Undifferentiated peripheral inflammatory arthritis

Red flags

Consider immediate referral to/liaison with specialist for

New onset inflammatory polyarthritis (swollen, tender joints with early morning stiffness > 30 minutes) even if RhF/CCP/ESR/CRP normal
Suspicion of septic arthritis i.e. fever, systemic illness

Routine referrals

Consider routine referral for

Other persistent inflammatory arthritis

Other important information for referring practitioners

Lifestyle changes

Dietary changes and move towards healthy BMI
Alcohol reduction and smoking cessation
Keep active (NHMRC: moderate intensity activity for 2.5-5h/week)

Medical management

NSAID + paracetamol +/- codeine as appropriate
Omega-3 >2.7g/d (Grade A evidence)
Consider role for physio/OT/hydrotherapy

Referral requirements

A referral may be rejected without the following information.

Essential referral information

History and examination

Number/location of swollen tender joints
Time since onset of joint symptoms
Duration of early morning stiffness
Extra-articular features

Investigations

FBC
E/LFT
ESR/CRP
Rheumatoid Factor/anti CCP antibody
ANA
Urinalysis

Additional referral information (useful for processing the referral)

X-ray of affected joint(s)
ENA, dsDNA, ANCA, HLA B27, viral serology

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.

Clinical Modifiers (where relevant)

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

Reason for Referral (essential)

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

Clinical Information (essential)

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

Patient’s Demographic Details (essential)

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

Referring Practitioner Details (essential)

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

Other Information (where relevant)

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.)

Send referral

Hotline: 1300 364 938

Electronic:

GP Smart Referrals (preferred)
eReferral system templates

Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs

Mail:
Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034

Health pathways

Access to Health Pathways is free for clinicians in Metro North Brisbane.

For login details email:
healthpathways@brisbanenorthphn.org.au

Locations

Resources

Specialists list

General referral criteria

Clinical resources

UPIA Interactive Educational Module Access