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Rheumatology Diagnosis

Trained rheumatologists differentiate most rheumatic conditions from the history and clinical examination – often no x-ray or other test is required.

However, advances in x-ray and scanning techniques have, over the past decade, proved extremely valuable in the diagnosis of rheumatic conditions. For example while simple x-rays detect bone conditions such as fractures (a broken bone is termed a fracture, this may be a simple crack or buckle in the structure of the bone, or a complete break resulting in two or more fragments) osteoarthritis (osteoarthritis is a condition that affects your joints. ‘wear and tear’) They are less effective in imaging “soft tissues” such as tendons.

CT scanning and MRI (magnetic scanning) now give clear pictures of muscles, ligaments and tendons, for example in painful shoulder conditions such as ‘frozen shoulder’, in knee conditions and in low back pain.

The machines themselves have also become more ‘user-friendly’ – for example, we now have ‘extremity MRI’ machines, allowing a look at, for example, arm or leg lesions without having to immerse the whole patient in an MRI scanner.

Another advance has been in the use of ‘DEXA’ scanning in the diagnosis and management of osteoporosis. Also known as Dual Energy x-ray Absorptiometry, no x-rays are involved. Dexa Scanning instead uses bone mineral densitometry technology to measure and monitor changes in bone density.

Finally, some patients may require other investigations such as blood tests, or opinions from other specialists such as a chest physician or cardiologist. At London Bridge Hospital, one of Britain’s largest private hospitals, we have a comprehensive medical and surgical consultant staff.