​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:

  • acute wrist trauma.
  • septic arthritis of wrist or hand joints (suspected or confirmed).

When public outpatient services are not routinely provided

  • Patient who would otherwise be referred to a fracture clinic.
  • Uncomplicated inflammatory arthropathy (including crystal arthropathies).
    Note: consider referral to rheumatology.

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Wrist or hand pain resulting in rapid deterioration in function.
  • History of trauma to wrist or hand (i.e. missed fracture).
  • Severe nerve compression of the hand (for example carpal tunnel syndrome).

Note: Antenatal in 3rd trimester or post-partum ≤ 6 months with carpal tunnel syndrome should be referred to hand therapy in the first instance. Patient to be escalated to hand or orthopaedic service if this management fails.

Category 2
Recommended to be seen within 90 calendar days.

Sudden onset pain in wrist or hand < 3 months.

Category 3
Recommended to be seen within 365 calendar days.

Painful or stiff wrist or hand for ≥ 3 months.

Information to include within a referral

Required

  • Reason for referral.
  • Details of the presenting condition, including symptoms and their duration, severity, location of pain and impact on function.
  • Provisional diagnosis.
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • fall or trauma history
    • functional assessment (including range of motion)
    • x-ray: anterior to posterior (AP) and lateral wrist (consider scaphoid) views (where appropriate)
    • nerve conduction study (as appropriate and where possible).

If available

  • Relevant pathology.
  • Management to date.
  • Medical and/or allied health reports.
  • 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 willing to have surgery (where clinically relevant).
  • 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