title: On-spot rheumatology consultations in a multilevel geriatric hospital.
abstract: BACKGROUND
  Musculoskeletal and joint disorders are extremely common in the elderly. They directly affect mobility, gait stability, quality of life, and independence.
  
  
  OBJECTIVE
  To assess the nature of joint problems encountered in a geriatric inpatient population and evaluate the contribution of a rheumatologist.
  
  
  METHODS
  We reviewed the rheumatology consultation records that were conducted in a geriatric medical center over a 10 year period.
  
  
  RESULTS
  A total of 474 consultations were held; most of these patients (86%) were hospitalized in the acute geriatric departments, 10% in the rehabilitation ward and 4% in the long-term care wards. Some patients were seen more than once. A rheumatologic joint problem was the main reason for hospitalization in 53% of these patients. Monoarthritis was the most frequent complaint (50%), followed by pauciarticular arthritis (two to five joints) in 30% of patients. Arthrocentesis, diagnostic and therapeutic, was performed in 225 patients, most of them in knee joints (81%). The most frequent diagnosis was osteoarthritis with acute exacerbation (28%), followed by gout (18%), pseudo-gout (9%) and rheumatoid arthritis (9%). In 86 cases (18%) the diagnosis was a non-specific rheumatologic problem: arthralgia, nonspecific generalized pain, or fibromyalgia.
  
  
  CONCLUSIONS
  Prompt and appropriate evaluation, as well as arthrocentesis and treatment initiation, including local injections, were made possible by the presence of an in-house rheumatologist.
authors.affiliation: Department of Geriatric Medicine, Shmuel Harofeh Geriatric Medical Center, Beer Yaakov, Israel. elubart@hotmail.com
authors.forename: Emily
authors.initials: E
authors.lastname: Lubart
authors.affiliation: Department of Geriatric Medicine, Shmuel Harofeh Geriatric Medical Center, Beer Yaakov, Israel.
authors.forename: Arthur
authors.initials: A
authors.lastname: Leibovitz
authors.affiliation: Department of Geriatric Medicine, Shmuel Harofeh Geriatric Medical Center, Beer Yaakov, Israel.
authors.forename: Vadim
authors.initials: V
authors.lastname: Shapir
authors.affiliation: Department of Geriatric Medicine, Shmuel Harofeh Geriatric Medical Center, Beer Yaakov, Israel.
authors.forename: Refael
authors.initials: R
authors.lastname: Segal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005853:Geriatrics / Q000379:methods; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel; D007592:Joint Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D011788:Quality of Life; D012017:Referral and Consultation; D012189:Retrospective Studies; D012219:Rheumatology / Q000379:methods*