Rheumatology Clinic

Please sign up for a MyChart account, before your first visit.

• When you arrive, please check-in at the reception desk. The Clerk will register you in the electronic system so that your team will know that you have arrived.

• The initial assessment will take approximately one hour, and follow-up appointments take approximately thirty minutes.

• As CHEO is a teaching hospital, you may meet several people during your visit. We train doctors, nurses and other health care professionals in our rheumatology clinic. 

Please plan and request medication refills five or more business days before your medication runs out.

All patients must be referred.

• For any emergency, call 911. This includes emergencies involving your child’s Rheumatology-related concerns.

• For patients who are being followed by the Rheumatology Clinic:
  

For patients who have seen a CHEO Rheumatology Provider, call your Nurse Case Manager or send a direct message to them through MyChart. This is not for urgent calls. Our nurses are here to give support, education and will work to coordinate your child’s care. It may take 3-5 days for us to get back to you (and sometimes longer during holidays). We will return the most serious calls first. Please avoid leaving multiple messages for the same issue.

• For patients who are waiting for their first visit with the Rheumatology Clinic:

Please do not call the nurses’ line if you have not yet been seen by a CHEO Rheumatology Provider. Please call your family doctor, pediatrician or visit your nearest walk-in clinic.

The Cassie + Friends Society’s (C+F) mission is to transform the lives of kids and families living with juvenile arthritis and other rheumatic diseases through research, education, connection and support. Cassie & Friends is now active in every province and territory in Canada and is a valuable resource for newly diagnosed patients and established patients alike.

Visit Cassie + Friends to learn more.

The focus of Camp Ontario is to provide a place where children with arthritis can come together and participate in fun, barrier-free activities where their medical and social needs can be supported. Campers get the chance to meet and interact with other children and volunteers living with arthritis. They are given an opportunity to increase their independence, learn new things, engage in social activities and meet new friends. In addition to a wide range of crafts, sports and water activities, the camp also offers the chance for children and youth to learn about their disease and discuss coping skills with peers just like them.

RheumInfo.com was first developed in 2003 to serve a need of providing accurate and reliable arthritis information (including medication information) for patients and health care providers.

Visit Rheum Info to learn more.

Referral criteria and eligibility

Suspected condition	Investigations	Additional considerations
Inflammatory arthritis	CBC, ESR, CRP, albumin, ALT, GGT, creatinine, ferritin, LDH, urate, IgGAM, anti-TTG, TSH, anti-nuclear antibody (ANA), Rheumatoid factor (RF), anti-cyclic citrullinated peptide (CCP), HLA B27	-Consider lyme serology if endemic area, monoarthritis, intermittent arthritis. -Consider targeted joint imaging
Systemic rheumatic disease (e.g. systemic lupus erythematosus, juvenile dermatomyositis, vasculitis)	CBC, ESR, CRP, albumin, ALT, AST, GGT, creatinine, ferritin, CK, LDH, urate, C3, C4, IgGAM, anti-TTG, TSH, anti-nuclear antibody (ANA), extractable nuclear antigens (ENA), anti-dsDNA, anti-neutrophil cytoplasmic antibody (ANCA), urinalysis, urine protein:creatinine ratio	N/A
Raynaud’s phenomenon	N/A	Encourage patient to take photos of extremity changes
Recurrent fevers	N/A	Encourage family to keep diary of fevers and symptoms

Other information

Mandatory for Triage:

Please report relevant findings on the patient’s physical examination. If the referral is for MSK pain, include joint or muscle examination and impact on function.

Please attach all relevant investigations. See required laboratory investigations above.

Additional Considerations:

If you require urgent advice, you may page the CHEO rheumatologist on-call at 613-737-7600 ext 0 or send an eConsult via OTNhub or Champlain BASE eConsult.

Please consider sending an eConsult if you are unsure whether a rheumatology referral is warranted.