How long does it take to start treatment after seeing a rheumatologist?

Hello

My GP has requested an urgent referral to rheumatology. I saw a rheumatologist two years ago and was diagnosed with fibromyalgia. However over the past few months things have got a lot worse with pain in most joints, swelling and raised rheumatoid factor. There is also a family history of rheumatoid arthritis. Having been to the rheumatologist before, I have a good idea of some of the questions/examinations they might do, however I am not sure about how/when they would start treatment if rheumatoid arthritis is diagnosed. Are they likely to run all bloods etc again and ask me to attend another appointment later down the line, or if rheumatoid arthritis is suspected would they start me on a course of treatment at the first appointment? I do not want to get my hopes up too much for the first appointment if they send me away again for a few weeks to wait for results. Thanks for reading x

8 Replies

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  • in 2014 My RA doc started by drawing some fluid off my left knee that was terrible painful and swollen.  She then gave me a steroid shot in the knee and when I woke up the next morning all the inflammation in my body went down and I felt brand new for the next couple of weeks.   I was already taking Hydroxy and Methotrexate and she also gave me a 30day perscription of prednizone which kept the inflammation away.  And the Hydroxy and Methotrexate seemed to take affect during the time I was on the steroid so the inflammation didn't return.  A month later she started me on Humira even though I wasn't having any additional problems.  She said I had an aggressive RA and she wanted to treat it with heavy drugs.  She has started reducing my Methotrexate dose for the last 6 months so maybe I'll get to wean off that one.  

  • Good questions,  I'd like to know the same.  My first apt is end if may. 

  • Hi Katt

    I think it will depend on whether the rheumatologist has enough information at your appointment to be sure of a diagnosis of rheumatoid. If so, then yes they will probably want to get you started on dmards straight away, if not, then probably more blood tests. They quite rightly won't start you on the drugs without being sure. 

    I needed more tests after my first visit, but it was only a few weeks before I was back to start on treatment and they gave me a steroid shot at my first visit.

    good luck

  • Like Beaches, I think it depends on the info the doctor has and your general health.  I had had all the tests, but my rheumy wanted a chest X-ray done before starting on DMARDs as I have a history of lung problems.   But I had a steroid shot to keep me going, and a follow up appointment a couple of weeks later to get started on treatment. 

  • My GP referred me on a fast track basis the day I saw him. He took bloods - my surgery and hospital file share - so that when I saw the consultant the results were on my notes. The consultant I saw had a feel and a poke at various joints, asked loads of questions and started me on stetoids that day - I could have had an injection but I opted for pills. I was also told that of the steroids worked then I would start DMARDS. I waited for four weeks - the steroids worked straight away - think I could have started the hydroxychloroquine a bit sooner though, it was my fault I misunderstood. That probably meant there was a little gap between finishing the steroids and the hydroxy really kicking in. Good luck, hopefully things will start straight away.

  • When I had my first appointment with rheumatology doctor they started treatment right away. I had blood test same day, and X-rays same day and got the medication from the hospital pharmacy so was able to start straight away. Hope same happens for you.

  • Forgot to say also had an injection which helped.

  • Hi there. In my hubby's case he took poorly end of Dec 2015. Went to go. Had blood tests then referred to rheumatology clinic. First appt they thought it might be reactive arthritis. Prescribed steroids. Had more blood tests. At second appt it was deemed to be RA 😞 prescribed sulphasalazine. So to cut out some of our long boring story it took 3 months from hubby to end of Mar. Hope that helps xxx

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