Rheumatology Services


The risk of osteoarthritis increases with age especially those aged 50 and above. Osteoarthritis is caused by the cartilage in your joints breaking down, often due to wear and tear. The degeneration of this cushioning tissue can result in painful, stiff and swollen joints. Often osteoarthritis develops in your hips, knees and small hand joints.

Diagnosis is made by a physical examination and sometimes blood tests, an x-ray or a joint aspiration test to rule out other likely conditions.

There is no cure for osteoarthritis but it can be effectively managed. We offer an effective integrated approach to your care and pain management. This may include the use of non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections to manage your pain. You may be advised to lose weight and engage in physical exercise. Our chartered physiotherapists can offer advice on appropriate footwear, the use of supportive devices and individual exercise plans.

If your pain is extremely severe and, it’s affecting your daily life, then surgery may be an option.

Inflammatory arthritis

Inflammatory arthritis includes rheumatoid arthritis, gout, psoriatic arthritis (develops in some people with psoriasis) and ankylosing spondylitis (inflammation of joints in the spine). It causes joints to become inflamed, painful, warm and tender.

A diagnosis may be made based on your medical history and a physical exam alone or your rheumatologist may request blood tests, x-rays or scans.

Treatment is dependent of the type of inflammatory arthritis you have as well as its severity and symptoms. You may be advised to take medications to relieve your pain and inflammation as well as disease-modifying anti-rheumatic drugs (DMARDs) or biologic agents to slow down or stop the progression of your condition. Physiotherapy may be useful in helping you to continue to perform daily tasks and move around safely.

Rheumatoid arthritis

Rheumatoid arthritis is a chronic autoimmune disease that causes your body’s immune system to mistakenly attack and damage cells that line your joints and the surrounding tissues. It results in your joints, often in your hands, feet and wrists, becoming inflamed, painful and stiff with prolonged stiffness often in the morning.

It’s important to diagnose and treat rheumatoid arthritis early treatment as this can reduce the likelihood of it getting worse and the risk of further problems occurring such as joint damage. Ultrasound or MRI scans are often performed to identify the arthritis type and to monitor your condition.

Treatment focusses on managing your condition and includes medications to relieve your pain and others that can work on your immune system to reduce the attack on your joints. We also offer physiotherapy to help retain your mobility and provide advice on ways of doing things that may have become difficult.

Surgery is available to correct any joint problems that may develop.


Gout occurs when your body creates too much waste product called uric acid that’s deposited as needle-like crystals in your joints and/or soft tissues, often the base of your big toe.

These uric acid crystals cause inflammatory arthritis that results in pain in your joints. Most people with gout have sudden, acute attacks every now and then. They often start at night or early morning with very painful joints that are swollen, red, overheated, shiny and sensitive.

As part of your assessment your rheumatologist may undertake a synovial fluid analysis that involves taking some fluid from your affected joint with a needle and examining it under a microscope.

Maintaining adequate fluid intake and reducing your alcohol intake, making dietary changes and weight reduction can all help prevent acute gout attacks.

Medications reduce the pain and inflammation of gout attacks, such as anti-inflammatory drugs, colchicine, and corticosteroids. There are other drugs available to reduce your uric acid levels in the long-term, such as allopurinol. Medication is a good option if your attacks become more frequent or there is a risk of complications.


Osteoporosis is a gradual condition that means you’ve got porous bones that lose bone density and have an increased likelihood of fracturing or breaking. It’s very common, especially in post-menopausal women. It’s often a silent disease but it can cause pain and disability.

A bone density scan will confirm if you’ve osteoporosis. It’s also used to monitor your bone density if you’re at risk of developing osteoporosis. CT scanning is an alternative test to identify bones at high risk of fracture.

Self-help measures include: increasing your daily calcium and vitamin D intake, partaking in regular exercise, smoking or alcohol cessation and, assessing your home for potential fall hazards.

Drugs may strengthen your bones and reduce your risk of a fracture. Most are called ‘antiresorptive’ drugs and work by slowing down the activity of the cells that break down old bone. You may also require pain relief and your options include: pain-relieving drugs, physiotherapy and pain management clinics. Your consultant will discuss the best treatment for your individual circumstances.

Connective tissue disorders

Connective tissue holds your muscles, skin and bones in place and can become injured or inflamed due to inherited or autoimmune diseases and environmental factors. Connective tissue disorders can affect many parts of your body including your bones, eyes, skin, nervous system, and lungs as connective tissue is found throughout your body.

There are many types of connective disorders. Less common heritable connective tissue disorders include Marfan’s syndrome, Ehlers-Danlos syndrome and Loeys Dietz syndrome. Autoimmune disorders that result in your body attacking its own healthy cells and tissues include: scleroderma (affects the skin), systemic lupus erythematosus (known as SLE, affects your skin, joints, kidneys, heart, brain and red blood cells), rheumatoid arthritis (affects your joints), dermatomyositis (muscle and skin inflammation) and polymyositis (widespread muscle inflammation and skin problems).

Treatment depends on the type of connective tissue disorder you have and your state of health. Most often anti-inflammatory medications are used to relieve inflammation, redness and pain.

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