Background Osteoporosis (OP) is a highly prevalent metabolic bone disease and may be secondary to endocrine diseases. In these cases the assessment of a rheumatologist and an endocrinologist may be complementary and beneficial for both the patient and the hospital.
Objectives To describe the experience of two years of a multidisciplinary out-patient consultation Rheumatology-Endocrinology in the care of patients with metabolic bone diseases.
Methods A multidisciplinary outpatient clinic Rheumatology-Endocrinology was set in December 2013 to assess patients coming from one or another specialty with some metabolic bone disease that could benefit from both a rheumatologist and an endocrinologist. The consultation takes place between 12–14h, on a monthly basis. Demographic characteristics, department of origin, diagnosis, complementary tests, and implemented changes in both the diagnosis and treatment were recorded. Data collected during the years 2014 and 2015 are presented.
Results In these 2 years there have been 20 consultation sessions (10 per year), with a total of 103 visits. 54 patients (43 women and 11 men) were treated as first visit. Age 57±15 years (range 29–88). There have been 27 successive visits (ratio first/successive 2/1) and in 22 cases the patients did not attend the appointment.
63% of patients (34) came from Endocrinology and 31% (17) from Rheumatology. Three patients came from other services (Internal Medicine, Primary Care and Physical Therapy).
Pathologies in order of frequency derived from Endocrinology were OP in the context of primary hyperparathyroidism (29%), hypogonadism (26%), bariatric surgery (15%) and glucocorticoid induced OP (6%). In 6 patients the inquiry was not related to bone metabolism and the diagnoses were: gout, psoriatic arthritis, osteoarthritis, fibromyalgia, among others. The pathologies most frequently derived from Rheumatology were primary hyperparathyroidism (41%), hypogonadism (18%) and adrenal insufficiency in patients with chronic corticosteroid therapy (12%). In 62% of patients referred from Endocrinology and in 65% of patients from Rheumatology underwent some change, either diagnosis or treatment.
Conclusions A multidisciplinary consultation Rheumatology-Endocrinology improves communication between the two specialties and facilitates the standardization of diagnostic and therapeutic criteria. It also represents a convenience for the patient and savings for the hospital, as the number of visits and complementary tests are reduced.
Disclosure of Interest None declared
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