Criteria for referral to public hospital service
- Persisting or intermittent stenosing tenosynovitis (suggested by stiffness, locking, tenderness or painful clicking symptoms that have persisted for longer than six months) with functional impairment, that has been unresponsive to at least three months of medical management (that is at least two of hand therapy, orthotics/splinting, local steroid injection, non-steroidal anti-inflammatory medicines, alone or in combination)
- Persisting De Quervain’s tenosynovitis with functional impairment, that has been unresponsive to at least three months of medical management (that is at least two of hand therapy, orthotics/splinting, local steroid injection, non-steroidal anti-inflammatory medicines, alone or in combination)
- New, intermittent or chronic fixed trigger finger.
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 onset, nature, recurrence and duration of symptoms
- Detailed clinical examination with functional assessment
- How symptoms are impacting on daily activities including impact on work, study or carer role
- Range of measurement (ROM) measurements for metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints flexion contracture
- Details of previous medical and non-medical management including the course of treatments and outcome of treatments
- History of smoking
- If stenosing tenosynovitis, hand ultrasound
- Statement about the patient’s interest in having surgical treatment if that is a possible intervention.
Provide if available
- Any recent allied health assessments
- Recent ultrasound results
- If the person identifies as an Aboriginal and/or 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.
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