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Rheumatology

Division: Med 

Dr Robert Marshall

0117 342 2902

Rheumatology

Dr Shane Clarke

0117 342 2902

Rheumatology and Osteoporosis

Dr Roopa Prasad

0117 342 2902

Rheumatology, Polymyagia Rheumatica (PMR)

Dr Matthew Roy

0117 342 2902

Rheumatology

Locum Consultant

0117 342 2902

General Rheumatology

Access / Referrals

General Practitioners should refer suspected inflammatory conditions directly to Rheumatology and not via the Musculoskeletal Assessment and Treatment Service (MATS). Current evidence supports the early treatment of rheumatoid arthritis so early referral is encouraged.

Referrals are distributed between the consultants and can be received via the Choose and Book system. Each new letter is allocated as urgent or routine priority after consultant review.   If you feel your referral is urgent, then please make clear as to why your patient should be prioritised over others.  Approximately 50% of new patients seen in our Rheumatology department have an inflammatory arthritis. In many instances GPs have already initiated investigations (blood tests, X-rays) and we would request that details of these and results are included in the referral letter to avoid unnecessary repetition. Faxes may be sent to 0117 3420279.

Emergency advice can be obtained from the Specialty Registrars who carry radiopagers (obtainable via switchboard). Alternatively please leave a message with the rheumatology secretaries on 0117 3422902 and 0117 3422910. If unavailable then telephone clinic reception on extension 0117 342 4880. 

The Rheumatology Team

0117 342 4880.

The multidisciplinary team includes specialised nursing, occupational therapy and physiotherapy support. The Day Case Ward in the Rheumatology Outpatient Centre has facilities for joint injections, infusions, and undergraduate teaching. 

Osteoporosis

The Department runs a clinical osteoporosis service with Dual energy Xray Absorptiometry (DXA) scanning facilities.

Polymyalgia Rheumatica (PMR)

The Rapid Access PMR Clinic will accept patients who have ALL of the following criteria:

  • Bilateral shoulder pain and stiffness
    • Worse in the morning
    • Abrupt onset (symptoms reached their peak in < 2 weeks)
  • Raised acute phase response (plasma viscosity, CRP or ESR)
  • Not yet on prednisolone
  • Once on treatment, the diagnosis can be hard to estalish, so please do not prescribe prednisolone before referral.

Please fax details to 0117 342 0279.

Giant-Cell Arteritis

The department keeps short-notice appointments for patients with suspected giant-cell arteritis.  Those with visual disturbance should be referred urgently to Ophthalmology initially, rather than Rheumatology. 

Following clinical assessment by a Rheumatologist, the patient may be referred for a Temporal artery biopsy and/or ultrasound and commenced on treatment accordingly.

Please consider referral via this route for patients aged over 50 with at least 2 of the following features:

  • Abrupt onset headache
  • Scalp pain / tenderness
  • Jaw / tongue claudication
  • Constitutional symptoms (fever, weight loss, fatigue)
  • Polymyalgic symptoms
  • Limb claudication
  • Visual symptoms should prompt urgent ophthalmology referral

Note: approximately 95% of patients with giant-cell arteritis have raised inflammatory markers. 

Fibromyalgia / Chronic Pain

Patients with unexplained chronic musculoskeletal pain may sometimes benefit from Rheumatological assessment to exclude other conditions and confirm a suspected diagnosis.  However, long-term management is usually best achieved through a multidisciplinary pain service.