Description

The Division of Rheumatology at the University of Cape Town is veryactively involved in teaching, service delivery and research.Teaching is directed at medical students in their 4th 5th and 6thyears of training. There is also training for post graduatesspecialising in general medicine in the form of registrar rotationsthrough Rheumatology, as well as formal teaching for the Part 1 andPart 2 of the FCP (SA) examinations. Medical registrars rotatingthrough the unit are encouraged to undertake rheumatology topicsfor the MPhil degree. The Division is highly suited for trainingsuper specialists in Rheumatology due to the wide spectrum ofrheumatic diseases that are treated in the different clinics.Service is provided through several outpatient clinics andinpatients admitted to the general medical wards as well as theorthopaedic wards. Patients with severe RA may be admitted forsurgery or for rehabilitation purposes. There are 2 new patientclinics per week and 2 follow-up clinics per week. In addition, aweekly Connective Tissue Diseases clinic has been established fortreating patients with SLE, Scleroderma, Myositis and differentforms of vasculitis, especially Takayasu’s Disease. The Division ofRheumatology has several research interests relating to differentaspects of the rheumatic diseases. Osteoporosis is an area ofinterest for many years and there is ongoing collection oflongitudinal bone mineral density data in patients with rheumatoidarthritis (RA) and systemic lupus erythematosus (SLE). Age-relatedbone loss at different skeletal sites is being prospectivelystudied in collaboration with the Department of Nuclear Medicineand the Endocrine Unit. Clinical drug trials are in progress tostudy the safety and efficacy of the newer non steroidal antiinflammatory drugs (NSAIDS), in collaboration with the GIT Unit.These newer COXIBS are being evaluated in patients with RA andosteoarthritis (OA). All of these include collaborativeparticipation with the GIT Unit, where gastropathy is an outcomevariable, measured by gastroscopy. Recently, the trials of coxibshave included cardiovascular outcomes as well. We have also beenlooking at SLE genetics in collaboration with the Hepatology Unitat UCT. Newer areas of research include the study of chronictophaceous GOUT; community aspects of diagnosing and treatingrheumatic diseases at CHC’s; early rheumatoid arthritis; geneticsof bone loss in SLE; and functional problems in ankylosingspondylitis and DMARDs in Psoriatic Arthritis. More recently, wehave been involved in studies looking at the short-term andlong-term effects of biologic therapiesin the different rheumaticdiseases, especially RA. The rheumatic diseases unit provides in-and outpatient rheumatology services for the entire Western Caperegion. Sessions are carried out at the Heideveld and KhayelitshaCommunity Health Centres 6 times a year. Training is provided on acontinuous basis for medical students, allied health professionals,a senior house officer, two rotating medical registrars and twocareer registrars. Research is largely clinically orientated, but alaboratory-based approach is being used to study the genetics ofSLE and the differentiation between flares and infection in SLEpatients. Family studies have also been started in patients withSLE and RA. In addition, there is very significant involvement inclinical drug trials in rheumatoid arthritis, systemic lupuserythematosus, psoriatic arthritis and osteoarthritis.Collaborative research is being carried out with the Liver Unit tostudy bone density in auto-immune hepatitis.