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.

  • nil

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

Southern Adelaide Local Health Network

Category 1 - appointment clinically indicated within 30 days

  • nil

Category 2 — appointment clinically indicated within 90 days

  • severe, unrelieved pain after administration of at least two corticosteroid injections; receiving hand therapy and splinting. Symptoms may include:
    • locking
    • stiffness
    • tenderness
    • pain

Category 3 — appointment clinically indicated within 365 days

  • De Quervain's tenosynovitis that persists despite receiving various forms of medical treatment, such as two corticosteroid injections and hand therapy, as well as splinting. Symptoms may include:
    • locking
    • stiffness
    • tenderness
    • pain for greater than 6 months

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 requirements
  • past medical/surgical history
  • current medications and dosages
  • allergies and sensitivities
  • presenting symptoms
  • management history including:
    • injury/trauma if relevant
    • onset and duration
    • severity
    • pain
    • associated features, e.g. functional impairment, range of motion (ROM)
    • treatments trialled/implemented prior to referral
  • ultrasound hand and wrist
  • plain X-ray wrist anterior-posterior (AP)/lateral views, include provider details and accession number

Clinical management advice

Please note that hand and wrist referrals can be managed by the following specialist services:

Consider referral to occupational therapy for splinting in Women less than 6 months postpartum, OR in third trimester pregnancy with symptoms present less than 8 weeks.

Consider trial of conservative measures such as hand therapy, splinting and/or local steroid injection prior to referral.

It is strongly recommended that people who smoke or vape stop 3 months prior to surgery. Smoking/vaping is associated with delayed skin healing. Please refer to useful resources section for further information.

Clinical resources

Consumer resources