Resources for referring HCPs

On this page you will find assessment tools for various conditions, medical calculators, and useful forms for your clinic.

There are also some links at the bottom of the page for further information on primary care rheumatology.

 

Updated Biologic Chart

Biologics 2017

Biologics 2018

 

Information we offer to patients

Combined Rheumors information for patients

 

Hydroxychloroquine dosing

OH chloroquine easy dosing chart   Hydroxychloroquine dosing chart   (Note we still prefer this method to the simpler and less compelling America Ophthalmology advice)

Vaccination in patients on biologics collection form  Clinical audit of infection and vaccination

 

Disease Outcome Measures

SLE:

  • SLE disease activity index SLEDAI

RA:

 

Ankylosing spondylitis:

 

Vasculitis:

 

Calculators:

 

 

Useful forms in Clinic

 

Prednisone reduction sheets

  1. 50 mg_-_15_mg (pdf)
  2. 15 mg_to_zero (pdf)

Corticosteroid Conversion Table

Glucocorticoid

Approx. Equivalent dose

Half life

Short-Acting

Cortisone

25

8-12

Hydrocortisone

20

8-12

Intermediate-Acting

Methylprednisolone

4

18-36

Prednisone

5

18-36

Prednisolone

5

18-36

Triamcinolone

4

18-36

Long-Acting

Betamethasone

0.6-0.75

36-54

Dexamethasone

0.75

36-54

 Steroid conversion on md calc

TOPICAL STEROIDS

Class Potency Example Formulation
Class 1 Ultra high Clobetasol propionate 0.05% All formulations
Class 11 High Betamethasone dipropionate 0.05%FluocinonideHalcinonide OintmentLidex cr/oint/gel 0.05%Halog cr / oint 0.1%
Class 111 Medium to high Betamethasone dipropionate 0.05% CreamDiprosone cr 0.05%
Class 1V and V Medium Mometasone furoate 0.1%Fluocinolone acetonide Elocon oint 0.1%Synalar-HP cr 0.2%Synalar oint 0.025%
Class VI Low Hydrocortisone butyrate 0.1%Triamcinolone acetonide All formulationsAristocort cr 0.1%
Class VII Least potent Hydrocortisone 1 % and 2.5% All formulations

 

Pediatrics

  1. Medication_Dosages_in_Paediatric_Rheumatology (PDF)
  2. Growth_charts (PDF)
  3. Ophthalmologic_examinations (PDF)

Mnemonic for  an approach to Arthritis in Children Ref Malleson, Southwood

Juvenile Ideopathic Arthritis is a diagnosis of exclusion:this mnemonic is a good tool to develop a rational approach to working up joint pain in children

 

Avascular necrosis        e.g. Sickle Cell Anemia

Reactive arthritis           e.g. Mumps, Rubella

Trauma                           e.g.Occult or unexplained fractures

Haematological              e.g. Leukemia

Rickets

Infection                          e.g.Septic Arthritis

Tumour                           e.g.Osteosarcoma

Idiopathic                        e.g.“Growing Pains”

Systemic                          e.g.Connective Tissue Disorders

Some key features of JIA

JT Cassidy, RE Petty, RM Laxer, CB Lindsley. Textbook of Pediatric Rheumatology, 2005

Characteristic Pauciarticular Polyarticular Systemic
% cases (F:M) 60 (5:1) 30 (3:1) 10 (1:1)
# Joints < 4 > 5 Variable
Age at onset Early childhood peak 1-2 yr Childhood peak 1-3 yr Childhood no peak
Systemic involvement None; uveitis (++) Mild; unremitting articular involvement Systemic, self-limited; chronic destructive arthritis ~ 50%
Uveitis 5-15% 5% Rare
RF/ANA Rare/75-85% 10%/40-50% Rare/10%
Prognosis Excellent except eyesight Guarded to moderately good Moderate to poor

 

Other useful Information

MSK Complications of DM

Autoantibody testing standards  (Annal of Rheumatology review)

Muscle Database by Nerve Root

 

Interested in Improving your knowledge of Rheumatology?

The following resources will help:

RCGP (UK) Curriculum – Rheumatology and MSK

ACR – High Impact Rheumatology Series

ARUK – MSK impact Toolkit

RCGP free online course

Musculoskeletal imaging for GPs

 

OSCAR resources for rheumatologists

 

Liverpool Guidelines on Drug interactions

 

 

Introductory slides (pdf)  QuarryMOC

 

Resources- Gout (sl bigger than the presentation!)

gouteditorial[1]

2013 review gout criteria(1)

annals gout managment

 

Additional resources

TESTING FOR ANAs

 

Clinical Audit resources

OH Chloroquine dose adjustment audit collection form Hydroxychloroquine Audit