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Description

Description of Practice
Auckland Rheumatology Specialists has extensive experience in:

Adult rheumatology including:
  • Inflammatory arthritis
  • Gout and crystal arthropathy
  • Autoimmune connective tissue disorders
  • Polymyalgia rheumatica and temporal arteritis
  • Osteoarthritis
  • Soft tissue conditions and tendonitis
  • Diagnosis of regional and generalised musculoskeletal pain conditions
  • Osteoporosis treatment advice

Services include consultations for:

  • Assessment, diagnosis and management of rheumatic diseases
  • Intra-articular and soft tissue corticosteroid injections
  • Autologous blood injections for selected soft tissue and entheseal disorders
  • Viscosupplementation injections for large joint osteoarthritis
  • Management of biological anti-rheumatic therapies (e.g. Adalimumab and Etanercept).
 
What is Rheumatology?
Rheumatology is the specialty of medicine that includes arthritis, tendonitis and bursitis, musculoskeletal pain conditions 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 called synovium 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

Hours

Mon – Tue 9:00 AM – 5:30 PM
Wed 8:00 AM – 6:00 PM
Thu 9:00 AM – 6:00 PM
Fri 8:30 AM – 11:00 AM

Reception at Remuera office is open: Monday 9.00am - 5.00pm Tuesday 9.00am - 6.00pm Wednesday 8.00am - 6.00pm Thursday 9.00am - 5.00pm Friday 9.00am - 11.00am

Referral Expectations

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. Please bring all available x-rays, although almost always the x-rays will already be available online.

Clinic appointments last 50-60 minutes for an initial consultation and 20-30 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 available to you at your request.

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.

Common Conditions

  • Osteoarthritis (OA)

    Otherwise known as degenerative arthritis. OA occurs when there is a breakdown of the cartilage, leaving the bones unprotected.… More

  • Rheumatoid Arthritis (RA)

    RA is an autoimmune disease where the body’s immune system attacks the lining of the joints.… More

  • Fibromyalgia

    This is a syndrome of widespread aches, pains and fatigue.… More

  • 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. … More

  • Polymyalgia Rheumatica

    An inflammatory condition affecting predominantly the shoulders,  back and hips in people over the age of 50. It causes severe stiffness of movement especially in the morning. The diagnosis is made from a careful evaluation of the symptoms, physical findings,  and the inflammation is detected in the blood  tests. In… More

Charges

Dr Terry Macedo

Initial consultation:          $465.00 (includes GST) - 1 hour consultation

Follow-up consultations:   $230.00 (includes GST) - 30 min consultation

Joint injections:               $50.00 to $110.00 (includes GST) - additional to consultation

Prescription charges:         $35.00 (includes GST)

Dr Terry Macedo is a Southern Cross Affiliated Provider. 

Telephone and email consultations and correspondence, medical/lab forms and Pharmac applications may be charged according to time and complexity of the interaction.

Travel Directions

The Remuera Clinic is close to the Market Road Exits (both North and Southbound), from the Southern Motorway. A map is available on the location webpage.

Get directions

Public Transport

Newmarket Train Station (Southbound, Onehunga and Westbound trains); 5 minutes walking distance.

Major bus routes Remuera Road; 2 minutes walking distance.

www.at.govt.nz   for details.

Get directions

Parking

Offstreet parking is available at all locations.  At the Remuera Clinic Ramp/wheelchair access is from the street side of the building. A wheelchair is available on site to assist disabled persons from their car to the Clinic. Please let Reception know in advance if you will need to use the wheelchair.

Pharmacy

OneHealth
122 Remuera Road, Remuera

Other

Labtests
OneHealth
122 Remuera Road, Remuera

Contact Details

102 Remuera Road, Remuera, Auckland

Central Auckland

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East Care, Botany

East Auckland

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This page was last updated at 9:51AM on September 2, 2019. This information is reviewed and edited by Auckland Rheumatology Specialists.