Rheumatology (GP information)

Procedures undertaken in our Unit include the following:

• Ultrasound of joints fand arteries or disease diagnosis confirmation
• Joint and soft tissue injections (in clinic for adults, in theatres under anaesthesia for children – Dr Fishman).

There are consultant lead clinics every day of the week, supported by Nurse clinics and two Specialist Registrars in Rheumatology and general medicine.

All nine consultants undertake general rheumatology clinics (for adults) and there is a dedicated Rheumatology outpatient area, with 9 consulting rooms, each with an ultrasound machine, where joint and soft tissue injections can be administered during the clinic.

In addition, the following sub-specialist services are undertaken:

Metabolic bone diseases clinic – aim to see adult metabolic bone disorders including osteoporosis
Alternate Tuesday morning Dr Nisar (Dr Balaji also has an interest in Osteoporosis and between the two of them they report on all the bone density scans done in the Trust).

Giant Cell Arteritis/PMR – Temporal Arteritis  Service
Dr Vanessa Quick and Dr Hoda Alkoky share the GCA/Temporal Arteritis service. There are urgent GCA Fast Track Pathway slots through the week for clinical assessment and vascular ultrasound for diagnosis. We aim to see patients within three working days and ideally sooner. Dr Quick works at Luton, Dr Alkoky works between Luton and Bedford Hospitals. Electronic referrals are triaged daily, please email ldh-tr.rheumatologyluton@nhs.net or phone if you need more urgent advice, or you need a copy of the GCA probability score (GCAPS) which should be sent with your referral letter. Please make every effect to refer the patient and draw bloods (FBC, LFTs, U/Es, CRP and ESR) on the day prednisolone is started.

Psoriatic Arthritis
Dr Tanya Baqai has a specialist interest in this and related conditions and sees patients in her general clinic, by arrangement with her – direct referrals are welcome.

There is a weekly nurse-led Psoriatic Arthritis clinic with virtual MDT with Dr Baqai. This is for our follow up Psoriatic Arthritis patients, so not open to primary care referrals.

There is a quarterly combined Rheumatology-Dermatology clinic, with Dr Baqai and Dr Rakhi Singh-Raghunath (Consultant Dermatologist), for our established Psoriatic Arthritis and Psoriasis patients, so not open to primary care referrals.

Acute/Early Arthritis
All consultants work in the Early Inflammatory Arthritis clinics, run weekly, to provide rapid diagnosis and early aggressive management of acute inflammatory arthritis.
Referrals via Choose and Book, Early Arthritis

Paediatric Rheumatology
Dr Fishman runs weekly paediatric rheumatology clinics and will be doing an extra bi-monthly clinic with visiting consultants from Addenbrookes from November 2024.

Axial Spondyloarthritis Clinic
Dr Chan has specialist interest in Axial Spondyloarthritis and in conjunction with specialist physiotherapist Lauren Astell and Denise Kilby are involved in working with community, primary and secondary partners in reducing the diagnostic delay and managing patients with Axial Spondyloarthritis across Bedfordshire and Luton.

Obstetric Rheumatology
This service is for patient with rheumatic conditions and pregnancy. Starting with pre-conception counselling  and rheumatology input until delivery.

To refer for pre conception counselling in medical conditions please email ldh-tr.bedfordshireppc@nhs.net

Links to tertiary centres:
Rare bone diseases network Cambridge; Great Ormond Street Hospital for Children, University College London Dept. of Rheumatology.