Inflammatory Arthritis Referral Access Criteria
Inflammatory Arthritis Referral Access Criteria
| Referrers should use this page when referring patients to public adult rheumatology outpatient services for Inflammatory Arthritis. |
| Emergency referral |
 If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region. |
- Patients with acutely painful, hot, swollen joint(s) especially if febrile
- Suspected sepsis in a patient with previously diagnosed rheumatoid arthritis
- Unexplained illness or fever in a patient being treated with biologic or immunosuppressant medicines
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| Immediate referral |
 Immediately contact on-call registrar or service to arrange immediate rheumatology assessment (seen within 7 days):
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- Acute, otherwise unexplained, monoarthritis
- Acute, otherwise unexplained, polyarthritis
- Patients with a previously diagnosed condition who are acutely unwell e.g.:
- Chronic idiopathic arthritis (inflammatory arthritis, psoriatic arthritis, axial spondylitis)
- System lupus erythematosus, myopathies, scleroderma
- Necrotising vasculitis (anti-neutrophilic cytoplasmic autoantibody-associated vasculitis)
- Patients on biological agents
To contact the relevant service, see HealthPathways: Acute Rheumatology Assessment (external site).
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| Presenting issues |
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
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- Suspected or diagnosed inflammatory arthritis with active symptoms (e.g. joint pain, swelling, tender to touch)
- Previously diagnosed inflammatory arthritis for review of management plan, monitoring or management of toxicity associated with treatment
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| Mandatory information |
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Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test due to financial reasons or geographical location).
This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
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| History |
- Relevant history, onset, duration and severity of symptoms including:
- Number and location of swollen, tender joints
- Duration of early morning stiffness (greater or less than 30 minutes)
- Current medications list
- Any known allergies
- Details of previous treatment and outcome
- If on a biologic Disease Modifying Anti-Rheumatic Drug (DMARD) and for PBS review, please state timeframe
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| Examination |
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| Investigations |
- FBC
- U&Es
- LFTs
- ESR
- CRP
- Rheumatoid Factor or anti-CCP
- XR or MRI/CT of affected joints
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| Highly desirable |
| History |
- Degree of functional impairment (e.g. impact on mobility/exercise tolerance/ADLs/ability to work/quality of life)
- Pain assessment e.g. waking up at night, analgesic consumption, aggravating and relieving factors
- Extra-articular and systemic features, if any including weight loss
- Previous rheumatology assessments or opinions
- If patient is pregnant or planning a pregnancy
- Other screening previously performed including CXR, HepB, HepC, HIV
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| Examination |
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| Investigations |
- Cancer screening if applicable
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| Indicative triage category |
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Category 1
Appointment within 30 days
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- New onset, suspected or recently diagnosed inflammatory arthritis with active symptoms
- Active established inflammatory arthritis requiring escalation of management
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Category 2
Appointment within 90 days
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- Known inflammatory arthritis on biologic/targeted synthetic DMARDs (b/tsDMARDs)
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Category 3
Appointment within 365 days
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- No defined category 3 criteria
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Last reviewed: 18-03-2024