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Auckland Rheumatology Specialists
Private Service, Rheumatology
Today
Description
Adult rheumatology including:
- Inflammatory arthritis
- Gout and crystal arthropathy
- Autoimmune connective tissue disorders
- Polymyalgia rheumatica and temporal arteritis
- Osteoarthritis
- Soft tissue conditions and tendonitis
- Diagnosis of regional and generalised musculoskeletal pain conditions
- Osteoporosis treatment advice
Services include consultations for:
- Assessment, diagnosis and management of rheumatic diseases
- Intra-articular and soft tissue corticosteroid injections
- Viscosupplementation injections for large joint osteoarthritis
- Management of biological anti-rheumatic therapies (e.g. Adalimumab and Etanercept).
Rheumatology is the specialty of medicine that includes arthritis, tendonitis and bursitis, musculoskeletal pain conditions and autoimmune diseases.
Arthritis means inflammation of a joint. A joint is where two or more bones meet and move in relation to each other. They are separated by a rubbery substance called cartilage which is smooth and slippery, allowing for easy movement. Cartilage covers the end of each bone. Tendons and ligaments attach bones to muscles and other bones. Cartilage, tendons and ligaments are enclosed within a membrane called synovium around the joint which releases a fluid into the joint space to keep it well lubricated.
Autoimmune disease is where an abnormality in the immune system leads to the body’s defence harming its own cells by mistake.
A rheumatologist is a doctor who has specialised in this area of medicine. Your GP will refer you to see a rheumatologist if they think you have an autoimmune disorder or if they need assistance diagnosing or treating arthritis.
Consultants
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Dr Terry Macedo
BHB, MBChB, FRACP Rheumatologist
Referral Expectations
Usually your GP will have referred you for the consultation. In most cases you will need to phone the Rheumatology Specialists Clinic to arrange an appointment. Please have ready information regarding your Medical Insurance Policy such as Membership / Policy Number.
Prior to coming to our clinic your GP may ask you to undergo tests such as blood tests or x-rays. X-rays will already be available online, but it is very helpful to have a record of which Radiology facility you had xrays or scans at (eg Auckland Radiology Group, Mercy Radiology etc) .
Clinic appointments last 50 minutes for an initial consultation and 20-25 minutes for a follow-up consultation.
A history of your symptoms will be taken, as well as a review of any medications you are on (so please bring these or an up-to-date list of medications with you). You will then be examined, which may include a general examination or only examination of your joints, depending on what condition your specialist is looking for. You may have further testing to establish the diagnosis.
The specialist will discuss with you the possible diagnosis and what further tests or treatments are recommended. They will contact your GP about your diagnosis, results of tests and a treatment plan. A copy of the Specialist's report is usually sent to you by email.
You may have ongoing follow-up in our clinic or be discharged back to the care of your GP. In most instances your GP would be able to continue prescribing any new anti-rheumatic medications, which would be specified in the report to the GP after the consultation.
You may also be referred to a physiotherapist, orthotist, or occupational therapist. You may also be referred to another specialist.
A physiotherapist provides physical therapy to assist with any disability you have.
An orthotist provides practical aids/footwear to help in overcoming any disability.
An occupational therapist reviews what equipment/advice will assist in activities of daily living if you have a disability.
Tests or procedures that may be required during or after your visit to the clinic include the following:
Joint Aspiration
Local anaesthetic is injected into the skin to numb the area and then a needle similar in size to that used to take a blood test is inserted into the space of your joint to take a sample of fluid. This is then sent to the laboratory for testing to aid in the diagnosis of your arthritis.
Joint Corticosteroid Injection
In some forms of arthritis or tendonitis the rheumatologist may offer a cortisone injection to relieve pain or swelling. The procedure is very similar to joint aspiration but will be fully explained by the rheumatologist.
X-rays are useful to examine joints and these may be requested of joints that give you pain and sometimes joints that have no symptoms to help with the diagnosis. An x-ray is a high frequency, high energy wave form. It cannot be seen with the naked eye, but can be picked up on photographic film.
Ultrasound uses sonar waves instead of x-ray to obtain images of joints and tendons to assist with diagnosis of the rheumatic condition. It is frequently used to assist diagnosis of shoulder problems. Ultrasound may also be used to assist the accurate placement of a corticosteroid injection.
MRI (Magnetic Resonance Imaging) gives even more detailed pictures of joints and organs so may be requested. An MRI machine does not work like an X-ray or CT (Computed Tomography) scan; it is used for exact images of internal organs and body structures. This method delivers clear images without the exposure of radiation.
The procedure uses a combination of magnetic fields and radio waves which results in an image being made using the MRI’s computer.
Fees and Charges Description
Dr Terry Macedo
Initial consultation: $480.00 (includes GST) - 1 hour consultation
Follow-up consultations: $240.00 (includes GST) - 30 min consultation
Joint injections: $55.00 to $110.00 (includes GST) - additional to consultation
Prescription charges: $35.00 (includes GST)
Dr Terry Macedo is a Southern Cross Affiliated Provider.
Telephone and email consultations and correspondence, medical certificates/lab forms and Pharmac applications may be charged according to time and complexity of the interaction.
Hours
| Mon | 9:00 AM – 5:00 PM |
|---|---|
| Tue | 9:00 AM – 5:30 PM |
| Wed | 8:00 AM – 6:00 PM |
| Thu | 9:00 AM – 6:00 PM |
| Fri | 8:00 AM – 11:00 AM |
Reception at Remuera office is open: Monday 9.00am - 5.00pm Tuesday 9.00am - 6.00pm Wednesday 8.00am - 6.00pm Thursday 9.00am - 5.00pm Friday 8.00am - 11.00am
Languages Spoken
English
Common Conditions
Otherwise known as degenerative arthritis. OA occurs when there is a breakdown of the cartilage, leaving the bones unprotected. It is very common and usually affects people as they get older. You can get it at any age and are more likely to if you have previously injured a joint, or are overweight. The symptoms can be very mild with just occasional pain with activity. Worsening symptoms include pain with activity and stiffness with rest. Joints can become swollen and restricted in movement. Joints can change shape as the bone changes in response to loss of protection. You otherwise feel well. The diagnosis is made on the basis of the history, examination findings and sometimes x-rays. The severity of joint damage seen on x-ray does not always correlate with the degree of pain you experience. Treatment includes guided exercises, weight reduction if needed, pain relief and sometimes surgery. For more information see www.arthritis.org.nz
Otherwise known as degenerative arthritis. OA occurs when there is a breakdown of the cartilage, leaving the bones unprotected. It is very common and usually affects people as they get older. You can get it at any age and are more likely to if you have previously injured a joint, or are overweight. The symptoms can be very mild with just occasional pain with activity. Worsening symptoms include pain with activity and stiffness with rest. Joints can become swollen and restricted in movement. Joints can change shape as the bone changes in response to loss of protection. You otherwise feel well. The diagnosis is made on the basis of the history, examination findings and sometimes x-rays. The severity of joint damage seen on x-ray does not always correlate with the degree of pain you experience. Treatment includes guided exercises, weight reduction if needed, pain relief and sometimes surgery. For more information see www.arthritis.org.nz
Otherwise known as degenerative arthritis. OA occurs when there is a breakdown of the cartilage, leaving the bones unprotected. It is very common and usually affects people as they get older. You can get it at any age and are more likely to if you have previously injured a joint, or are overweight.
The symptoms can be very mild with just occasional pain with activity. Worsening symptoms include pain with activity and stiffness with rest. Joints can become swollen and restricted in movement. Joints can change shape as the bone changes in response to loss of protection. You otherwise feel well.
The diagnosis is made on the basis of the history, examination findings and sometimes x-rays. The severity of joint damage seen on x-ray does not always correlate with the degree of pain you experience.
Treatment includes guided exercises, weight reduction if needed, pain relief and sometimes surgery. For more information see www.arthritis.org.nz
RA is an autoimmune disease where the body’s immune system attacks the lining of the joints. This results in inflamed (red, hot, swollen), stiff and painful joints and eventually the destruction of the cartilage and bone of joints. RA can occur at any age. The cause is unknown. Symptoms do not only involve the joints but you may suffer from tiredness, low energy, fevers, poor appetite with weight loss and poor sleep. Diagnosis is made on the basis of your history and examination of your joints. X-rays may be normal in the early stages of the disease. MRI can be more sensitive at picking up early changes but can also be normal. Blood tests are done looking for an antibody that is present in about 75% of people with RA. This is called the rheumatoid factor. Unfortunately people who don’t have RA can have a positive rheumatoid factor test. Other blood tests can also help make the diagnosis. Treatment includes medications to relieve pain and inflammation. It also involves medication aiming at modifying the immune system to stop it from damaging the joints further. There are several medications in this group and your specialist will discuss side effects and benefits with you so you can work out which suit you best. For more information see www.arthritis.org.nz
RA is an autoimmune disease where the body’s immune system attacks the lining of the joints. This results in inflamed (red, hot, swollen), stiff and painful joints and eventually the destruction of the cartilage and bone of joints. RA can occur at any age. The cause is unknown. Symptoms do not only involve the joints but you may suffer from tiredness, low energy, fevers, poor appetite with weight loss and poor sleep. Diagnosis is made on the basis of your history and examination of your joints. X-rays may be normal in the early stages of the disease. MRI can be more sensitive at picking up early changes but can also be normal. Blood tests are done looking for an antibody that is present in about 75% of people with RA. This is called the rheumatoid factor. Unfortunately people who don’t have RA can have a positive rheumatoid factor test. Other blood tests can also help make the diagnosis. Treatment includes medications to relieve pain and inflammation. It also involves medication aiming at modifying the immune system to stop it from damaging the joints further. There are several medications in this group and your specialist will discuss side effects and benefits with you so you can work out which suit you best. For more information see www.arthritis.org.nz
RA is an autoimmune disease where the body’s immune system attacks the lining of the joints. This results in inflamed (red, hot, swollen), stiff and painful joints and eventually the destruction of the cartilage and bone of joints. RA can occur at any age. The cause is unknown.
Symptoms do not only involve the joints but you may suffer from tiredness, low energy, fevers, poor appetite with weight loss and poor sleep.
Diagnosis is made on the basis of your history and examination of your joints. X-rays may be normal in the early stages of the disease. MRI can be more sensitive at picking up early changes but can also be normal. Blood tests are done looking for an antibody that is present in about 75% of people with RA. This is called the rheumatoid factor. Unfortunately people who don’t have RA can have a positive rheumatoid factor test. Other blood tests can also help make the diagnosis.
Treatment includes medications to relieve pain and inflammation. It also involves medication aiming at modifying the immune system to stop it from damaging the joints further. There are several medications in this group and your specialist will discuss side effects and benefits with you so you can work out which suit you best. For more information see www.arthritis.org.nz
This is a syndrome of widespread aches, pains and fatigue. There may be morning stiffness and sleep problems. The diagnosis is made on the history of the pain and accompanying symptoms as well as the presence of tender points at specific sites on the body. There are a number of different theories and reasons for this condition. There will often be blood tests and maybe x-rays to exclude other diagnoses. Treatment involves pain killers, exercises, rest and sometimes medications often referred to as "pain modulating agents". An example of a pain modulating agent is amitriptyline, which is a tricyclic anti-depressant but used in very small doses for pain relief. For more information see www.arthritis.org.nz
This is a syndrome of widespread aches, pains and fatigue. There may be morning stiffness and sleep problems. The diagnosis is made on the history of the pain and accompanying symptoms as well as the presence of tender points at specific sites on the body. There are a number of different theories and reasons for this condition. There will often be blood tests and maybe x-rays to exclude other diagnoses. Treatment involves pain killers, exercises, rest and sometimes medications often referred to as "pain modulating agents". An example of a pain modulating agent is amitriptyline, which is a tricyclic anti-depressant but used in very small doses for pain relief. For more information see www.arthritis.org.nz
This is a syndrome of widespread aches, pains and fatigue. There may be morning stiffness and sleep problems. The diagnosis is made on the history of the pain and accompanying symptoms as well as the presence of tender points at specific sites on the body. There are a number of different theories and reasons for this condition. There will often be blood tests and maybe x-rays to exclude other diagnoses. Treatment involves pain killers, exercises, rest and sometimes medications often referred to as "pain modulating agents". An example of a pain modulating agent is amitriptyline, which is a tricyclic anti-depressant but used in very small doses for pain relief. For more information see www.arthritis.org.nz
This is an autoimmune disease where the immune system harms cells of the body. It can affect the joints, skin, nervous system, kidneys and heart. Although it is a disease for which there is no long term cure, it can be managed and usually controlled with medication. It affects different people in different ways and can have symptoms that come and go. Symptoms initially can include tiredness, muscle and joint pain and swelling, hair loss, rash, and fevers. The diagnosis is made on the basis of the history and examination findings as well as blood tests and urine tests. For more information see www.arthritis.org.nz
This is an autoimmune disease where the immune system harms cells of the body. It can affect the joints, skin, nervous system, kidneys and heart. Although it is a disease for which there is no long term cure, it can be managed and usually controlled with medication. It affects different people in different ways and can have symptoms that come and go. Symptoms initially can include tiredness, muscle and joint pain and swelling, hair loss, rash, and fevers. The diagnosis is made on the basis of the history and examination findings as well as blood tests and urine tests. For more information see www.arthritis.org.nz
This is an autoimmune disease where the immune system harms cells of the body. It can affect the joints, skin, nervous system, kidneys and heart.
Although it is a disease for which there is no long term cure, it can be managed and usually controlled with medication. It affects different people in different ways and can have symptoms that come and go.
Symptoms initially can include tiredness, muscle and joint pain and swelling, hair loss, rash, and fevers. The diagnosis is made on the basis of the history and examination findings as well as blood tests and urine tests. For more information see www.arthritis.org.nz
An inflammatory condition affecting predominantly the shoulders, back and hips in people over the age of 50. It causes severe stiffness of movement especially in the morning. The diagnosis is made from a careful evaluation of the symptoms, physical findings, and the inflammation is detected in the blood tests. In most cases, treatment with low doses of corticosteroid tablets rapidly relieves the symptoms. The treatment is usually required over a period of at least several months. For more information see www.arthritis.org.nz
An inflammatory condition affecting predominantly the shoulders, back and hips in people over the age of 50. It causes severe stiffness of movement especially in the morning. The diagnosis is made from a careful evaluation of the symptoms, physical findings, and the inflammation is detected in the blood tests. In most cases, treatment with low doses of corticosteroid tablets rapidly relieves the symptoms. The treatment is usually required over a period of at least several months. For more information see www.arthritis.org.nz
An inflammatory condition affecting predominantly the shoulders, back and hips in people over the age of 50. It causes severe stiffness of movement especially in the morning. The diagnosis is made from a careful evaluation of the symptoms, physical findings, and the inflammation is detected in the blood tests. In most cases, treatment with low doses of corticosteroid tablets rapidly relieves the symptoms. The treatment is usually required over a period of at least several months. For more information see www.arthritis.org.nz
Travel Directions
The Remuera Clinic is close to the Market Road Exits (both North and Southbound), from the Southern Motorway. A map is available on the location webpage.
Public Transport
Newmarket Train Station (Southbound, Onehunga and Westbound trains); 5 minutes walking distance.
Major bus routes Remuera Road; 1 minute walking distance.
www.at.govt.nz for details.
Parking
Offstreet parking is available at all locations. At the Remuera Clinic Ramp/wheelchair access is from the street side of the building. A wheelchair is available on site to assist disabled persons from their car to the Clinic. Please let Reception know in advance if you will need to use the wheelchair.
Pharmacy
OneHealth
122 Remuera Road, Remuera
Other
Labtests / Awanui
OneHealth
122 Remuera Road, Remuera
Website
Contact Details
102 Remuera Road, Remuera, Auckland
Central Auckland
-
Phone
(09) 524 2492
Healthlink EDI
rheumasp
Email
Website
Eastcare, 260 Botany Road, Golflands, Auckland
East Auckland
-
Phone
(09) 277 1540 appointments only
Healthlink EDI
rheumasp
Website
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This page was last updated at 9:23AM on August 8, 2024. This information is reviewed and edited by Auckland Rheumatology Specialists.