Know a good Rheumy in York or EA/London area?

[SnazzyD]

I’m asking for someone who has been sent packing by the private doctor seen on their work’s health plan. 45 year old male, never been ill, with sudden onset hand and feet pain, shoulders, neck and backs of knees with tinnitus on January after Covid. Worse in the morning, occasionally waking him up, improving through the day but never goes away.

Many blood tests done by GP in May all came back normal, including for rheumatoid arthritis. He had an ultrasound of hands and feet and they said he had inflamed tendon sheaths and suspected he would have that elsewhere if they could get to it. GP put him on 20mg Pred reducing over 3 weeks and the overnight result was miraculous (including the tinnitus) with symptoms returning at 12.5mg. GP stopped there and referred him.

The rheumatologist near York recommended by AXA said that he has tensosynovitis and needs Methotrexate. Also, he said that since it is a chronic condition (but didn’t say which) it wasn’t covered so get the GP to refer to NHS. His next GP appt is 1st July.

He doesn’t ‘do’ medical stuff and doesn’t feel able to advocate for himself so needs a decent Rheumy in any of the 3 areas above who will at least consider PMR/GCA or at least not be so terse. He is struggling to work now. Any ideas?

[PMRpro Ambassador]

If London is an option - obviously Rod Hughes somes high on the list. Leeds is a bit dodgy since the good ones don't do private work.

Just been in a zoom meeting discussing non-recognition of GCA red flags - this is exactly what we were saying ...

[SnazzyD in reply to PMRpro]

Needless to say I listed all the GCA signs to be aware of just in case.

[PMRpro Ambassador in reply to SnazzyD]

Though to be fair - York NHS has a protocol for GCA and use it. They are worth trying if he can face the potential wait. Or we could try to coordinate a visit to Scarborough ED with a pre-warned ACP ...

[SnazzyD in reply to PMRpro]

So far all he has is tinnitus in that regard and the rest is from the neck down. Didn’t know about GCA at all, so it was a shame to have to worry him with red flags. I’ll let him know that.

[PMRpro Ambassador in reply to SnazzyD]

The GP seems to suspect it though - if it were just PMR surely he would deal with it? That was a classic confirmation with pred response. Did you offer the 8th cranial nerve paper as supporting evidence?

[SnazzyD in reply to PMRpro]

The GP just did it as an experiment before referral. I will press on this chap to ask for continued treatment if there is a long wait for anything. Do you have the paper handy?

[DorsetLady PMRGCAuk volunteer in reply to SnazzyD]

link.springer.com/epdf/10.1...

[PMRpro Ambassador in reply to DorsetLady]

Ta

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

😊

[Sophiestree in reply to SnazzyD]

I have LVV diagnosed via PET CT as all other multiple scans (over 20 to date) didn't show enough of anything. Mine happens a lot in my neck, throat and clavicle, plus tinnitus....

[DorsetLady PMRGCAuk volunteer]

Same comment as PMRpro and chat -try RH