THU0641 Musculoskeletal disease clinic managed by a rheumatology department
Authors: A.J. Aznar Esquivel, H. Sánchez-Pérez, A. López-Hijazo, S. Bustabad-Reyes
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Medical pathology of the Locomotor Apparatus (LA) is highly prevalent in the general population, tends to chronicity, generates an important temporary or definitive disability with great impact on the quality of life and functionality of the patient and entails high indirect and direct costs for the System National Health Classically, the medical pathology of LA has been managed by Traumatology departments. <h3>Objectives</h3> To analyse the characteristics of an LA clinic managed by the Rheumatology department and compare the data with the Traumatology department in the health area of the north of Tenerife (Reference population: 4 30 021 inhabitants). <h3>Methods</h3> We present the data collected from the Rheumatology clinic aimed to treat the medical pathology of the LA during the first 3 months, October to December 2017 and we compared the results with the same period of 2016, when this consultation was in charge of Traumatology department. Patients are referred from Primary Care (PC). We recorded the epidemiological characteristics of the patients, reason for consultation and final diagnosis, ability to resolve the consultation, need to request additional tests, treatment prescribed at discharge and referrals to other specialties. <h3>Results</h3> We treated 744 patients, with an average age of 55.26 years (±15.02), mainly women (62.6%). The most frequent referral consultation were: gonalgia (30.6%), polyarthralgia (14.5%) and low back pain (13.7%). Peripheral Osteoarthritis (26.6%) and soft tissue diseases (24.2%) were the most frequent processes. In 11.6% of the cases, no organic cause was found that justified the referred clinic ("nonspecific mechanical pathology") and 4.3% were asymptomatic when assessed. They provided complementary tests in the first consultation 85.2% of patients: 92.43% simple radiographs and 10.72% magnetic resonances. We requested: 7.2% MRI (54), 7.8% X-Ray (58), 7.1% Ultrasound (53), 5% Analysis,<sup>37</sup> 4.2% neurophysiological study,<sup>31</sup> 1.2% scintigraphy.<sup>9</sup> Discharged at the first consultation 72.4% and at the second visit 5%, leaving 22.6% of patients still in follow-up. 23.1% of the patients were referred to another specialty, mainly to Thraumatology (15.3%). During the same period of time, October-December 2016, Traumatology treated 3730 patients and requested 506 MRI (13.5%). <h3>Conclusions</h3> The management of an locomotor apparatus clinic carried out by rheumatologists is more efficient: high resolution capacity in the first consultation, less number of complementary tests requested, mainly MRI (7.2% vs. 13.5%), and little referral to other specialties It is necessary to create referral protocols from Primary Care to Rheumatolgy and to enhance the Rheumatology as the medical specialty of reference of the locomotor apparatus musculoskeletal diseases. <h3>References</h3> [1] Gómez Rodríguez N, Ibáñez Ruán J, Penelas-Cortés Bellas Y, García Ferreiro T. Comparative analysis of the out patient consultories of rheumatology and orthopedic surgery-traumatology in a Gallician health care area. Rev Esp Reumatol2001;28:52–6. [2] Comité de Estrategias de la Sociedad Española de Reumatología. Reflexiones sobre la realidad de la especialidad y líneas de acción futura. Rev Esp Reumatol1994;21:205–13. <h3>Disclosure of Interest</h3> None declared