Rheumatology

The St. Michael’s Hospital Autoinflammatory Disease Clinic began in July 2016. It runs on a monthly basis where three to five patients are seen. This is a consultation clinic for patients with undiagnosed suspected autoinflammatory diseases, or those with defined autoinflammatory diseases with specific questions regarding management. The Clinic facilitates diagnosis through the genetic testing available services available at The Hospital for Sick Children. In addition, for those patients in whom diagnoses cannot be made yet the suspicion remains high for an auto inflammatory disease, patients may be entered into an associated research program entitled GRIID (Genetic Research, and Immune and Inflammatory Diseases.) Through this program we are attempting to find genetic changes which may explain inflammatory disease.

In addition to the role of the clinic and providing consultation care, it is also a unique teaching resource and trainees from both Adult and Pediatric Rheumatology and Allergy and Immunology attend the clinic.

The Myositis clinic is a sub-specialty, multi-disciplinary clinic providing complex care to patients with inflammatory muscle conditions. It is a provincial centre of excellence and a referral source for adolescents with juvenile myositis. It encompasses a unique collaboration with Neurology, Rehabilitation Medicine, Allied health and other cross-disciplinary specialty clinics to provide holistic, one-point, patient-centered care.

The clinic is part of the Myopathy program that also involves rich educational activities, training both Canadian and International medical residents from various disciplines. The program also spearheads research activities with multiple related publications and presentations. In addition, the Myopathy program includes the development of a unique Myositis rehabilitation program in collaboration with Providence Rehab, providing both in-patient as well as out-patient care, along with promoting better access and resources for patients with muscle conditions.   

The St. Michael’s Hospital Interdisciplinary Osteoarthritis Clinic provides care for people with suspected or confirmed osteoarthritis, drawing on a team of rheumatologists and rehabilitation professionals with advanced training in arthritis care. The focus of the clinic is facilitating access to a full range of non-surgical treatment options, tailored to the individual needs of each patient, to reduce osteoarthritis-related pain and improve physical function. The clinic is also linked with the Osteoarthritis Research Program, providing patients opportunities to participate in research studies. Medical trainees, including medical student and residents, frequently participate in the clinic to further their training in arthritis care.

The St. Michael’s Rheumatic Diseases and Pregnancy Clinic is a unique multidisciplinary rheumatology clinic, which provides in-depth care for patients with rheumatic conditions during pregnancy. Patients with rheumatic conditions including, but not limited to, Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA), seronegative spondyloarthritis, vasculitis and myositis receive sub-specialty care.

The St. Michael’s Rheumatic Diseases and Pregnancy clinic works closely with other specialties, including the maternal fetal medicine obstetrics as well as pediatric cardiology. The program supports patients during pregnancy, as well as during the pre- and post-partum periods. Robust research evaluating the impact of pregnancy and medication use on rheumatic diseases, as well as patient experiences, is ongoing. Additionally, the program is recognized for its rich educational opportunities, and contributes to training of learners from across the country.

This clinic is held twice a month at Providence by the Arthritis Society. It is open to anyone in the community who has a confirmed diagnosis of arthritis. Services provided by this clinic include:

• Assessment and education
• Coping strategies
• Exercise instruction
• Stanford University’s Arthritis Self-Management Program

This program is designed to help people who have osteoarthritis in their hips or knees. After seeing wild success in Denmark, the Good Life with Arthritis: Denmark (GLA:D) program was made available in Ontario for conservative management of arthritis.

The program goals are to help people avoid surgery, assist in pain management and provide education on some of the challenges of living with arthritis. Each clinic runs for eight weeks, and clients receive 12 exercise classes in the Ortho-Amp Clinic plus two education sessions in the Scotiabank Learning Centre during that timeframe.