments: Rheumatoid arthritis is one the most well studied conditions in Rheumatology so there are always new treatments for the disease. Every year, a conference is held where people present their research and new developments. New drugs like Rinvoq, approved by the FDA in 2019 and Kevzara approved in 2017 have helped provide options for treatment of moderately to severe rheumatoid arthritis. Additionally, new TNF blockers/inhibitors are constantly being researched and developed. TNF blockers are anti-inflammatory drugs used for treatment of rheumatoid arthritis. TNF (Tumor Necrosis Factor) is a protein produced by cells, and it controls inflammation in the body. A person suffering from an autoimmune disease like rheumatoid arthritis produces too much TNF, which increases inflammation in the body. There are several TNF blockers approved by the FDA, but recently in 2019, the FDA approved another drug, Cimzia, an injection for adults to treat certain types of rheumatoid arthritis.
Rheumatology vs Orthopedics: By interviewing Dr. Myers, I was able to better understand the difference between rheumatology and orthopedics. Orthopedists are more focused on surgical treatment while rheumatologists focus on medical, non-surgical treatment of the musculoskeletal system. By working together, these experts can help find the best treatment options for their patients.
https://www.fda.gov/news-events/press-announcements/fda-approves-treatment-patients-type-inflammatory-arthritis
https://www.fda.gov/drugs/new-drugs-fda-cders-new-molecular-entities-and-new-therapeutic-biological-products/novel-drug-approvals-2017
Comments