Rheumatology Services


Osteoarthritis is the most common type of arthritis in the UK. Also known as degenerative joint disease, it occurs when the protective cartilage between your joints breaks down, often due to wear and tear. It causes your joints to become painful, stiff and swollen. It most often develops in the knees, hips and small joints of the hands.

Osteoarthritis is more common in people over 50 with your risk of developing the condition increasing as you get older. After a physical examination your doctor may request other tests such as blood tests, x-rays and joint aspiration test to help diagnose osteoarthritis and rule out other possible causes.

There isn’t a cure for osteoarthritis but we can offer advice and treatments to help ease your symptoms. Sometimes symptoms can be managed by: physical activity to reduce pain and help maintain a healthy weight, losing weight if you're overweight, appropriate footwear and the use of devices to support you during your everyday activities. Our physiotherapy service can work with you to develop the best self-help strategies. Pain relieving medications may also help.

If your pain is severe or is having a significant impact on your life, surgery may be advised. Often this is for hip or knee osteoarthritis.

Inflammatory arthritis

Inflammatory arthritis is a collection of diseases that cause inflammation of the joints and often other tissues. The most common types of chronic inflammatory arthritis include: rheumatoid arthritis, gout, psoriatic arthritis (develops in some people with psoriasis) and ankylosing spondylitis (spine and other areas of the body become inflamed).

Symptoms of inflammatory arthritis are pain, swelling, warmth and tenderness in the joints. Your rheumatologist may make a diagnosis on your medical history, physical exam and other tests including blood tests, x-rays and scans.

Treatment is specific to the type of arthritis, its symptoms and its severity. Medications may include: nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and inflammation and, disease-modifying anti-rheumatic drugs (DMARDs) or biologic agents to slow or stop the progression of the disease and damage to the joints. Physiotherapy such as massage and manipulation may be useful for ankylosing spondylitis to improve comfort and spinal flexibility.

Rheumatoid arthritis

Rheumatoid arthritis is a chronic condition that causes inflammation in your joints and results in stiffness, pain and swelling usually in your hands, feet and wrists. Your joint stiffness may be prolonged in the morning. Rheumatoid arthritis is an autoimmune disease that develops when your body’s immune system starts to attack and damage the cells that line your joints and the surrounding tissues, by mistake.

It’s important to diagnose rheumatoid arthritis quickly. Early treatment can help prevent it getting worse as well as reducing the risk of further problems such as joint damage.

Your rheumatologist may suggest imaging tests such as ultrasound or MRI scan to determine the type of arthritis and to monitor your condition.

Unfortunately, there isn’t a cure for rheumatoid arthritis but early treatment may allow you to continue your daily life and employment. Medication can relieve your symptoms and also work on your immune system to reduce the attack on your joints. Our physiotherapy service can help keep you mobile and may provide advice on other ways of doing daily activities which have become difficult or are taking longer to complete. We can also perform surgery to correct any joint problems that may develop.


Gout is an inflammatory arthritis that’s caused by a chemical made by your body called uric acid that forms crystals normally inside and around your joints. These crystals can also be found in your tendons, ligaments and under your skin.

Symptoms of gout include: extremely painful, hot and swollen joint that has red and shiny skin over it. Often gout comes on rapidly at night in your big toe. It’s important to see your GP if you think you may have gout. They will assess you and they may refer you to a rheumatologist for further tests.

Your rheumatologist may take some fluid from your swollen joint with a needle and look at it under a microscope to see if it contains uric acid crystals.

You can try self-help treatments for gout including: resting, raising and, keeping cool your affected joint. Over-the-counter painkillers, such as paracetamol or ibuprofen may help.

Your doctor may also prescribe medicines to ease an attack of gout such as non-steroidal anti-inflammatory drugs (NSAIDs), colchicine or corticosteroids.

To prevent gout returning you can make lifestyle changes, such as losing weight or changing your diet, and take medication that lower your uric acid levels, such as allopurinol.


Osteoporosis is a condition that develops slowly and causes your bones to weaken, become more fragile and lose bone density. Your bones are more likely to break and the condition is often only diagnosed after a minor fall or sudden impact that causes a bone fracture.

Osteoporosis is a common disorder that’s more likely to develop as you get older, especially in post-menopausal women. If you’re at risk of having osteoporosis, your doctor may request a DEXA scan to measure the density of your bones. This may also be recommended after a fall.

Our treatments for osteoporosis aims to strengthen your bones and prevent fractures. If you're at risk of developing osteoporosis you may be advised to increase your daily intake of calcium and vitamin D in your diet or by way of supplements, take regular exercise and make some lifestyle changes such as stopping smoking or reducing your alcohol consumption. It’s also worth doing a risk assessment of your home.

If you have osteoporosis there are a number of medications available that your rheumatologist will discuss with you. The medication will depend upon: your age, your sex, your fracture risk and if you’ve had a fracture before due to osteoporosis.

Connective tissue disorders

Connective tissue disorders primarily affect the connective tissues of your body and cause them to become inflamed. Connective tissues hold the cells of your body together and are composed of two major structural proteins, collagen and elastin. Collagen is in your tendons, ligaments, skin, cornea, cartilage, bone, and blood vessels. Elastin is in your ligaments and skin.

Connective tissue disorders can be inherited or caused by environmental factors such as injury or infection. Heritable connective tissue disorders are less common and include Marfan’s syndrome and Ehlers-Danlos syndrome. More common autoimmune disorders are due to a dysfunction in your immune system. They cause inflammation and include: dermatomyositis (muscle inflammation and skin rash), polymyositis (widespread muscle inflammation and weakness), rheumatoid arthritis, scleroderma (hard, thickened areas of skin) and, systemic lupus erythematosus (body attacks its own healthy cells and tissues).

Treatment depends on the type of connective tissue disorder you have and your overall health. As they cause inflammation anti-inflammatory medications are the most common form of treatment for relieving swelling, redness and pain. Your rheumatologist will advise you on the best course of treatment for your specific connective tissue disorder.

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