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The first visit takes 45 to 60 minutes. The rheumatologist will perform a detailed joint exam (checking for swelling, warmth, and tenderness in every joint), review your blood work, and take a thorough history of your symptoms including when they started, what triggers them, and how they have progressed. They may order additional labs, X-rays, or ultrasound. Treatment plans often involve medication adjustments over several visits to find the right combination.
See a rheumatologist for persistent joint pain or swelling in multiple joints, morning stiffness lasting more than 30 minutes, unexplained rashes combined with joint pain, positive autoimmune blood tests (ANA, rheumatoid factor), gout attacks, chronic widespread pain or fatigue your PCP suspects is fibromyalgia, or any condition where your immune system appears to be causing inflammation.
Office visit copay: $30-75 · Rheumatoid factor/ANA panel: $100-300 · Biologic infusion: $1,000-5,000 per treatment · Joint ultrasound: $200-500
Rheumatoid arthritis is an autoimmune condition that attacks the joints. Rheumatologists prescribe disease-modifying drugs early to prevent joint damage and manage the condition long-term.
Lupus can affect the skin, joints, kidneys, brain, and other organs. Rheumatologists manage flares, monitor organ involvement, and adjust treatment to keep the disease under control.
Wear-and-tear arthritis causes joint pain and stiffness that worsens over time. Rheumatologists help distinguish it from inflammatory arthritis and develop management plans that keep you active.
Sudden, intense joint pain (often in the big toe) may be gout. Rheumatologists confirm the diagnosis, treat acute flares, and prescribe long-term uric acid-lowering therapy to prevent future attacks.
Widespread pain, fatigue, and brain fog that cannot be explained by other conditions may be fibromyalgia. Rheumatologists diagnose it, rule out other causes, and create a multifaceted treatment plan.
Rheumatology visits are covered as specialist visits. Biologic medications (Humira, Enbrel, Rinvoq, etc.) are expensive, often $2,000 to $6,000 per month before insurance. Most are covered under specialty pharmacy benefits with prior authorization. Manufacturer copay assistance programs can dramatically reduce out-of-pocket costs. Your rheumatologist's office typically handles authorization paperwork.