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Services

Rheumatology

Rheumatology is the branch of medicine that looks after rheumatic and musculoskeletal diseases. These diseases are usually caused by problems in the immune system, inflammation, infections, or the gradual deterioration of joints, muscles and bones. The service covers the full range of adult rheumatological conditions, from osteoarthritis and soft tissue rheumatism to inflammatory arthritis and complex systemic disorders, such as connective tissue diseases and vasculitis. Osteoporosis assessment by a dual energy X-ray absorptiometry (DEXA) scan and an osteoporosis clinic are also part of our service and are held at Corbett Outpatient Centre. We hold routine clinics, specialty clinics and combined clinics with medical colleagues (chest physicians, renal physicians and dermatologists) and surgical colleagues (orthopaedic and ENT surgeons and ophthalmologists).

How to access the service

Outpatient services are provided on three of our Trust’s sites (Russells Hall Hospital, Corbett Outpatient Centre and Guest Outpatient Centre) with day case facilities and services provided at Russells Hall Hospital. The service is multidisciplinary with dedicated physiotherapy, occupational therapy, chiropody, orthotic and psychology sessions, supporting the medical and specialist nursing teams.

The rheumatology team aims to work closely with the community and primary care settings to provide shared care for chronic arthritic patients. Patients need to be referred to us via their GP, who must use the e-Referral Service. Referrals are triaged daily into urgent, suspected inflammatory arthritis or routine appointments.

We are delighted to provide an Advice and Guidance service to GPs. If a patient is already under the follow up care of a consultant rheumatologist, please contact that consultants’ secretary, if you need to get in touch.

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This service is available at: Russells Hall Hospital

Where to find us: Clinical Research Unit, North Wing, Russells Hall Hospital

Telephone numbers – Russells Hall Hospital switchboard number: 01384 456111

Dr Karen Douglas – Consultant

Dr Nicola Erb – Consultant and Deputy Clinical Director

Dr Rainer Klocke – Consultant

Dr Rav Sandhu – Consultant

Dr Holly John – Consultant and Medical Service Head

Dr Elizabeth Hale – Psychologist

Dr Andrew Whallett – Consultant

Dr Adrian Pace – Consultant

Sr Steph Mole – Lead Clinical Nurse Specialist

Julie Walklate – Matron

Sharon Petford – Lead nurse

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Subspecialty clinics

In addition to routine clinics, we hold a large number of specialist clinics. Please click the below links for further information:

Lupus is a long-term condition that can cause inflammation in the skin, and organs. Lupus is an autoimmune condition. The immune system, which normally protects us against infection and illness, starts to attack the body’s own tissues instead. There are two main types of lupus: Cutaneous (CLE) and systemic lupus erythematosus (SLE).

CLE only affects the skin. It can be one small area on the skin, or it can be widespread and different forms can occur. SLE can affect many parts of the body including the joints, kidneys and lungs. It can range from mild to severe. There is no cure, but early treatment can help to keep symptoms under control. The Lupus clinic at Russells Hall hospital mainly looks after patients with SLE and aims to provide holistic care for patients with this multisystem condition.

More information about lupus can be found at https://www.lupusuk.org.uk/ and https://www.versusarthritis.org/about-arthritis/conditions/lupus-sle/

Vasculitis refers to a rare group of conditions characterised by inflammation of the blood vessels. Depending on which body part is affected by the inflammation, many different symptoms may occur, but commonly affected areas are the skin, blood
vessels at the temples, organs involved in breathing, and the kidneys. Conditions include temporal arteritis (giant cell arteritis), granulomatosis with polyangitis (Wegner’s) and leucocytoclastic skin vasculitis. www.nras.org.uk/rheumatoid-vasculitis
www.vasculitis.org.uk/

The Dudley rheumatology department has a weekly early arthritis clinic, which is based at Russell’s Hall Hospital and runs on a Tuesday morning. If on your first rheumatology visit you are diagnosed with an inflammatory arthritis, it is likely you
will be referred to this service. The service is led by Dr Sandhu and Clinical Nurse Specialists Steph Mole and Rene Koumi.

The aim of the service is to enable rapid control of the inflammatory arthritis and therefore prevent joint damage and improve physical functioning. This can be achieved by:
1. Starting and adjusting your medical treatment in order to get control of your inflammatory arthritis. This is usually with drugs known as Disease Modifying Anti Rheumatic Drug or DMARDs.
2. Monitoring your arthritis and your treatment to ensure it is safe to continue.
3. Providing education and support about the disease, it’s treatment and its impact on you.
4. Coordinate your care with our multidisciplinary team colleagues, including physiotherapists, occupational therapists, podiatrists, orthotics and health psychology as well as your GP.
National Rheumatoid Arthritis Society (NRAS): www.nras.org.uk;
Versus Arhtritis: www.versusarthritis.org

Osteoporosis is a condition where bones lose strength and are more likely to fracture.
It is often inherited but can also be caused by other medical conditions or medication. Patients in whom osteoporosis is suspected can be referred for a DEXA (Dual energy xray absorptiometry) scan at Corbett hospital to assess bone strength.
This is an open scanner which uses very low doses of xrays. www.nras.org.uk/osteoporosis-in-ra

Ultrasound is a painless and radiation-free imaging technique used in our department to aid the diagnosis and treatment of rheumatic conditions. As examples, it can help to gain certainty about the presence or absence of inflammation when joints are painful, stiff and/or swollen. It may also help in certain situations to aspirate joint fluid and inject joint areas where previous injections without ultrasound have not helped. www.nras.org.uk/imaging-techniques-in-rheumatology

Scleroderma (which is also known as systemic sclerosis) is a rare, chronic disease of the immune system, blood vessels, skin and tissues. Symptoms can be:

  • Raynauds disease ( poor circulation to the hands and feet)
  • Skin thickening
  • Indigestion or oesophageal reflux
  • Involvement of the internal organs.

Scleroderma can be a complex disease. At Dudley, Dr Karen Douglas with her specialist interest in the disease leads the service. Therapies and research in scleroderma is moving fast and Dr Douglas as a member of the UK Scleroderma
study group is up-to-date with new developments. We offer a weekly clinic, active participation in clinical research, video-capillaroscopy, and excellent links to national experts. www.sruk.co.uk

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Medications

Whilst some soft tissue rheumatic conditions can be managed with anti-inflammatories and analgesics, most of the autoimmune rheumatic conditions are treated with steroids, or immunosuppressive drugs, be they conventional disease modifying anti-rheumatic drugs (DMARDs) or biologic drugs. Click on the links below for further information.

Disease-modifying anti-rheumatic drugs (DMARDs) act by altering the underlying disease rather than treating symptoms. They’re not painkillers, but they’ll reduce symptoms over a period of weeks or months by slowing down the disease process. This group of drugs are slow-acting and can take several weeks to work, so it’s important to keep taking them even if they don’t seem to have any effect at first. If you don’t respond well to one of these drugs, or if you develop any side-effects, then your doctor may try one of the others.

The below infomration is provided by Versus Arthritis:

Versus Arthritis

Copeman House

St Marys Court, St Marys Gate

Chesterfield

S41 7TD

Main number – 0300 790 0400

Email – enquiries@versusarthritis.org

Website – https://www.versusarthritis.org/

The most common DMARDs we use, with links to further information, are:

Please click here for more information about our biologic drug service.

Most of these DMARD drugs require monitoring, most commonly through regular blood tests. Your doctor or Clinical Nurse Specialist will advise you about the specifics of the monitoring required and the frequency of blood tests; in general, monitoring blood test requirements becomes less frequent with time. However, if you do not have the required blood tests done, the drug will not be prescribed.

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Non-drug treatments

Therapies, such as physiotherapy, occupational therapy and psychological support, are extremely important in managing rheumatic conditions and are provided alongside medication. Click on the links below for further information.

We run a physiotherapy service at the Therapy Department at Russells Hall Hospital and the Physiotherapy Department at Corbett Outpatient Centre.

We accept referrals for 1:1 treatment and also for group based treatment.

For 1:1 treatment all patients will receive an assessment. Following this assessment appropriate treatment options will be discussed with you. Treatment may include exercises, advice on exercising with a rheumatological condition, acupuncture and some manual therapy techniques. Patients can also be referred to our group sessions.

Our group sessions are all based at Russells Hall Hospital. We have a hydrotherapy pool, where patients complete individual exercises in a group based session. We run a gym based exercise class for people looking to increase their general activity in a supervised environment.

We are based in the Outpatient Therapy Department on the Ground Floor, East Wing, at Russells Hall Hospital. Our aim is to support and provide education to patients on how to manage their condition. This may include specific information about pacing, joint protection and splinting. We also provide relaxation and mindfulness sessions.

These are jointly provided by physiotherapy and occupational therapy:

  • ‘Tools for Life’ is an education group offering advice and strategies for living with arthritis
  • ‘Inflammatory arthritis education session’ is a one off session for patients who have been recently given this diagnosis. This session provides the opportunity to make the patient aware of the services available to them.
  • ‘Fibromyalgia group’ is an education group for patients with this diagnosis. We run this group with the rheumatology health psychologist. The aim of this group is to provide self-management strategies to help patients living with this condition.

Dr Elizabeth Hale is a Chartered Health Psychologist and works with the rheumatology team to provide specialist services supporting patients at any point in their treatment journey. The rheumatology team here at DGH believe in a ‘whole person’ approach, which includes your emotional well-being. Liz can help with making difficult treatment decisions (such as not liking injections) and other worries and concerns that arise due to physical health challenges such as anxiety and depression. She utilises a variety of therapeutic approaches including Mindfulness. Together with the Therapies team she helps to support people with chronic pain conditions such as fibromyalgia.

For information about the work Psychologists do, see: www.bps.org.uk/public

You can contact Dr Hale via your usual rheumatology secretary who will pass on a message.