Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • suspected sepsis or unexplained fever
  • severe disease with inability to function in the community — phone the rheumatology registrar or on call consultant to discuss options for admission

Please contact the on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Category 1 (appointment clinically indicated within 30 days)

  • acutely painful disabling conditions such as frozen shoulder

Category 2 (appointment clinically indicated within 90 days)

  • other regional pain conditions that are less disabling or refractory to routine management. For example, regional bursitis, epicondylitis, plantar fasciitis

Category 3 (appointment clinically indicated within 365 days)

  • nil

For information on referral forms and how to import them, please view general referral information.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter required
  • if the patient is pregnant or planning a pregnancy
  • history of presenting condition:
    • duration of symptoms
    • aggravators
    • history or trauma
  • clinical examination:
    • active and passive range of motion
    • impact on function
    • pain behaviours
    • tender joints
    • clinical weakness
  • treatments previously trialled
  • blood results including location of company and accession number if available:
    • full blood count (FBC)
    • electrolytes, urea, creatinine (EUC)
    • estimated glomerular filtration rate (eGFR)
    • liver function tests (LFTs)
    • C-reactive protein (CRP)
  • relevant diagnostic/imaging reports, including location of company and accession number:
    • ultrasound imaging if clinically relevant
    • X-ray of localised area if symptoms have failed to improve

Additional information to assist triage categorisation

  • previous assessments or opinions from a rheumatologist or other relevant specialist or allied health clinician

Clinical management advice

To preserve rheumatology outpatient capacity for high acuity presentations, an alternative service model has been adopted at the Royal Adelaide Hospital (RAH) and The Queen Elizabeth Hospital (TQEH). Patients with uncomplicated non-inflammatory musculoskeletal conditions and recent onset inflammatory arthritis requiring fast tracking may be triaged into a physiotherapist-led clinic at the RAH or TQEH for assessment and management, with rheumatology consultant access as required. Outcomes may include provision of non-pharmacological management options in primary care or further imaging/pathology and review with a rheumatologist for ongoing care where indicated.

Regional soft tissue pain is not responsive to paracetamol

  • consider short term non-steroidal anti-inflammatory drugs (NSAIDs) if no contraindication or localised corticosteroid injection.
  • consider early referral to pain unit if suspicion for complex regional pain syndrome.

Consumer resources