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
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:
Vasculitis:
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
Prednisone reduction sheets
- 50 mg_-_15_mg (pdf)
- 15 mg_to_zero (pdf)
Corticosteroid Conversion Table |
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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 |
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
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
Autoantibody testing standards (Annal of Rheumatology review)
Interested in Improving your knowledge of Rheumatology?
The following resources will help:
RCGP (UK) Curriculum – Rheumatology and MSK
ACR – High Impact Rheumatology Series
Musculoskeletal imaging for GPs
OSCAR resources for rheumatologists
Liverpool Guidelines on Drug interactions
Introductory slides (pdf) QuarryMOC
Resources- Gout (sl bigger than the presentation!)
Additional resources
Clinical Audit resources
OH Chloroquine dose adjustment audit collection form Hydroxychloroquine Audit