Department of Rheumatology
The Rheumatology department was established in 1992 as a distinct administrative unit on the basis of previous Department of Internal Medicine. It is located in the Hospital of Lithuanian University of Health Sciences Kauno Klinikos. From the beginning the interest of the Rheumatology faculty members - specialists of highest qualification, associated professors, doctors of medicine, supervised by professor N. Misiūnienė, later professor A. Baranauskaitė was to perform and provide good patient care, to develop research and education for arthritis and the rheumatic diseases in Lithuania, creating the next generation of physician-scientists, according theirs’ own or foreign partners’ experience.
Almost all members of this division – 9 doctors at the moment - work both as physicians and as faculty members. They consult other departments in the Hospital of Lithuanian University of Health Sciences Kauno Klinikos, participates in students’ and medical residents’ education process, faculty members participate in the activity of Lithuanian Association of Rheumatologists, preparing local diagnostic and treatment protocols of rheumatic diseases. Several clinical trials are constantly running in our clinic.
Rheumatology clinic consists from 27 beds Rheumatology inpatient department and two outpatient cabinets.
Members of this division have expertise in the diagnosis and management of a broad spectrum of rheumatic disease including rheumatoid arthritis, osteoarthritis, systemic rheumatic diseases ( systemic lupus erythematosus, systemic sclerosis), gout, ankylosing spondylitis, reactive arthritis, psoriatic arthritis, inflammatory muscle diseases, various forms of vasculitis and soft tissue syndromes. The III level differential diagnosis of rheumatic diseases and musculoskeletal tumors have been done in our Rheumatology department. The modern treatment, such as biological agents – TNF blockers (infliximab, etanercept, adalimumab), monoclonal antibody CD20 – rituximab, certolizumab pegol, tocilizumab, belimumab are being used to treat rheumatic diseases.
Our specialists are performing such procedures: joint ultrasound, US guided and blind joint aspirations, intraarticular injections, detection of uric crystals in the synovial fluid, capillaroscopy, skin biopsy. For the diagnosis of the diseases the modern radiological diagnostic tools are possible – CT, MRI, bone scan, densitometry, also specific immunological tests, organ biopsies, videocapillaroscopy.
Rheumatology department is enrolled in the study process of Lithuanian University of Health Sciences. Fourth and sixth year medical students are studying rheumatic diseases. Fourth year students have a cycle of Rheumatic diseases as a part of “musculoskeletal diseases’ module”, during which they have a possibility individually or with lector to study the real cases of rheumatic diseases, the process of diagnosis and treatment of the patients, to listen to a lectures, participate in seminars and tutorial meetings. The sixth year students have an elective of rheumatic diseases for 1,5 month. Besides students we participate in all kind of residents training process. During the 2 months course of rheumatic diseases residents work in our inpatient and outpatient departments. Residents in rheumatology participate in 4 year Rheumatology residenship programme, during which half of the time they work in the Rheumatology department, the rest of the time- in all kind of internal medicine departments, neurology, radiology, dermatology departments. Finishing the Rheumatogogy residenship residents have the basics of musculoskeletal ultrasound and have an ability to perform diagnostic joint aspirations. Faculty members participate in the postgraduate teaching process. Different lectures, postgraduate courses for family doctors and specialists of internal medicine and rheumatologists are being held every year.
Innovative research conducted or planned by our physicians and faculty has been done for more effective methods of prevention, diagnosis, and treatment of the rheumatic diseases. In our clinic there were epidemiological studies in back pain, spondyloarthritis. The Raynaud’s syndrome, systemic sclerosis and Lupus erythematosus differential diagnosis, immunogenetics during the biological treatment have been studied. Clinic was participating in the international study of the course, early diagnosis and prognostic factors of rheumatoid arthritis. We participate in the EULAR and EUSTAR international projects. At the moment students pending doctoral thesis are interested in such fields as the epidemiology of gout, hiperuricemia, cardiovascular pathology in gout and hyperuricemia, gout ultrasound, an early diagnosis of seronegative spondyloarthropathies. Students pending doctorate thesis have a wide accesses to the e- database, access to the newest medical journals, books, potential for interdisciplinary cooperation. The research is funded by a research training grant from the Lithuanian University of Health Sciences Study fund, other funds, according principles of project funding.