The first 500 patients seen at a rheumatology clinic in a public hospital

Five hundred new patients seen at a rheumatology clinic during the first three years of specialist practice were categorised according to diagnosis, age and sex, source of referral, geography of referral and follow up data. Degenerative joint disease was diagnosed in 33.4% of patients; inflammatory joint diseases in 29.4% and soft tissue rheumatism in 9.4%. Connective tissue diseases were rarely encountered (2%) and in 10.4% of patients the diagnosis was uncertain or undetermined. The age range was 6 to 85 years and the mean age 46. Sixty-nine percent of patients were women. General practitioners referred 85.2% of patients and 57.2% of the total patients seen lived within 20 km of the hospital, an area containing approximately 84,000 people. After three years all patients with inflammatory joint diseases and connective tissue diseases were still attending the follow-up clinic compared to 40% of those with non-inflammatory joint diseases. From the data collected, only a small percentage of patients with rheumatic complaints in the community were referred to the clinic and the dichotomy between academic and practical rheumatology was apparent.