Despite being a community office we have maintained robust links with Queen’s University and are also involved in projects which cross over with academic institution  in Toronto.


CONGRATULATIONS to Dr Sahil Koppikar for winning the Gold Practice reflection CRA award for his work carried out in our office in 2016. This is our third consecutive Gold award.

Sahil is presenting his work at the 2017 CRA AGM





I am currently  President of the Ontario Rheumatology Association


Models of Care

Since 1996 we have explored the models of care which provide the best care to patients when resources are limited. In 2015 we stareted our first course aiming to increase the overall knowledge of management of rheumatic diseases across our community and we are now planning our third for 2017.


Access to Care

Rheumatic diseases are more prevalent and often more severe in Aboriginal patients. Many remote communities face unique challenges in terms of access to rheumatologists and to appropriate treatment. We are committed to developing effective models of care for Indigenous patients.

We have been meeting successfully with the NIHB program to review the LU criteria and process of accessing biologic medication  for Aboriginal patients. Here is our latest newsletter (pdf)


Musculoskeletal Ultrasound

Ultrasound is becoming an important tool in the assessment and diagnosis of rheumatic diseases.

See the EULAR recommendations for the use of imaging of the joints in patients with RA

I have completed the Canadian Rheumatology Ultrasound Society course, and now offer ultrasound assessment of disease activity and damage in patients with inflammatory joint disease. We have recently developed and successfully run a course on sonoanatomy at Queen’s University


Electronic Medical Records

I have a longstanding interest in the development of medical databases and electronic medical  records (EMR). I have collected robust outcome data since 1996 on all patients seen in clinic.  I am working with the Ontario Rheumatology Association on their Ministry approved project to improve the uptake and efficacy of EMRs by specialists, and to develop additional tools for clinicians and patients to improve their care. We are currently engaged in active research on how to improve patient safety and outcomes by optimizing the collection of data. I Chair the ORA informatics committee



I have a long standing interest in outcome assessment. For several years we have been developing tools to assist in the decision making process when assessing patients with inflammatory joint disease. We have been performing research to validate these assessment tools and to evaluate their role in managing patients and some of this work was presented at the Canadian Rheumatology Association Meeting in 2014

In addition we have developed some tools to help follow up gout  – these forms are in an early stage and all feedback to improve their utility is useful


Medical Education

We are pleased to announce that Dr Averns is the recipient of the 2015 Canadian Rheumatology Association Innovation in Education award. Details to follow in February.

I have held a number of posts both in the UK and Canada, including Honorary Senior Lecturer  and Assistant Dean roles in the UK,, and Director of Clinical Skills at Queens University. We continue to offer opportunities to residents and students who wish to expand their experience in caring for patients with rheumatic diseases. In 2015 we will be opening our new education room – a resource for local HCPs wishing to learn more about rheumatology



I would like to thank all of my patients who kindly took part in our research on the effects of anti-inflammatory medication on cardiac conduction. This research has now been accepted for publication.

Click here for the Manuscript (PDF)


Series Editor: Occupational Medicine and rheumatic diseases, British Journal of Rheumatology – 1997

1.    H L  Averns

Career Grade Posts: Do they work?

J Roy Coll Phys Lon 1994;28:46-48

2.     H L Averns, P L Boardman

Granulocyte Colony Stimulating Factor in Drug-induced Agranulocytosis (letter)

Br J Rheum 1993;32: 1029-30

3.     H L Averns, M Chellingsworth.

Prevention and Management of Steroid induced Osteoporosis. (Invited review paper).

Br J Hosp Med 1994; 52: 86-9

4.     H L Averns, R Kerry

Role of antibiotic prophylaxis in prevention of late infection of prosthetic joint.

Br J Rheumatol 1995;34:380-2

5.     H L Averns, N Cheung, P T Dawes.

Painful knees associated with septic focus.

Br J Rheumatol 1995;34:862-4

6.     H L Averns Oxtoby J, Taylor HG, Jones PW, Dziedzic K, Dawes PT

The effect of smoking on outcome of ankylosing spondylitis

Scand J Rheumatol 1996;25:138-42

7.     H L Averns Oxtoby J, Taylor HG, Jones PW, Dziedzic K, Dawes PT

Radiological outcome in ankylosing spondylitis, and the role of the Stoke Ankylosing Spondylitis Spine Score.

Br J Rheumatol 1996;35:373-6

8.     H L Averns

COX – 2: The next step in the NSAID story

Practitioner 1996;240:532-4

9.     H L Averns, J Hall , M Webley

Role of Opticare Eye Drop Delivery System in Patients with Rheumatoid Arthritis.

Journal of Rheumatology 1999;26

10.  J. R. Kirwan, H. Averns et al  Changes in rheumatology out-patient workload over 12 years in the South West of England

      Rheumatology 2003; 42: 175-179

11.  Davidson L, Averns H. Examination of the Shoulder. MedEdPORTAL; 2013.4.

12.   Henry  Averns, Mark Maraschiello, Elaine Van Melle, Andrew Day.

Evaluation of a web-based teaching module on examination of the hand..

J Rheumatol. 2009 Mar;36(3):623-7. Epub 2009 Feb



 Posters with Published Abstracts

1.   H L Averns, J Wood, T Sheeran, T Price.  Role of DEXA in assessment of Reflex Sympathetic Dystrophy. ILAR Barcelona 1993
2.   H L Averns, K Dziedzic, P T Dawes, D Mattey. IgA anticollagen antibodies in ankylosing spondylitis. BSR April 1994
3.   Effect of smoking on outcome in Ankylosing Spondylitis.  BSR September 1995
4.   Prevalence of keratoconjunctivitis sicca in rheumatoid arthritis and role of OPTICARE eye-drop delivery system.  American College of Rheumatology, November 1996
5.   Pimm TJ, Byron MA, Curson D, Hill S, Hall J, Averns H. Quality of life in rheumatoid arthritis an individualised approach. Brit J Rheumatol, 1997; 36(Suppl 1):148.
6.   Oliver, S., Powell, R.J. and Averns, H. (1999) The North Devon Assessment tool - a functional physical examination for use in primary and secondary care. ACR 63rd Annual Scientific Meeting, Boston.
7.   A web based undergraduate portfolio.  Ayres R, Averns HL. Berlin AMEE 2001 (European medical education forum). Oral presentation, with published abstract.
8.  PRHO assessment tool – ASME Norwich 2001.  Averns HL, Feest K

9. Audit of NSAID use in rheumatology practice .CRA 2008, Averns HL, Nicolson P

10.12 years use of a rheumatology database. CRA 2008.  Averns HL

11.Clinical Audit: NSAID related gastrointestinal adverse events CRA 2009 NR Romatowski, J Ostrow MD, HL Averns

12. Draping During the Physical Examination - Learning and Teaching .
     CAME 2011 Christopher Lusty, Averns HL

13.The oral report – a new teaching and assessment strategy CAME 2012
     Henry Averns, Cherie Jones, Sheila Pinchin, Laura McEwen, Caroline Averns, Katherine Bowes, Michael Sylvester