Emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice via phone to on-call consultant/registrar:

  • abnormal calcium levels
  • fracture.

When public outpatient services are not routinely provided

Bow legs and aged < 1 year old (in an otherwise normal child).

Criteria to access public outpatient services

CategoryCriteria

Category 2
Recommended to be seen within 90 calendar days.

  • Bow legs with any of the following:
    • chronic illness (for example renal disease, rickets, prolonged steroid use)
    • severe or progressive bowing (i.e. intercondylar distance in standing > 6 cm)
    • unilateral deformity
    • height below 3rd percentile.
  • Multiple joint involvement or other skeletal deformities.
  • New onset bow legs in child aged ≥ 3 years.
  • Bow legs following healed fracture.

Information to include within a referral

Required

  • Reason for referral.
  • Details of the presenting condition, including evolution of symptoms and their duration, and associated complaints (onset, progression).
  • Provisional diagnosis.
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • history of infection, trauma and fracture
    • treatment prescribed and efficacy
    • relevant family history
    • risk factor for rickets
    • growth parameters
    • observation of gait
    • x-ray: weight bearing bilateral long leg (if unilateral deformity, progressive deformity, lack of spontaneous resolution and/or aged > 3 years).

If available

  • Dietary and vitamin intake.
  • Relevant pathology (for example calcium, magnesium, phosphate, corrected calcium, albumin, parathyroid hormone, vitamin D levels (if severe bowing)).
  • If the patient identifies as Aboriginal and/or Torres Strait Islander.
  • If the patient is considered 'at risk' or among a vulnerable, disadvantaged or priority population.
  • If the patient is suitable for virtual care or telehealth.
  • If the patient has special needs or requires reasonable adjustments to be made.
  • If the patient requires an interpreter (if so, list preferred language).

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.

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Current as at: Monday 17 June 2024
Contact page owner: System Purchasing