"Rheumatology so unsatisfactory I transferred"

First I'd like to say that I have nothing but praise for the nurses in this department. Can not say the same for the consultant who when I eventually saw them, was brusque and patronising, treating me like a sixteen year old rather than an intelligent sixty year old.

On referral for suspected PMR I did not even see the consultant for nearly a year - all my appointments were with a staff registrar, who had doubts about my diagnosis but did not offer any further investigations. Various key symptoms were ignored if they did not fit in with the diagnosis. At one stage when I pointed out my swollen knee the consultant said "yes it is swollen - but that's nothing to do with PMR" and left it at that. Hence vital clues , which were picked up and acted on immediately when I transferred to a London hospital, were missed. As soon as I transferred to London I was quickly diagnosed with spondyloarthropathy and treated accordingly.

I realise rheumatological diseases can be difficult to diagnose, and we patients often find it difficult to pinpoint where the pain and stiffness is located, but a systematic check list of symptoms might go some way towards preventing people like me slipping through the net. At no stage during my appointments over a two year period was I even offered MRI scans, which would have detected the spinal symptoms.

I believe the department has a reputation for "efficiency" - I suspect this is achieved by rushing patients through appointments and skimping on investigative procedures.

I hate to be critical and thought long and hard about writing this more than a year after I was last seen. But in doing so I think I have had time to reflect on where things went wrong - and also am able to compare the treatment I have received at my London hospital. I have no criticism of RDE hospital in general or its staff who are fantastic - and only submit this in the hope that it will contribute to a better diagnostic system.