Rheumatology, Allergy & Immunology Department

Our services

Rheumatologic disorders affect the muscles, bones and joints. Some of these disorders may also affect major organ systems like the kidneys, nerves, heart and lungs.

New patients may be referred to:

  • Consultant’s Personal Clinic
    • All named or private referrals may be made to any of our consultant rheumatologists.
  • General New Case Clinic
    • Referrals for any suspected rheumatic disease.
  • Urgent New Case Clinic
    • Referrals that need attention within 1-2 weeks.

Stable patients are internally referred by our rheumatologists for continuing care to the following clinics:

  • Lupus Clinic
  • Rheumatoid Arthritis Clinic
  • Spondyloarthropathy Clinic
  • Connective Tissue Disease Clinic
  • Mixed Connective Tissue Disease/Scleroderma Clinic
  • Gout Clinic
  • Osteoporosis Clinic

Where appropriate, patients are referred to the following services available within TTSH for further treatment:

  • Disease-specific education programmes/group therapy run by Rheumatology Nurse Clinicians
  • Physiotherapy
  • Occupational therapy
  • Podiatry
  • Orthopaedic surgery
  • Acupuncture service
  • Pain Clinic

Arthritis

Arthritis is one of the most common rheumatologic disorders seen at our centre. These include:

  • rheumatoid arthritis
  • ankylosing spondylitis
  • spondyloarthritis
  • psoriatic arthritis
  • osteoarthritis
  • gout
  • infective arthritis

Connective Tissue Diseases

Systemic lupus erythematosus (SLE) is the most common disorder in this category that we manage.

Others include:

  • anti-phospholipid syndrome (APS)
  • Sjogren’s syndrome
  • scleroderma (systemic sclerosis)
  • dermatomyositis/polymyositis
  • systemic vasculitides

Myofascial pain/soft tissue rheumatism

These are common problems often related to workplace and home ergonomics.

Osteoporosis and metabolic bone diseases

These may lead to fragility fractures of the hip and spine in postmenopausal women and the elderly.

Musculoskeletal Ultrasound Service

This is run by 4 rheumatologists trained in musculoskeletal ultrasonography. It provides diagnosis and treatment for patients with arthritis and soft tissue rheumatism including ultrasound-guided aspiration of joints, biopsies and injections.

Nailfold Video Capillaroscopy Service

Examination of the nailfold capillaries can be diagnostic in patients with certain disorders including:

  • raynaud’s phenomenon
  • systemic sclerosis
  • dermatomyositis

Day Treatment & Diagnostic Centre

This centre provides ancillary outpatient services including:

  • intravenous cyclophosphamide infusion
  • infusion of biologic agents for refractory arthritis/ spondyloarthritis
  • minor procedures:
    • minor salivary gland biopsy
    • soft tissue
    • joint aspirations/injections

Clinical Immunology and Allergy Services

We evaluate and manage older children (above 7 years of age) and adults with the following conditions:

  • Airway allergy
  • Allergic rhinosinusitis/conjunctivitis
  • Asthma
  • Anaphylaxis
  • Atopic dermatitis/eczema syndrome
  • Drug allergy
  • Food allergy and intolerance
  • Insect venom allergy
  • Urticaria and angioedema
  • Primary immunodeficiency diseases.

Clinical Immunology Allergy (CIA) Clinics

New patients may be referred to:

  • Consultant’s Personal Clinic.
  • All named or private referrals may be made to any of our consultant clinical immunologist/allergists

CIA New Case Clinic:

  • These are for unnamed referrals
  • Drug Allergy Clinic
  • General Allergy Clinic

More on Immunology Research Laboratory.

Day Treatment & Diagnostic Centre

The following diagnostic and therapeutic services are available:

  • Skin tests for allergens (e.g. drug, food, insect, aeroallergens)
  • Rhinolaryngoscopy
  • Provocation/challenge tests (e.g. to food, drug)
  • Drug desensitisation
  • Specific immunotherapy (for insect venom allergy, allergic rhinitis and asthma)
  • Monthly intravenous immunoglobulin replacement (for antibody deficiency).

Education and counselling is provided by the Clinical Immunology/Allergy Nurse Clinician. These include allergen avoidance, emergency management of anaphylaxis (including epinephrine autoinjector use), use of inhalers and skin care for atopic dermatitis.

Clinical Immunology Laboratory

Our Clinical Immunology Laboratory provides diagnostic tests for rheumatologic, immunologic and allergic diseases. These include autoantibody tests, serological tests for syphilis, HLA-B27, total and specific IgE to various aeroallergens and food allergens. It is accredited by the College of American Pathologists (CAP) and United Kingdom National External Quality Assessment Schemes (UK NEQAS).

More on Clinical Immunology Laboratory.