Information for referring practitioners
Dr Elaine Ng welcomes referrals from across the Riverina and Murrumbidgee region for patients aged 16 years and above. We prefer email communication.
Email (preferred): admin@waggawaggarheumatology.com.au
HealthLink: drmspies
Phone: (02) 5955 3000
Required referral content
Patient demographics:
- Full name, date of birth, postal address, contact number, Medicare number; referrer name, address, provider number and signature.
Clinical content:
- Reason for referral and presenting problem
- Symptom duration and trajectory
- Past medical history and complete current medication list (including over-the-counter and complementary)
- investigations including most recent bloods and imaging.
Referral triage categories
Referrals are triaged into one of three categories based on clinical priority. Actual appointment times depend on current demand and may differ from the target.
Category 1 — Urgent (target within 30 days)
- Suspected giant cell arteritis (new headache, jaw claudication, or markedly raised inflammatory markers in a patient over 50)
- Suspected systemic vasculitis or connective tissue disease with organ involvement
- New inflammatory arthritis with significant functional loss or systemic features
- Acute flare of established connective tissue disease with new organ involvement
- New monoarthritis where septic arthritis has been excluded
Category 2 — Routine (target within 90 days)
New suspected inflammatory arthritis (synovitis, morning stiffness >30 min, raised inflammatory markers, or positive RF / anti-CCP)
New suspected spondyloarthritis (inflammatory back pain, positive HLA-B27, or imaging evidence of sacroiliitis)
Suspected new connective tissue disease (positive ANA with clinical features, suspected Sjögren’s with extraglandular involvement, suspected inflammatory myopathy)
Suspected polymyalgia rheumatica
Crystal arthropathy with frequent flares not controlled on standard therapy
Patients transferring care while on biologic therapy
Category 3 — Non-urgent (target within 182 days)
Stable established rheumatology patients transferring from another practitioner
Osteoarthritis where diagnostic confirmation or a management opinion is sought
Fibromyalgia and chronic widespread pain — diagnostic confirmation
Gout, stable between flares (urate-lowering therapy initiation or optimisation)
Osteoporosis — assessment and treatment planning
Soft tissue rheumatism and tendinopathy where the diagnosis is unclear
ME/CFS, Ehlers-Danlos / hypermobility spectrum disorders, and CRPS — single focused assessment to exclude inflammatory causes
REFER DIRECTLY TO EMERGENCY
– Unexplained illness or fever in a patient on a biologic or immunosuppressant
– Vision loss or diplopia in a patient over 50 (suspected GCA) — commence prednisolone 60mg before transfer to ED
– New bilateral leg weakness, urinary retention or saddle anaesthesia (suspected cord or cauda equina syndrome)
– Haemoptysis, sudden shortness of breath or pleuritic chest pain (PE or pulmonary vasculitis)
– New neurological deficit in known vasculitis or lupus
– Severe new rash, particularly with mucosal involvement or fever
– Hot, swollen, exquisitely tender single joint with fever (suspected septic arthritis)