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Rheumatology Services | Auckland | Te Toka Tumai | Te Whatu Ora

Public Service, Rheumatology

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Description

Formerly Auckland DHB Rheumatology Services
 
What is Rheumatology?

Rheumatology is the specialty of medicine that includes arthritis and autoimmune diseases. Arthritis means inflammation of a joint. A joint is where two or more bones meet and move in relation to each other. They are separated by a rubbery substance called cartilage which is smooth and slippery, allowing for easy movement. Cartilage covers the end of each bone. Tendons and ligaments attach bones to muscles and other bones. Cartilage, tendons and ligaments are enclosed within a membrane around the joint which releases a fluid into the joint space to keep it well lubricated. Autoimmune disease is where an abnormality in the immune system leads to the body’s defence harming its own cells by mistake. A rheumatologist is a doctor who has specialised in this area of medicine. Your GP will refer you to see a rheumatologist if they think you have an autoimmune disorder or if they need assistance diagnosing or treating arthritis.

Consultants

Referral Expectations

Outpatient Clinics and Services
Your GP will refer you to our Department if they think you may have arthritis or an autoimmune disease and they require a specialist opinion regarding the diagnosis or treatment of the condition.

Waiting times for clinics range from 1-4 months depending on urgency, which is assessed from the referral letter we receive from your GP. Prior to coming to our clinic you may be asked to undergo tests such as blood tests or x-rays.

Clinic appointments last 30-60 minutes. You will be seen by a rheumatologist or registrar (a doctor training to become a specialist who is under supervision). A history of your symptoms will be taken, as well as a review of any medications you are on (so please bring these with you). You will then be examined which may include a general examination or only examination of your joints, depending on what condition your specialist is looking for. You may have further testing to establish the diagnosis.

The specialist or registrar will discuss with you the possible diagnosis and what further tests or treatments are recommended. They will contact your GP about your diagnosis, results of tests and a treatment plan. You may have ongoing follow-up in our clinic or be discharged back to the care of your GP.

You may see the rheumatology nurse specialist who can provide further education and information on rheumatological diseases and the medications you are prescribed. The nurse may also provide you with support.

You may also be referred to a physiotherapist, orthotist, or occupational therapist.
A physiotherapist provides physical therapy to assist with any disability you have.
An orthotist provides practical aids/footwear to help in overcoming any disability.
An occupational therapist reviews what equipment/advice will assist in activities of daily living if you have a disability.

 

Inpatients
We also have beds available in the hospital under the care of a rheumatologist if you require admission to hospital for any treatment or testing.

 

Tests
Tests that may be required during or after your visit to the clinic include the following:


Joint Aspiration
Local anesthetic is injected into the skin to numb the area and then a needle similar in size to that used to take a blood test is inserted into the space of your joint to take a sample of fluid. This is then sent to the laboratory for testing to aid in the diagnosis of your arthritis. 

Radiology
X-rays
are useful to examine joints and these may be requested of joints that give you pain and sometimes joints that have no symptoms to help with the diagnosis.

MRI (Magnetic Resonance Imaging) gives even more detailed pictures of joints and organs so may be requested.
An MRI machine does not work like an X-ray or CT; it is used for exact images of internal organs and body structures. This method delivers clear images without the exposure of radiation.
The procedure uses a combination of magnetic fields and radio waves which results in an image being made using the MRI’s computer.

Hours

Mon – Fri 8:00 AM – 5:00 PM

Outside of these times you can contact the Rheumatology Dept via 0800 474 386 (leave a message on voice mail) or on email: rheumatologydept@adhb.govt.nz 

Please state clearly your first name and last name, and NHI No. followed by the purpose of the call.

If you have a contact number, please mention it as well.

Procedures / Treatments

Infusion Centre

The Department now offers an infusion centre for rheumatology patients receiving infliximab, tocilizumab or rituximab infusions on an outpatient basis. The infusion centre was operational from 6th April 2009. It is an alternative to patients going to Auckland Hospital for their infusions. Patients receiving Rituximab, Infliximab and Tocilizumab receive their infusions in the Endocrinology Dept at Greenlane. Patients receiving Rituximab infusion for the first time generally receive their first infusion in the Immunology Day Stay Unit or in the Transition Lounge at Auckland Hospital.

The Department now offers an infusion centre for rheumatology patients receiving infliximab, tocilizumab or rituximab infusions on an outpatient basis.

The infusion centre was operational from 6th April 2009.  It is an alternative to patients going to Auckland Hospital for their infusions.

Patients receiving Rituximab, Infliximab and Tocilizumab receive their infusions in the Endocrinology Dept at Greenlane. Patients receiving Rituximab infusion for the first time generally receive their first infusion in the Immunology Day Stay Unit or in the Transition Lounge at Auckland Hospital.

Rheumatoid Arthritis (RA)

RA is an autoimmune disease where the body’s immune system attacks the lining of the joints. This results in inflamed (red, hot, swollen), stiff and painful joints and eventually the destruction of the cartilage and bone of joints. RA can occur at any age. The cause is unknown. Symptoms do not only involve the joints but you may suffer from tiredness, low energy, fevers, poor appetite with weight loss and poor sleep. Diagnosis is made on the basis of your history and examination of your joints. X-rays may be normal in the early stages of the disease. MRI can be more sensitive at picking up early changes but can also be normal. Blood tests are done looking for an antibody that is present in about 75% of people with RA. This is called the rheumatoid factor. Unfortunately people who don’t have RA can have a positive rheumatoid factor test. Other blood tests can also help make the diagnosis. Treatment includes medications to relieve pain and inflammation. It also involves medication aiming at modifying the immune system to stop it from damaging the joints further. There are several medications in this group and your specialist will discuss side effects and benefits with you so you can work out which suit you best. For more information see www.arthritis.org.nz

RA is an autoimmune disease where the body’s immune system attacks the lining of the joints. This results in inflamed (red, hot, swollen), stiff and painful joints and eventually the destruction of the cartilage and bone of joints. RA can occur at any age. The cause is unknown.

Symptoms do not only involve the joints but you may suffer from tiredness, low energy, fevers, poor appetite with weight loss and poor sleep.

Diagnosis is made on the basis of your history and examination of your joints. X-rays may be normal in the early stages of the disease. MRI can be more sensitive at picking up early changes but can also be normal. Blood tests are done looking for an antibody that is present in about 75% of people with RA. This is called the rheumatoid factor. Unfortunately people who don’t have RA can have a positive rheumatoid factor test. Other blood tests can also help make the diagnosis.

Treatment includes medications to relieve pain and inflammation. It also involves medication aiming at modifying the immune system to stop it from damaging the joints further. There are several medications in this group and your specialist will discuss side effects and benefits with you so you can work out which suit you best. For more information see www.arthritis.org.nz

Systemic Lupus Erythematosus (SLE)

This is an autoimmune disease where the immune system harms cells of the body. It can affect the joints, skin, nervous system, kidneys and heart. It is a disease for which there is no cure. It can be managed and usually controlled with medication. It affects different people differently and can have symptoms that come and go. Symptoms initially can include tiredness, muscle and joint pain and swelling, hair loss, rash, and fevers. The diagnosis is made on the basis of the history and examination findings as well as blood tests and urine tests. For more information see www.arthritis.org.nz

This is an autoimmune disease where the immune system harms cells of the body.  It can affect the joints, skin, nervous system, kidneys and heart.  It is a disease for which there is no cure. It can be managed and usually controlled with medication. It affects different people differently and can have symptoms that come and go.   Symptoms initially can include tiredness, muscle and joint pain and swelling, hair loss, rash, and fevers.  The diagnosis is made on the basis of the history and examination findings as well as blood tests and urine tests. For more information see www.arthritis.org.nz

 

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Wheelchairs

Wheelchairs are available from the information desk just inside the Centre, easily accessible from the drop-off zone.

Contact Details

Greenlane Clinical Centre

Central Auckland

Please email all correspondence to: Maria Lobo, Rheumatology Nurse Specialist mlobo@adhb.govt.nz

Rheumatology Dept
Building 7 - GCC
Private Bag 92189
Auckland Mail Centre
Auckland 1142.

If the correspondence is clinical in nature, please send it as an e-referral to either the treating clinician or to the Rheumatology dept. (rheumatologydept@adhb.govt.nz)

214 Green Lane West
One Tree Hill
Auckland 1051

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Street Address

214 Green Lane West
One Tree Hill
Auckland 1051

Postal Address

Private Bag 92 189
Auckland Mail Centre
Auckland 1142

This page was last updated at 1:22PM on November 20, 2023. This information is reviewed and edited by Rheumatology Services | Auckland | Te Toka Tumai | Te Whatu Ora.