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

Biologics 2020

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:

Health Assessment Questionnaire (PDF)
RA outcome (PDF)

Ankylosing spondylitis:

NASS_Bath_Indices

Vasculitis:

BVAS (PDF)

Calculators:

Sheffield’s FRAX osteoporosis risk calculator

Infection risk calculator
Body Surface Area
Lean body mass calculator (eg for hydroxychloroquine dosing)
Framingham CVS Risk Score
Prednisone dose calculator for GCA (This is the calculator developed by Chetan Mukhtyar, Norfolk and Norwich University Hospital UK)

Useful forms in Clinic

Anti-TNFa_Checklist

Prednisone reduction sheets

50 mg_-_15_mg (pdf)
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

Medication_Dosages_in_Paediatric_Rheumatology (PDF)
Growth_charts (PDF)
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