The ideal team medical care with a collaboration between internal and orthopaedic rheumatologists.

Abstract

Objective: To clarify patients’ condition in which the internal rheumatologist referred to the orthopedic rheumatologists.

Patients and methods: The author（internal rheumatologist）investigated the age, sex, diagnosis, disease duration, referral details and treatments of the outpatients who were referred to the orthopaedic rheumatologists.

Results: There were 111 patients（male; 26, female; 85）, the age 68.2 ± 13.5 years（mean ± SD）, and disease duration 12.8 ± 11.0 years. Underlying diseases were rheumatoid arthritis（RA）in 85 patients, polymyalgia rheumatica in 6, systemic lupus erythematosus in 5, psoriatic arthritis in 4, and others in 11. The treatment done by the orthopaedic rheumatologist were as follows: For the upper limbs, reconstruction of tendon rupture in the hand in three patients, finger and wrist joint surgery in 14, two of which were emergency surgery for suppurative wrist arthritis and suppurative flexor tenosynovitis, and others in 23. For the lower limbs, total hip arthroplasty in one patient, total knee arthroplasty in seven, toe arthroplasty in five, osteosynthesis for the atypical femoral fracture in one, and others in 10. Consultation for seronegative patients using ultrasound examination in 25 patients, frail hospitalization in 5, vertebral compression fracture in five, and others in 19.

Conclusion: In the treatment of RA, team medical care with a collaboration between internal and orthopaedic rheumatologists is essential.