Rheumatology, Allergy and Immunology

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
• Psoriatic Arthritis 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

This is run by 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. ​

Examination of the nailfold capillaries can be diagnostic in patients with certain disorders including Raynaud's phenomenon, systemic sclerosis and dermatomyositis.

This centre provides ancillary outpatient services including:

• Intravenous cyclophosphamide infusion
• Infusion of biologic agents for refractory arthritis/spondyloarthritis
• Infusion of bisphosphates for osteoporosis
• Minor procedures:
  • Minor salivary gland biopsy
  • Soft tissue and joint aspirations/injections

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 (unnamed referrals)
     
  • Immunodeficiency Clinic
  • Allergy Clinic
    All referrals are screened by allergist to ensure right siting, and priority is given to urgent cases

The following diagnostic and therapeutic services are available:

• Skin prick testing for allergens (e.g. food, insect venom, local aeroallergens)
• Skin prick and intradermal testing for drug allergy
• Provocation/ challenge tests (e.g. to food, drug)
• Drug desensitisation where indicated
• Allergen-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 intranasal steroids, inhalers and skin care for atopic dermatitis.