Direct to an emergency department for:
- Patients with acutely painful, hot, swollen joint(s) especially if febrile
- Suspected sepsis in a patient with previously diagnosed psoriatic arthritis
- Unexplained illness or fever in a patient being treated with biologic or immunosuppressant medicines.
Criteria for referral to public hospital specialist clinic services
- Suspected psoriatic arthritis with one or more of the following:
- inflammatory back pain
- heel pain (enthesitis)
- inflammatory bowel disease
- positive family history of spondyloarthritis
- HLA-B27 positive.
Information to be included in the referral
Information that must be provided
- Description of joints affected and onset, characteristics and duration of symptoms
- Details of skin conditions
- Details of all sentinel findings
- Details of previous medical management including the course of treatment and outcome of treatment
- Full blood examination results
- Erythrocyte sedimentation rate (ESR)
- C-reactive protein (CRP)
- Current and complete medication history (including non-prescription medicines, herbs and supplements)
- If the patient is pregnant or planning a pregnancy.
Provide if available
- Rheumatoid factor (RhF) levels
- Anti-cyclic citrullinated peptide (anti-CCP) antibody levels
- Relevant x-rays
- Liver function tests
- Urea and electrolyte results
- How symptoms are impacting on daily activities (e.g. work, study, or carer role)
- Previous rheumatology and dermatology assessments or opinions.
The Summary and referral information lists the information that should be included in a referral request.
As psoriatic arthritis is chronic or progressive condition that requires ongoing specialist advice the referral should request partnership care between the patient, their general practitioner and the health service.
The referral should note if the request is for a second or subsequent opinion as requests for a second opinion will usually not be accepted.
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
Referral to a public hospital is not appropriate for