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Dr. Ravoof
Dr. Ravoof, Doctor
Category: Medical
Satisfied Customers: 3278
Experience:  Experienced Physician in the field of Medicine and Surgery.
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Should I see a Neurologist or Rheumatologist or Orthopaedic

Resolved Question:

Should I see a Neurologist or Rheumatologist or Orthopaedic Surgeon?I developed severe and apparently permanent adverse reactions as a result of Hepatitis B vaccine.
About 4 years ago I was completely healthy and very athletic before this vaccination and have now
suffered severe, debilitating autoimmune side effects from this vaccine. Such as getting joint pain,
and a limited range of motion when I lift weights in the gym, only on one side of the body, not in
both shoulders at once, just the left, previously I had no shoulder problems, I used to lift 100KG but
now I get joint pain when I lift 50KG and these started after vaccination. There's a measurable loss in
stamina before the vaccine to how I am now, I experience breathlessness much earlier when I do
cardiovascular exercise then before I had the vaccine. I have chronic fatigue and it is not improved by
getting rest. I have a dry persistent cough when there's nothing to bring up.I have a severe constant pain whenever I'm sitting down, it's on the upper left side of my abdomen, it's
always in the same place. This place hurts when I'm using my laptop or when I'm watching TV or when I'm
sitting on the bus. Sometimes I get sharp stabbing pain on the left side of my stomach. The ache seems to
dissapear after I stand up. I suffered the residual effects of all these symptoms for more than 4 years.
Submitted: 6 months ago.
Category: Medical
Expert:  Dr. Ravoof replied 6 months ago.

Dear customer,

Thanks for your question.

With these symptoms and your history, I would suggest consulting a rheumatologist.

Take care.

Please rate the answer with a 5 star rating.

Thanks.

Customer: replied 6 months ago.
In my case only one joint is painful. Wouldn't it be better to consult a Orthopaedic surgeon?
Expert:  Dr. Ravoof replied 6 months ago.

Dear customer,

Thanks for your reply.

Since the initiating event is the vaccination, this is most likely due to autoantibodies that may have developed post vaccination. Also due to your numerous other symptoms besides the joint symptom makes it more worthwhile to consult a rheumatologist.

Take care.

Please rate the answer with a 5 star rating.

Thank you.

Customer: replied 6 months ago.
What's the difference between orthopaedician and a rheumatologist? Can you please say it I did some Google searching and didn't find that much.
Expert:  Dr. Ravoof replied 6 months ago.

Dear customer,

An orthopedic surgeon is a surgeon who deals with conditions involving the bones such as fractures and other bone diseases. A rheumatologist is not a surgeon but an internal medicine physician or a pediatrician, who is further specialized in the diagnosis and treatment of musculoskeletal disease and systemic autoimmune conditions.

Take care.

Please rate the answer with a 5 star rating.

Thank you.

Customer: replied 6 months ago.
Orthopedic surgeon deals with diseases of bones and joints, primarily single bone or joint involvement. Orthopedician generally acts as both a physician and a surgeon.Rheumatologist deals with systemic diseases affecting bones and joints, primarily 2 or more bones or joints involvement, like in rheumatoid arthritis, gout, systemic autoimmune disorders. Rheumatologist acts only as a physician.In my case only one joint is involved (left shoulder) which is less likely in autoimmune/systemic disorders, although can happen in initial stages.
Expert:  Dr. Ravoof replied 6 months ago.

Yes it can happen initially. However more concerning are the associated symptoms and therefore an autoantibody panel is recommended which can be ordered by a rheumatologist and interpreted correctly by this specialist.

Take care.

Please rate the answer with a 5 star rating.

Thank you.

Customer: replied 6 months ago.
I did Autoimmune blood test and it came out negative.
Expert:  Dr. Ravoof replied 6 months ago.

Dear customer,

Thanks for your reply.

Even if the tests were negative, a rheumatologist being a physician trained in internal medicine would be better able to manage your other symptoms such as breathlessness, fatigue, persistent cough in addition to your musculoskeletal complaints.

Take care.

Please rate the answer with a 5 star rating.

Thanks.

Customer: replied 6 months ago.
A primary care physician/GP/Internal Medicine physician suspects a generalized musculoskeletal disorder and then refers the patient to a rheumatologist.
A rheumatologist routinely does not see patients with other complaints, so may have less experience in dealing with problems other than those of joints and bones.
Expert:  Dr. Ravoof replied 6 months ago.

Dear customer,

Yes but his/her background knowledge (since being an internal medicine doctor) in dealing with other complaints such as breathlessness, fatigue, persistent cough will be much stronger than an orthopedic surgeon. Also a rheumatologist will be able to correlate these symptoms better with the musculoskeletal symptoms.

Take care.

Please don't forget to rate the answer with a 5 star rating by clicking 5 stars above.

Thanks.

Customer: replied 6 months ago.
But, you need to consider the basic requirement in consulting a rheumatologist (versus an orthopaedician) - suspected systemic disorder affecting multiple joints - which is less likely in MY case - in view of the details provided by me.
Expert:  Dr. Ravoof replied 6 months ago.

Dear customer,

But your other symptoms such as breathlessness, fatigue, persistent cough also need to be put in context and treated. Regarding the joint symptom the rheumatologist will be able to diagnose it also and if required he/she will refer you to an orthopedic surgeon.

Take care.

Please don't forget to rate the answer with a 5 star rating by clicking 5 stars above.

Thanks.

Customer: replied 6 months ago.
1. If my left shoulder pain is due to rotator cuff injury (which appears more likely), the rheumatologist will likely ask me to consult an orthopaedician.
2. All of my symptoms and/or complaints may or may not have a single cause. However, in view of results of investigations (all negative or normal), it is more likely that few of these symptoms are not due to a single cause.
3. Overall, only after further investigations and specialist consultations, list of probable causes can be narrowed down. Sometimes if a single specialist can not arrive at a conclusion, a doctors' team work is required.
Expert:  Dr. Ravoof replied 6 months ago.

Dear customer,

Yes you are correct, sometimes a team of doctors need to mutually consult each other and arrive at a diagnosis.

Take care.

Please don't forget to rate the answer with a 5 star rating by clicking 5 stars above.

Thanks.

Dr. Ravoof, Doctor
Category: Medical
Satisfied Customers: 3278
Experience: Experienced Physician in the field of Medicine and Surgery.
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