Rheumatology has seen much progress in recent years. 
There is an increased understanding of mechanisms that cause the diseases at the cellular and molecular level. From 1998 to 2012, eight new medications were added to our armamentarium just for treatment of rheumatoid arthritis and more are on the way. New laboratory studies are constantly introduced for diagnosis and management of diseases.
Our “treat to target” strategy is to reduce the disease activity, prevent structural joint and bone damages and improve the overall patient outcome. We have increased the accuracy of physical examination and interventions by using ultra sonogram in our practice on a daily basis.
Each patient is a unique individual with a different genetic makeup. Extent and severity of symptoms, disease complications, response to medications and development of side effects could be quite different from one patient to the other.
After confirming the diagnosis and determining the disease severity and presence or absence of systemic manifestations, the patient needs to be counseled regarding the available therapeutic options including the new FDA approved medications or even clinical trials if necessary.
It is the patient’s right to choose the course of action. Our job is to measure the response to therapy, monitor for emergence of adverse reactions or complications, tailoring the therapy accordingly and stay up-to-date with new emerging diagnostic and therapeutic modalities in our field.
