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.
- suspected acute bone or joint infection. Do not commence antibiotics until reviewed or discussed with the relevant clinicians. Please call your local hand service to discuss your concerns.
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
- Royal Adelaide Hospital (08) 7074 0000
- The Queen Elizabeth Hospital (08) 8222 6000
Southern Adelaide Local Health Network
- Flinders Medical Centre (08) 8204 5511
Exclusions
Arthritis of hand and wrist without functional disability
Triage categories
Category 1 - appointment clinically indicated within 30 days
- nil
Category 2 — appointment clinically indicated within 90 days
- nil
Category 3 — appointment clinically indicated within 365 days
- rheumatoid arthritis of hand or wrist with functional disability
- osteoarthritis arthritis of hand or wrist with functional disability
For more on outpatient referrals, see the 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
- medications and dosages
- onset, duration, and progression of symptoms
- 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), hand dominance
- treatments trialled/implemented prior to referral
- plain X-ray hand/wrist anterior-posterior (AP)/lateral views. Please include provider details
Clinical management advice
Please note that hand and wrist referrals can be managed by the following specialist services:
- orthopaedics
- plastic surgery
- rheumatology
Consider referral for occupational therapy/physiotherapy to maintain function and optimise symptoms.
It is strongly recommended that people who smoke or vape stop 3 months prior to surgery. Smoking/vaping is associated with delayed healing. Please refer to useful resources section for further information.
Clinical resources
- Central Adelaide Local Health Network (CALHN) PreHab: Getting Ready for Surgery
- Therapeutic Guidelines - Limb Conditions
- Therapeutic Guidelines - Osteoarthritis
- Therapeutic Guidelines - Rheumatoid Arthritis