Rheumatology Consultation

MCP's rheumatology programme is designed for patients with unexplained joint pain, restricted mobility, or stiffness who have not received a definitive diagnosis through standard NHS-style referrals. Rather than treating only joints, MUDr. Klubal's team evaluates the full immune–metabolic–genetic picture: autoimmune markers, complement disorders, chronic infection load, hormonal profile, and DNA analysis. This approach is particularly effective for patients who fall between standard rheumatoid arthritis and fibromyalgia criteria and need a root-cause investigation.

Rheumatic diseases — from classic rheumatoid arthritis to more diffuse conditions like fibromyalgia and ankylosing spondylitis — share a common feature: they are driven by immune system dysregulation. MCP's rheumatology programme draws on the clinic's core immunological expertise to investigate the underlying drivers of musculoskeletal symptoms, not just their manifestations. The clinical assessment begins with a detailed rheumatological anamnesis: joint symptom history, morning stiffness duration, range-of-motion assessment, family history of autoimmune disease, and previous diagnostic workups. A thorough clinical examination follows, assessing joints, spine, muscles, ligaments, and tendons. The integrated laboratory panel covers: - **Autoimmune markers**: ANA, anti-CCP, rheumatoid factor, anti-dsDNA, ANCA, antiphospholipid antibodies - **Complement disorders**: C3, C4, CH50 — relevant in lupus and certain vasculitides - **Metabolic panel**: uric acid (gout), glucose, thyroid function, vitamin D and B12 (metabolic drivers of musculoskeletal symptoms) - **Infection screen**: Borrelia borreliosis, CMV, EBV, parvovirus B19 — reactive arthritis triggers - **Hormonal profile**: sex hormones, cortisol, DHEA — relevant in fibromyalgia and systemic connective tissue disease - **DNA analysis**: genetic risk variants for rheumatoid arthritis (HLA-DR4), ankylosing spondylitis (HLA-B27), lupus, and inflammatory bowel disease–associated arthritis The written report maps the findings across all dimensions and provides a diagnosis where possible, or a prioritised differential with recommended next steps — including referral pathways for imaging (MRI, ultrasound) if indicated. Ongoing monitoring programs are available for confirmed autoimmune conditions. Who benefits most: Patients with joint pain persisting more than 6 weeks without diagnosis, suspected early rheumatoid arthritis, axial spondyloarthritis, lupus, polymyalgia rheumatica, or fibromyalgia; patients with multiple failed standard referrals.