Clinical Immunology & Rheumatology

Out Patient Clinic

Clinical Immunology & Rheumatology Clinic Monday,Thursday
Early Arthritis Clinic (EAC) Tuesday
Lupus & Vasculitic Clinic (LVAS) Wednesday
Paediatric Rheumatology (PRH) Clinic Friday
Spondyloarthritis & Crystal Arthritis (SCA) Clinic Saturday







Rheumatology department cares for people with arthritis (painful joints) and other problems caused when the body “attacks itself” - Systemic Autoimmune Connective Tissue Diseases.

Rheumatology looks after:

  • Rheumatoid Arthritis - RA, - mainly pain and swelling in the joints but can be systemic (problem inside the body with the organs eg lungs, kidneys)
  • Systemic Lupus Erythematosus (SLE) - Lupus is the wolf. This can cause problems with many organs including kidneys, skin, nerves and the heart
  • Scleroderma ( Systemic sclerosis) - Here the collagen is too thick making problems with the skin, lungs and heart etc
  • Polymyositis / Dermatomyositis - Problem with the muscles – myositis, and skin – dermato.
  • Sjogren’s syndrome -patients get dry eyes and a dry mouth and other problems.
  • Spondyloarthritis -Spondyloarthritis is arthritis of the spine (back bone).Some of the diseases include:
  • Ankylosing spondylitis (AS)
  • Psoriatic spondyloarthritis.
  • Reactive Arthritis -This is arthritis that an infections will cause. So some weeks after a viral illness or tummy upset the person will get joint pains. Reiter’s syndrome is one example.
  • Crystal arthropathies - Sometimes crystals will be made in the joints eg the big toe joints. The crystals, like those in gout, can be seen down special microscopes. The patient will suddenly get a red, swollen big toe that is very painful. Treatment can help it get better quickly and different treatment can stop the gout from coming back. Crystal arthropathies include
  • Gout
  • Pseudogout
  • Vasculties Diseases - There are many diseases that cause the walls of the blood vessels to be inflamed. White cells move into the wall and can damage the blood vessel. This can block the vessel and/or it can cause pain. The vasculitidies are grouped together according to the size of the damaged vessel.
    • Takayasu’s arteritis or aortoarteritis - this attacks the large blood vessels leaving the heart – the aorta and the vessels coming off the aorta. This causes pain in the legs, the pulses in the arm can stop etc.
    • Polyarteritis nodosa ie. PAN causes weight loss, muscle pain, nerve problems, high blood pressure etc
    • Kawasaki disease - is seen in children more than adults. It can cause problems in many size blood vessels. Patients will get a fever lasting a long time, eye problems, a skin rash and swollen lymph nodes. Some will get chest pain from the heart.
    • Wegener’s granulomatosus - This can attack the chest causing breathing problems, ulcers in the nose or mouth, blood in the urine and kidney problems.
  • Small Vessel Vasculitis:
    • Churg Strauss syndrome - this causes “granulomatosis” and gives asthma, nerve problems like weakness and skin problems.
    • Microscopic polyangitis – In this condition, tiny vessels like the capillaries are attacked.
    • Hennoch-Schonlein purpura - affects many parts of the body. This is because molecules from the immune defense system are put into the inflamed areas. Children will get this and have a red rash, stomach pain, blood in the urine and from the bowel.
  • Osteoarthritis- Osteoarthritis (OA) is found in older people and is due to “wear and tear” of joints. Joints get damaged as people get older and this causes pain. Medical treatment does not work very well in these diseases – it will not cure them but can help with the pain. However a multidisciplinary approach with physiotherapy and Occupational therapy can help them.
  • Osteoporosis - Osteoporosis is another common problem that we diagnose and treat. Osteoporosis is thin bones and makes it easier to break bones. Treating this will help improve the quality of life of the patients and also help prevent fractures of the bones. It is a silent disease – people who have it do not know they have it as they have no problems and no symptoms to begin with. Many people have it but the symptoms only show late when it is no longer possible to undo the damage that has already been done. This means it is important to look for people who think they are OK but who do have the disease. Treatment can be started early to stop problems coming on later.

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