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Osteoarthritis, gout and joint pain

Emergency department referrals

All urgent cases must be discussed with the on call Registrar to obtain appropriate prioritisation and treatment. Contact through:

  • Caboolture Hospital (07) 5433 8888
  • Redcliffe Hospital (07) 3883 7777
  • Royal Brisbane and Women's Hospital (07) 3646 8111
  • The Prince Charles Hospital (07) 3139 4000

Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.

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:

  • Acute non-traumatic monoarthritis associated with severe pain and/or incapacitating loss of joint function and/or marked constitutional symptoms
  • Suspected septic arthritis

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable

  • Acute inflammatory arthritis

Category 2

Appointment within 90 days is desirable

  • Early or stable inflammatory arthritis
  • Poly arthritis with functional impairment
  • Recurrent gout despite treatment, with any of the following:
    • maximum tolerated allopurinol dose
    • progressive joint damage despite therapy
    • allopurinol intolerance
  • Chronic tophaceous gout

Category 3

Appointment within 365 days is desirable

  • Complex osteoarthritis
  • Functional impairment and/or joint pain that persists despite optimal management, such as physiotherapy, weight loss and analgesics

If your patient does not meet the minimum referral criteria

Consider other treatment pathways or an alternative diagnosis.

If you still need to refer your patient:

  • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Other important information for referring practitioners

Not an exhaustive list

  • If appropriate, encourage weight loss and regular exercise.
  • For management of gout:
    • consider NSAIDs or colchicine for acute symptoms
    • consider prophylaxis with allopurinol or probenecid (caution with slow up-titration in CKD and close monitoring)
    • dietary modification (particularly alcohol intake)
    • modify medications that may contribute to gout where possible (eg. thiazide diuretics)
    • increase fluid intake
    • consider referral to a physiotherapist or occupational therapist for functional assessment.
  • Refer to HealthPathways for assessment and management information if available

Please note that referral guidelines have been developed Knee pain (acute) and Knee pain (chronic) by Orthopaedics.

Referral requirements

A referral may be rejected without the following information.

Essential referral information

History and Examination

  • Relevant medical history, comorbidities and medications
  • Description of joints affected (swelling, pain, morning stiffness)
  • Details of treatments offered and assessments of efficacy
  • Interference with activities of daily living and working ability

Pathology and Test Results

  • FBC,  urea, creatinine & LFT results

Additional Referral Information (Useful for processing the referral)

Pathology and Test Results

  • Urinalysis results
  • If suspected inflammatory or crystal arthropathy include ESR/CRP, uric acid, rheumatoid factor, anti CCP & ANA results
  • Imaging of joints (XR/CT/MRI results)

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can’t order, or the patient can’t afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
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