Inflammatory Arthritis Referral Access Criteria

• 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

• 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 Clinician Assist WA: Acute Rheumatology Assessment (external site).

• 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

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.

• 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

• Nil

• FBC
• U&E
• LFT
• ESR
• CRP
• RF or anti-CCP
• X-ray or MRI/CT of affected joints

• 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, Hepatitis B, Hepatitis C, HIV

• Nil

• Cancer screening if applicable

Category 1

Appointment within 30 days

• New onset, suspected or recently diagnosed inflammatory arthritis with active symptoms
• Active established inflammatory arthritis requiring escalation of management

Category 2

Appointment within 90 days

• Known inflammatory arthritis on biologic/targeted synthetic DMARDs (b/tsDMARDs)

Category 3

Appointment within 365 days

•  No defined category 3 criteria

• Nil

• See Clinician Assist: Arthritis (external site)