Rheumatology

The rheumatology service at Emerald Avenue Medical Clinic covers joint pain and swelling where the cause is inflammatory rather than purely mechanical: the arthritides, the crystal conditions, and the soft tissue disorders that sit alongside them.

Telling one from the other is usually the first task, which is why the service is held by a consultant carrying board recognition in rheumatology as well as orthopaedics. The medical and the surgical sides of a joint problem are weighed in a single consultation rather than across two referrals.

Where a condition is systemic and needs ongoing medical management beyond the joints, that is said plainly at consultation and the onward referral is made. Rehabilitation is planned with the clinic's physiotherapy service.

The first appointment is a consultation with the consultant. You will be asked about the pattern of your symptoms, which joints are involved, how they behave through the day and what has already been tried, followed by an examination of the affected joints.

Blood tests and imaging are arranged where they are needed to separate an inflammatory cause from a mechanical one, and the findings are discussed with you directly. You will leave with a plan setting out the options open to you.

Please bring any previous blood results, scans, radiology reports and operation notes you hold, along with a list of any medication you take.

Rheumatological assessment

Examination of the affected joints, with blood testing and imaging arranged as needed, to establish whether the cause is inflammatory, degenerative or mechanical.

Management of inflammatory joint disease

Treatment planning for rheumatoid, psoriatic and crystal arthritis. Where long-term immunosuppressive therapy and its monitoring are required, the onward referral is made.

Osteoarthritis management

Non-surgical management of joint wear, including activity modification, injection and rehabilitation, with the surgical options set out where they become relevant.

Image-guided joint injection

Diagnostic and therapeutic injection of the shoulder, hip, knee and small joints under image guidance.

Joint aspiration

Aspiration of a swollen joint, both for diagnosis and for the relief of an effusion.

Soft tissue and tendon treatment

Assessment and treatment of bursitis, tendinopathy and soft tissue rheumatism, including shockwave therapy through the physiotherapy service.

Synovectomy

Surgical removal of inflamed joint lining in the shoulder, knee, elbow and wrist, where medical treatment has not settled the joint.

Rehabilitation planning

A physiotherapy plan built alongside the medical treatment rather than after it.