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Rheumatology

What is Rheumatology?

Rheumatology is a branch of medicine, which cares for patients suffering from arthritis, as well as diseases arising from joints, bones, muscles and other soft tissues related to joints.

What are the common conditions treated in rheumatology?

The illnesses treated at the Department of Rheumatology and Rehabilitation

  1. Diseases of the joints
    1. Inflammatory joint diseases

      1. Rheumatoid arthritis

      2. Juvenile idiopathic arthritis ( after the age of 13 years)

      3. Spondyloarthropathies

        1. Ankylosing spondylitis

        2. Psoriatic arthritis

        3. Reactive arthritis (Reiter's disease)

        4. Enteropathic arthritis

      4. Connective Tissue diseases

        1. Systemic Lupus Erythematosus

        2. Systemic sclerosis

        3. Polymyositis / Dermatomyositis

        4. Sjogren's disease

        5. Mixed Connective tissue diseases

      5. Crystal induced arthritis

        1. Gout

        2. Pseudo-gout

      6. Miscellaneous inflammatory arthritis

        1. Adult Still's disease

        2. Sarcoidosis

    1. Degenerative joint diseases

      1. Osteoarthritis

      2. Cervical spondylosis

      3. Lumbar spondylosis

  1. Generalised and Regional Pain syndromes

    1. Fibromyalgia

    2. Neck pain

    3. shoulder pain

    4. Low-back pain

  1. Disease of muscles

    1. Polymyositis

    2. Dermatomyositis

    3. Inclusion-body myositis

  1. Disease of Bone

    1. Osteoporosis

    2. Osteomalacia

    3. Other Bone diseases

  1. Systemic Inflammatory conditions

    1. Vasculitis

      1. Polymyalgia Rheumatica

      2. Wegener's granulomatosis

      3. Polyarteris nodosa

      4. microscopic polyangiitis

      5. Churg-Strauss syndrome

      6. Henoch-Schonlein purpura

History & Brief

The Rheumatology Department of the National Hospital (then called as the "General Hospital Colombo"), was initiated by Dr J. E. Frank Perera in July 1957.  Initially this department was called as the "Department of physical medicine". It was providing fragmented care to rheumatic patients and physiotherapy services to the physically disabled.

Rheumatology and Rehabilitation was first recognised as a medical speciality in the country in 1977 with Dr Roy Kulatunga assuming duties as the consultant in charge of the same department succeeding Dr Frank Perera.

Currently there are 2 Departments of rheumatology and medical rehabilitation in the National Hospital. They are:

  1. The Department of Rheumatology and Rehabilitation (General), which was the first established and is situated opposite the blood bank at the Medical Faulty end.

  2. The Department of Rheumatology and Rehabilitation  (Special) at the first floor of the Orthopaedic Clinic building opposite the Out Patient Department.

There are 3 consultants in Rheumatology and Rehabilitation one serving the General and the other two working at the special department.

 Statistics: Daily

  1. Number of patients seen by the Consultant in Charge for a day = 20

  2. Total number of patients seen by all Medical officers for a day = 300

  3. Total number of patients treated at the Physiotherapy Unit = 250

  4. Total Number of Patients seen at the Occupational therapy unit  = 30

Medical Services available

  1. Clinics conducted by the Medical staff

  2. Pharmacy

  3. Physiotherapy

  4. Occupational therapy

Out Patient clinics

Out Patient clinics are conducted during all the weekdays and half day on Saturdays.  The Consultant rheumatologist and the Medical officers conduct these clinics.


The Consultant Rheumatologist or the Medical Officers first sees all patients who attend the outpatient Clinics.  Here they are evaluated in detail to arrive at a diagnosis. Subsequently they are treated with drugs and some with invasive procedures such as injection of joints and soft tissues as well as aspiration of fluid from joints.
As Rheumatology is a field, which has a multidisciplinary approach, some patients are in addition treated with physiotherapy and Occupational therapy. Therefore to facilitate this approach both the departments of rheumatology and rehabilitation has a Pharmacy, Physiotherapy and an Occupational therapy unit.

Pharmacy

All the latest drugs used for the treatment of arthritis and other diseases of the musculoskeletal system are available in the pharmacy and a qualified pharmacist dispenses them.

Physiotherapy

Patients with arthritis and other rheumatic conditions are treated with physiotherapy on the request of the medical staff. There are qualified physiotherapists who treat patients manually as well as with the assistance of various machines.

Physiotherapy mainly focuses on the muscle power, muscle tone, joint movement, balance and on walking mechanism. Any abnormality involving any of these aspects need physiotherapy.  Physiotherapists also train patients to walk with assistive devices such as walking sticks, crutches and frames.  They also teach and train patients to maintain correct posture in order to minimise the pain and to reduce the progress of the disease. Patients with abnormalities of their lungs and breathing abnormalities are also treated with physiotherapy to improve their lung function

Occupational therapy

Qualified occupational therapists treat patients with rheumatic diseases who are evaluated and subsequently requested by the doctors.

The main focus of Occupational therapy for patients suffering from arthritis is on their day-to-day activities.  They are also called as the “hand therapist” as they treat patients who are unable to attend to daily activities as a result of abnormalities of their hands. Their goal is to make these patients as independent as possible in their daily activities so they can attend to these activities by themselves.  They also train and teach patients with arthritis to use their hands in daily activities in such a way to minimise further damage.

Occupational therapists use various types of splints, supports and other devices to the hands and feet in treating patients with diseases of their joints.

Services Provided

  1. Medical treatment as mentioned above

  2. Physiotherapy Facilities for the other Units of the National Hospital

    1. All Medical wards (Both male and female wards)

    2. All Surgical wards (Both male and Female)

    3. Dental institute

    4. Eye Hospital

  3. Teaching and  Training

The department provides training facilities to medical undergraduates, postgraduates and to Physiotherapy undergraduates and Diploma students.

  1. Research

Involved in a few Multi Centre International research projects to assess new drugs in the treatment of arthritis.

Staff

  1. Consultant Rheumatologist and Rehabilitation

  2. Medical Officers

  3. Nursing Staff

  4. Physiotherapists

  5. Occupational Therapists

  6. Pharmacist

  7. Minor Staff (Orderlies)

Available Facilities

  1. Reception / Information counter

  2. Consultants office / Consultation Room

  3. Medical officer's Consultation rooms

  4. Physiotherapy Unit

  5. Occupational Therapy unit

  6. Auditorium

  7. Research Room

How to refer patients

Any patient who is suffering from arthritis or a musculoskeletal disease can be referred by :-

  1. Medical officers of the OPD of the National hospital

  2. Any Consultant doctor.

All patients attending the department for the first time should carry a referral letter

Clinics

Rheumatology Tuesday 2.00 p.m O.P.D 26
Rheumatology & Rehabilitation
(General) (D.R.&.R )
Monday 8.00 am D.R.R (G)
Tuesday
Wednesday
Thursday
Friday
Saturday
Rheumatology & Rehabilitation
(General) (D.R.&.R )
Monday 8.00 am D.P.M (S)
Tuesday
Wednesday
Thursday
Friday
Saturday

Rheumatology & Rehabilitation

(General) (D.R.&.R )
Monday 8.00 am D.P.M (S)
Tuesday
Wednesday
Thursday
Friday
Saturday

 
Future Vision

Rheumatology has evolved over the last few years. To give the best of care for ill patients they need to be observed closely in dedicated Rheumatology Wards. Therefore our vision is to have ward facilities at the National Hospital to treat very ill arthritis patients and to improve the standard of care in order to make this facility as the National Centre of excellence in Rheumatology and Rehabilitation.

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