When your client approaches you with a musculoskeletal condition, it can be difficult to know which specialist would be best to perform a medicolegal assessment. Both Orthopaedic Surgeons and Rheumatologists assess issues such as joint, bone and soft tissue health, however they assess the issues from different angles. Understanding the difference between these two medical professions is crucial when selecting the right medicolegal assessor.
What is an Orthopaedic Surgeon?
An Orthopaedic Surgeon is a doctor that focuses on issues such as fractures, sport injuries, joint replacements and congenital deformities. This can include bones, joints, ligaments, tendons, muscles and nerves. They specialise in diagnosing and surgically correcting conditions that affect the musculoskeletal system.
Different Orthopaedic Surgeons will specialise in different areas of the body. Some of these include:
- Bone fractures and breaks
- Degenerative joint diseases
- Ligament injuries
- Spinal deformities
Orthopaedic surgeons focus on repairing the injured musculoskeletal condition mainly through surgical intervention. They aim to restore functionality and mobility through alleviating the pain and fixing the problem.
What is a Rheumatologist?
A Rheumatologist is a doctor that specialises in the treatment of inflammatory and autoimmune response conditions that affect and cause issues within joints, muscles and soft tissue. They focus on treating conditions and diseases that are caused by chronic inflammation and autoimmune dysfunction i.e., rheumatoid arthritis, lupus, gout, osteoporosis & fibromyalgia.
Differentiating from Orthopaedic Surgeons, Rheumatologists don’t perform surgery. Instead, they focus on medication and lifestyle changes to manage and control levels of inflammation. This helps to slow the disease progression. Diagnoses is usually done through blood tests, imaging studies and detailed patient consults and assessments.
How to choose the right specialist for a medicolegal assessment?
Depending on the case and the presented concerns from the client, you will make a choice between an orthopaedic surgeon and a rheumatologist for a medicolegal assessment.
Choosing an Orthopaedic Surgeon
If the client’s concerns are around structural or mechanical damage to the musculoskeletal system, an Orthopaedic Surgeon would be the best choice. In the case of medicolegal assessments, this usually looks like a trauma-related injury such as a car accident or workplace injury. However, it does include any issue involving clear anatomical damage such as degenerative joint disease.
They can provide an expert opinion on the potential for long term related issues and the level of impairment that will occur due to the condition. They are able to provide opinion if surgical intervention is needed and any other rehabilitation suggestions.
Choosing a Rheumatologist
If your client’s concerns lie around an autoimmune disease, inflammatory disorder or any chronic pain, a rheumatologist will be best for medicolegal assessment. These sort of issues are usually present when no obvious mechanical injury is present but there is the presence of pain, stiffness or inflammation.
If your client’s case is involving a complex medical history with inflammation and autoimmune affecting areas such as the hands, a rheumatologist will be able to provide crucial insights into how their condition will likely evolve over time and the long term prognosis. When your client’s ongoing care and condition is in question, a rheumatologist will be the best for the assessment.
Conclusion
Both orthopaedic surgeons and rheumatologists play a huge role in the medicolegal world, however, their expertise and areas of focus differ from each other significantly. Orthopaedic surgeons diagnose and treat musculoskeletal trauma and structural damage while rheumatologists manage inflammatory and autoimmune diseases that attack joints and soft tissue. In some cases, your assessing rheumatologist may refer the patient to see an orthopaedic surgeon and vice versa.
Choosing the right specialist for an independent medicolegal exam depends on the nature of the injury or disease and the specific details of the case. By selecting the appropriate expert, you ensure that the examination is thorough, accurate, and aligned with the medical complexities involved.
