Rheumatology Clinic

Conditions Treated

Achilles Tendinopathy

Adolescent Rheumatology

Ankylosing Spondylitis

Antiphospholipid Syndrome (APS)

Carpal Tunnel Syndrome

Complex Regional Pain Syndrome

Connective Tissue Disease

EGPA (Churg-Strauss Syndrome)

Giant Cell Arteritis

Juvenile Idiopathic Arthritis

Systemic Lupus Erythematosus (Lupus)

Plantar Fasciitis

Polymyalgia Rheumatica

Psoriatic Arthritis

Reactive Arthritis

Rheumatoid Arthritis

Scleroderma / Systemic Sclerosis

Sjogren's Syndrome

More coming soon

Medications

DMARDs

An anchor medication used to calm inflammation in many rheumatic conditions.

Hydroxychloroquine

Commonly used in lupus and inflammatory arthritis.

Used in inflammatory arthritis and some related conditions.

An alternative DMARD for inflammatory arthritis.

Used in several autoimmune rheumatic conditions.

CellCept (mycophenolate)

Used in lupus and some connective tissue diseases.

Biologics & IV therapies

IV immunoglobulin (IVIG)

A specialist infusion used in selected autoimmune conditions.

A biologic used in rheumatoid arthritis and giant cell arteritis.

A TNF inhibitor biologic injection.

Remicade (infliximab)

An originator TNF inhibitor infusion.

An IL-17 biologic used in psoriatic and axial disease.

An IL-17 biologic used in psoriatic disease.

Bone health & osteoporosis

A newer bone-building injection used in severe osteoporosis with high fracture risk.

A twice-yearly injection used to reduce fracture risk in osteoporosis.

Fosamax (alendronic acid)

An oral bisphosphonate used to protect bones.

Calcium and vitamin D

Foundational bone-health support that depends on diet and individual risk.

Diabetes & GLP-1 medicines

Mounjaro (tirzepatide)

A prescription GIP and GLP-1 medicine used mainly in type 2 diabetes.

Ozempic (semaglutide)

A prescription GLP-1 medicine used mainly in type 2 diabetes.

Rybelsus (semaglutide tablets)

An oral form of semaglutide used mainly in type 2 diabetes.

Thyroid medicines

Thyroxine (levothyroxine)

A thyroid hormone replacement used in underactive thyroid.

More coming soon

Patient Guides

SLE and Sun Protection

Why SPF 50 and above sunblock and daily UV protection matter for lupus patients.

Falls Risk Assessment Tool

A free 5-question check to understand your risk of falling.

Calcium Calculator

Estimate your daily calcium intake from common foods and supplements.

Bone Healthy Recipes Malaysia

Local Malaysian meals and small swaps to support stronger bones.

Exercises for Toes, Feet and Ankles

12 simple exercises with a video demonstration, useful for Achilles and foot pain.

8-Question Osteoporosis Risk Check

A quick check to see if you may have risk factors for osteoporosis.

More coming soon

Doctor Guides

Psoriatic Arthritis: When to Refer

GP referral guide. Recognising psoriatic arthritis and when to refer to a rheumatologist.

FRAX® Score: A Practical Guide

Doctor guide to fracture risk assessment, inputs, interpretation and referral.

Clinical Approach to Inflammatory Arthritis

Practical diagnostic algorithm for joint pain, swelling and morning stiffness.

Gout Classification Tool for Clinicians

Interactive 2015 ACR/EULAR gout classification criteria for GPs and clinicians.

Clinical Calculators & Scoring Tools

Interactive rheumatology classification criteria and disease activity scores for clinicians.

More coming soon

Vaccination Talks

Doctor Guides Clinical Calculators LupusSLICC Classification Criteria for SLE

LupusClassification criteria

SLICC Classification Criteria for SLE

2012 SLICC classification criteria. Classifies SLE when ≥4 criteria are met (≥1 clinical and ≥1 immunologic), or with biopsy-proven lupus nephritis and ANA or anti-dsDNA positivity.

For clinicians only. This tool is for healthcare professionals and clinical education only. It does not diagnose, replace clinical judgement, or replace specialist assessment. Any decisions about a patient must be based on full clinical assessment, investigations where appropriate, and current clinical guidelines.

Clinical criteria (any at any time)

Acute cutaneous lupus (malar rash, bullous lupus, TEN variant, maculopapular lupus rash, photosensitive lupus rash) OR subacute cutaneous lupus

Chronic cutaneous lupus (classical discoid, hypertrophic verrucous lupus, lupus panniculitis, mucosal, lupus erythematosus tumidus, chilblains, discoid/lichen planus overlap)

Oral or nasal ulcers (in absence of other causes)

Non-scarring alopecia (in absence of other causes)

Synovitis involving ≥2 joints and ≥30 min morning stiffness

Serositis (typical pleurisy >1 day, or pleural effusion, pericardial pain >1 day, or pericardial effusion, or pericarditis by ECG)

Renal: urine protein/creatinine ratio (or 24h protein) representing 500 mg/24h; or red blood cell casts

Neurologic: seizures, psychosis, mononeuritis multiplex, myelitis, peripheral or cranial neuropathy, acute confusional state (in absence of other causes)

Hemolytic anemia

Leukopenia (<4,000/mm³) or lymphopenia (<1,000/mm³) at least once

Thrombocytopenia (<100,000/mm³) at least once

Immunologic criteria

ANA above laboratory reference range

Anti-dsDNA above laboratory reference range (or >2× the reference for ELISA)

Anti-Sm: presence of antibody to Sm nuclear antigen

Antiphospholipid antibody positivity (lupus anticoagulant, false-positive RPR, medium/high-titre anticardiolipin, or anti-β2-glycoprotein I)

Low complement (C3, C4 or CH50)

Direct Coombs test positive (in absence of hemolytic anaemia)

Biopsy pathway

Biopsy-proven lupus nephritis compatible with SLE

ANA positive

Anti-dsDNA positive

Live result

0 clin · 0 imm

Does not meet SLICC classification

Threshold not currently met. Reassess as clinical picture evolves.

Interpretation

Threshold: ≥4 total criteria with ≥1 clinical AND ≥1 immunologic.

OR biopsy-proven lupus nephritis + ANA or anti-dsDNA positive.

Sources

Petri M, et al. Derivation and validation of the SLICC classification criteria for SLE. Arthritis Rheum. 2012.

For clinicians only. This tool is for healthcare professionals and clinical education only. It does not diagnose, replace clinical judgement, or replace specialist assessment. Any decisions about a patient must be based on full clinical assessment, investigations where appropriate, and current clinical guidelines.

Related tools

Lupus · Disease activity score

Weighted 24-item score for lupus disease activity across organ systems.

Lupus · Disease activity index

BILAG-2004 / Easy-BILAG

Structured recording of lupus disease activity by organ system using the A–E scheme.

Rheumatoid Arthritis · Classification criteria

2010 ACR/EULAR Classification Criteria for RA

Score joint involvement, serology, acute-phase reactants and duration to classify RA.

Rheumatoid Arthritis · Disease activity score

28-joint disease activity score using CRP, tender/swollen joint counts and patient global.

Discuss a case with my clinic

For colleagues considering referral or shared care, please WhatsApp my clinic for professional-to-professional discussion.

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Dr. Ramani Arumugam

Kuala Lumpur

Consultant Rheumatologist & Internal Medicine Physician

MBBS, Manipal Academy of Higher Education, India · Masters in Internal Medicine, University Malaya

Rheumatology fellowship training · Ministry of Health Malaysia & Royal National Hospital for Rheumatic Diseases, Bath, UK

MMC 34627 · NSR 129944

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This website is for education only and does not replace medical advice.