Usually your GP will have referred you for the consultation. In most cases you will need to phone the Rheumatology Specialists Clinic to arrange an appointment. Please have ready information regarding your Medical Insurance Policy such as Membership / Policy Number.
Prior to coming to our clinic your GP may ask you to undergo tests such as blood tests or x-rays. X-rays will already be available online, but it is very helpful to have a record of which Radiology facility you had xrays or scans at (eg Auckland Radiology Group, Mercy Radiology etc) .
Clinic appointments last 50 minutes for an initial consultation and 20-25 minutes for a follow-up consultation.
A history of your symptoms will be taken, as well as a review of any medications you are on (so please bring these or an up-to-date list of medications 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 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. A copy of the Specialist's report is usually sent to you by email.
You may have ongoing follow-up in our clinic or be discharged back to the care of your GP. In most instances your GP would be able to continue prescribing any new anti-rheumatic medications, which would be specified in the report to the GP after the consultation.
You may also be referred to a physiotherapist, orthotist, or occupational therapist. You may also be referred to another specialist.
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.
Tests or procedures that may be required during or after your visit to the clinic include the following:
Joint Aspiration
Local anaesthetic 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.
Joint Corticosteroid Injection
In some forms of arthritis or tendonitis the rheumatologist may offer a cortisone injection to relieve pain or swelling. The procedure is very similar to joint aspiration but will be fully explained by the rheumatologist.
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. An x-ray is a high frequency, high energy wave form. It cannot be seen with the naked eye, but can be picked up on photographic film.
Ultrasound uses sonar waves instead of x-ray to obtain images of joints and tendons to assist with diagnosis of the rheumatic condition. It is frequently used to assist diagnosis of shoulder problems. Ultrasound may also be used to assist the accurate placement of a corticosteroid injection.
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 (Computed Tomography) scan; 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.