Rheumatology

Guidelines for specialist referrals:

GENERAL INFORMATION FOR PRIMARY REFERRALS
SPECIFIC REFERRAL LETTER GUIDELINES

Acute Single Joint  

• Important: septic arthritis
   
• Common: gout, pseudogout, reactive arthritis
   
• Rare : haemarthrosis, psoriatic arthritis, ankylosing spondylitis, avascular necrosis

Sub-Acute Single/Few Joint(s)  

• Osteoarthritis; Oligoarticular Synovitis; Intercritical Gout; Rare: Tumour - primary or secondary

Multiple Joint  

• Rheumatoid Arthritis / SLE
   
• Reactive Arthritis
   
• Polyarticular Gout

Periarticular /Soft Tissue Rheumatism  

• Shoulder/Rotator Cuff; Tennis Elbow; Anserine Bursitis; Trocanteric Bursitis; Carpal Tunnel Syndrome; Plantar Fascitis, etc.
   

Osteoporosis / Metabolic Bone Disease

• Post-menopausal Osteoporosis; Secondary Osteoporosis (inflammatory arthritis, steroid therapy); Osteomalacia
   

Chronic Pain Syndrome

• Fibromyalgia (FMS); Complex Regional Pain Syndromes (reflex sympathetic dystrophy, causalgia); Chronic Low Back Trouble
   

Multisystem / Connective Tissue Disease

• SLE (uncommon); Scleroderma; Poly/Dermatomyositis; Sjogrens; Vasculitis; Polymalgia Rheumatica; Rarely - Polyarteritis Nodosa; Wegener's Granulomatosis
   

Rheumatological Rehabilitation

• Chronic Arthritis (RA, multijoint OA, ankylosing spondylitis, psoriatic arthritis, polyarticular gout); Recent Onset Arthritis
   

Muscular Aches and Pains

• Polymyositis
   
• Polymyalgia Rheumatica / Giant Cell Arteritis
   
• Fibromyalgia Syndrome