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Peripheral clinic


The peripheral musculoskeletal clinic treats a wide range of musculoskeletal problems. In particular this clinic is useful for patients:
  • With uncertain diagnoses and prognosis
  • Patients not responding to conservative treatment
  • Patients who require the latest, expert, holistic treatment and interventions
  • Patients who require advice and guidance following primary care imaging.

Conditions we treat

The types of conditions that we see are joint-related issues including:
  • bursitis
  • synovitis
  • non-surgical management of osteoarthritis
  • all tendon-related problems (shoulder, knee, hip, groin, ankle and feet)
  • all ligamentous problems (upper and lower limb)
  • muscle injuries and tears

About the clinic

Who will I see?

The peripheral musculoskeletal clinic is led by orthopaedic physiotherapy practitioners (OPPs) who are highly-skilled physiotherapists and are specialised in the assessment and treatment of peripheral musculoskeletal conditions. Often patients or referrers express concern about seeing a physiotherapist as often our patients have already had physiotherapy treatment without success. However this clinic appointment is not about physiotherapy treatment, although if after assessment it would seem that physiotherapy is the best treatment, the OPP can refer to the nearest Physiotherapy Department.

When can I expect my appointment?
We have an automated booking in system which will give you a call number. Once you have booked in you can take a seat and you will be called through to the clinic rooms. There is always a receptionist to help you should you require assistance. If you had previous investigations such as X-rays or MRI scans and your GP has made us aware of this, we will always endeavour to obtain both the report and the images prior to your appointment to help with clinical decision making.

The OPP will ask a number of questions and will perform a clinical assessment. If you require undressing we have hospital gowns to change into. Following the assessment the OPP will give you a diagnosis and explanation about your condition and will discuss the various treatment options - if investigations are required, the OPP will arrange this. Follow-up appointments will be arranged following investigations, however in some instances a telephone follow-up can be arranged if preferred. If we need to do an X-ray we can usually arrange this on the day however waiting times for this can vary and some patients may choose to book an X-ray for a different day. Blood tests can also be done on the same day however MRI, CT and ultrasound scans have a waiting time of about 4-6 weeks.
What investigations can I be referred for?

OPPs can refer for a range of investigations such as MRI scans, CT scans X-rays, nerve conductions studies, ultrasound scans and blood tests, and will arrange this as required depending on your symptoms and clinical assessment.

What treatments can I be referred for?

There are usually a number of treatment options available and the OPP will discuss this with you and will explain in detail what the risks and benefits are of different treatment options. The non-surgical treatment options are: peripheral joint injections, physiotherapy, podiatry, orthotics, advice, education and reassurance. The OPPs are trained in injection treatment and this might be offered if appropriate at your clinic appointment. Other Injection therapies that require image guidance may be carried out in the Ultrasound Suite or on the Admissions Day Care Unit (ADCU). Treatment may involve referral to the Physiotherapy Department, which could either take place here or locally, if preferred.

I have been told I need surgery; do I still need to be assessed in the peripheral musculoskeletal clinic?

Yes. The OPPs have worked with surgeons for many years and will be able to give you more detailed information about the role of surgery, what surgery might entail and which of your symptoms might improve following surgery. The OPP will also be able to explain to you what sort of risks and benefits there are with surgery so you will be able to decide if you want to consider surgical treatment. We will do a ‘work up’ for surgery which means that the surgeon will get a detailed report about your condition, your clinical presentation, your general medical health and any relevant up-to-date investigations.

Can I be referred to other departments?

Yes, we have well-established referral pathways to our orthopaedic surgeons. For example, if on assessment it appears that you have a hip problem rather than a knee problem we will arrange a hip X-ray and if required we can refer directly to a hip surgeon. We can also refer outside our Trust to neurologists, pain clinics or vascular surgeons. We are fortunate that we also have a Rheumatology Consultant and a Metabolic Bone Specialist, Professor Bowman and Dr Gittoes respectively, who have clinics at The Royal Orthopaedic Hospital and are based at the Queen Elizabeth Hospital. In our clinic you will have a comprehensive assessment with access to a variety of treatment options or onward referrals.