Refer for emergency assessment
Direct to an emergency department for:
- Acutely septic prosthetic joint
- Joint dislocation
- Suspected acute bone infection
- Suspected fracture, or fracture requiring manipulation or operation.
Criteria for referral to public hospital specialist clinic services
- Existing total hip replacement with new pain, loosening or other concern
- Developmental dysplasia of the hip
- Avascular necrosis of the hip
- Hip with ongoing moderate or severe pain and / or functional impairment, despite at least three months of treatment that included: targeted education, physiotherapy and weight loss (where appropriate) and where a diagnosis of osteoarthritis or joint infection has been excluded
- Suspected malignancy of the hip or thigh.
Information to be included in the referral
Information that must be provided
- Reason for referral and expectation, or outcome, anticipated by the patient, or their carer, and the referring clinician from referral to the health service
- Description of joint affected and onset, nature and duration of symptoms
- Findings on physical examination
- How symptoms are impacting on daily activities including impact on work, study or carer role and level of sleep disturbance
- Details of previous medical and non-medical management including the course of treatments and outcome of treatments
- If referral relates to infection or inflammation provide full blood examination and inflammatory marker results (erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP))
- x-ray of the affected hip: anteroposterior (AP) view of pelvis and affected hip showing proximal 2/3 femur, and lateral view of affected hip including weight bearing / standing views
- Details of any previous joint surgery.
Provide if available
- Results from most recent hip and knee questionnaire, or similar symptom burden questionnaire
- Recent HbA1c results if patient has diabetes
- History of smoking
- Current and complete medication history (including non-prescription medicines, herbs and supplements and recreational or injectable drugs)
- Statement about the patient’s interest in having surgical treatment if that is a possible intervention
- If the person identifies as an Aboriginal and Torres Strait Islander
- If the person is part of a vulnerable population.
The Summary and referral information lists the information that should be included in a referral request.
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
There are other statewide referral criteria that include reference to hip pain:
Vulnerable populations include:
- people from culturally and linguistically diverse backgrounds
- older Australians
- carers of people with chronic conditions
- people experiencing socio-economic disadvantage
- people living in remote, or rural and regional locations
- people with a disability
- people with mental illness
- people who are, or have been, incarcerated.
Vulnerable patient groups also include terminally ill patients, patients with experiences of family violence, in out-of-home care, foster care and those in state care.
Referral to a public hospital is not appropriate for