Early Arthritis Clinic
Allows rapid access to Rheumatology services for assessment of patients with painful, stiff or swollen joints which may represent the onset of rheumatoid arthritis.
Please advise patients to stop taking any NSAIDs for 24 hours before clinic and DO NOT prescribe steroids before referral. Simple analgesics like paracetamol or codeine can be prescribed.
Patient must have:
- Joint pain present for at least 4 weeks but LESS than one year
- Early morning stiffness in joints of > 30 mins
PLUS either of the following:
- 2 or more swollen joints
- Tender metacarpophalangeal joints hands by squeeze test
NB It is not for patients with probable osteoarthritis, widespread pain symptoms or raised inflammatory markers ? cause patients.
If your patient is systemically unwell with raised ESR /CRP please discuss with medical Registrar on call.
If your patient has developed an acutely swollen, hot joint which may be septic or gouty in origin please contact the Registrar on call in Orthopaedics or Rheumatology to discuss the patient that day.
The E-referral will be reviewed by a Consultant and if felt appropriate for this particular clinic, an appointment will be sent out to the patient directly.
If not, then a routine appointment will be made in the general clinics and the referring GP will be informed of the outcome.
Please ensure we have up to date contact details, including a mobile telephone number for the patient, on the form.
For those confirmed with inflammatory arthritis, follow up appointments will be arranged approximately every 4-6 weeks in order to escalate the treatment until the disease activity is felt to be either in remission or at the lowest level possible for that particular patient.
Please note that a summary letter outlining the patient’s history, joints affected, analgesics and anti-inflammatories used together with previous medical history is also required.
Referral criteria for this clinic are also outlined on the NHS eReferral Service under Rheumatology ‘Early Arthritis Clinic’.
Ask yourself has this patient got the ‘S’ factor?
Suspected Giant Cell Arthritis
For suspected cases of Giant Cell Arteritis please bleep one of the rheumatology registrars (bleep 2531 or 1365) for further advice and/or to arrange an urgent review of the patient.
It would be useful if an urgent ESR could be sent off either from the GP practice or on arrival at hospital.
Out of hours 9-5 Monday to Friday, patients with suspected GCA should be sent to A&E or the AEC Clinic for further assessment.
The UHCW rheumatology service runs various clinics, mainly at UHCW but also at St Cross Hospital, Rugby and George Eliot Hospital, Nuneaton.
There is a wide range of services, including an early arthritis clinic, an ankylosing spondylitis clinic, an urgent review clinic, and an osteoporosis service.
Here is a list of the consultants, with their interests and involvement at other hospitals:
- Dr Tanya Potter (Early inflammatory arthritis/transitional care) UHCW ext 26708
- Dr Kaushik Chaudhuri (Osteoporosis) UHCW/George Eliot ext 26708
- Dr Phillip Perkins UHCW/George Eliot ext 26708
- Dr Shirish Dubey (Connective tissue diseases/Vasculitis) UHCW/St Cross ext 26707
- Dr Price-Forbes UHCW/George Eliot ext 26707
- Dr Gillian Peffers UHCW ext 26707 (Early Arthritis, General Rheumatology, Sjogrens)
- Dr Nicola Gullick UHCW (Psoriatic Arthritis and Research)
- Dr Tim Blake UHCW (Acute Medicine, Spondyloarthropathy, Connective Tissue Diseases).
- The Rheumatology Registrars carry bleeps (2531 or 1365) and are contactable 9am-5pm for advice.