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Clinical Challenges in a Prison Rheumatology Referral Practice

California Department of Corrections, Sacramento; Department of Medicine, California Medical Facility, Vacaville; 875 Meadowridge Drive, Fairfield, CA 94534; e-mail scott.anderson{at}corr.ca.gov

Joseph Bick, MD

Deborah Harriss, NP

Department of Medicine, California Medical Facility, Vacaville

The objective of this study was to describe 100 consecutive patients evaluated by a consultative rheumatology service at the California Medical Facility, a 3,300-bed adult male correctional medical facility in Northern California. Methods entailed review of a database containing the first 100 consultations performed by the rheumatology service. Age, ethnicity, and diagnosis were recorded. Results: Age ranged from 24 to 78 years, with a mean of 44 years. Ethnic breakdown was 40% White, 36% Black, 18% Hispanic, 1% Native American, and 1% "other." The most common diagnoses were osteoarthritis (27%), ankylosing spondylitis (8%), normal examination (6%), internal derangement of the knee (5%), and gout (4%). A variety of conditions were found in 3% or less of the patients seen, ranging from polymyositis to spinal osteomyelitis. Study conclusions are that rheumatology patients in prison may be young or old, are ethnically diverse, and manifest broad-ranging pathology. Osteoarthritis is the most common diagnosis, perhaps due to traumatic injuries often described by incarcerated persons.

Journal of Correctional Health Care, Vol. 9, No. 4, 425-437 (2003)
DOI: 10.1177/107834580300900405


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