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Southern DHB Rheumatology Services

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    Southern DHB (SDHB) Rheumatology is a district wide service primarily delivered from Dunedin Hospital.  
    At Southland Hospital, the rheumatology service is provided by Dunedin-based rheumatologists who visit the hospital two days a fortnight. Referrals to the rheumatology service must be made via your General Practitioner.
    What is Rheumatology?

    Rheumatology is the specialty of medicine that includes arthritis 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 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.


    • Dr Joanne Mitchell

      Rheumatologist - Clinical Leader
    • Dr Sarah Jordan

      Dr Sarah Jordan

    • Dr Fiona McQueen

    • Dr Katherine Jenks

    • Dr Simon Stebbings


    Osteoarthritis (OA)

    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

    Rheumatoid Arthritis (RA)

    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


    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 antidepressant medication. For more information see

    Systemic Lupus Erythematosus (SLE)

    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.  It is a disease for which there is no cure. It can be managed and usually controlled with medication. It affects different people differently 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