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.

Additional comments

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

Not applicable.