Management of the patient with rheumatic diseases going to surgery

This article reviews the perioperative management of rheumatoid arthritis, gout, systemic lupus erythematosus, scleroderma, and ankylosing spondylitis. It discusses the unique interactions between each rheumatologic disease and a surgical challenge and provides guidelines for the assessment of patients preoperatively. The available literature on surgical risks is analyzed, and approaches are suggested to both reduce postoperative complications and control the rheumatic disease. It is hoped that this will aid the internist in evaluating and treating the rheumatic patient undergoing surgery.