Breadcrumbs

Rheumatology outpatient services at Central Adelaide

The Royal Adelaide Hospital (RAH) Rheumatology Unit provides inpatient and outpatient services for patients living in the Central Adelaide Local Health Network area who suffer from arthritis, inflammatory connective tissue disease and other musculoskeletal disorders.

Services are also provided to patients referred from rural and remote areas.

Children are usually managed by paediatricians with referral to the Women’s and Children’s Hospital or a paediatric rheumatologist as required.

Contact details 

Fax (for referrals): (08) 7074 6247

Appointment enquiries and new case appointments

Rheumatology unit: (08) 1300 153 853

Review or change of appointments

Rheumatology outpatients: (08) 1300 153 853

Appointment locations

Rheumatology outpatients: c/o Orthopaedic and Rheumatology outpatients

Location: Level 3,
Royal Adelaide Hospital
Port Road, Adelaide SA 5000

Telephone: (08) 1300 153 853 
Fax:
(08) 7074 6247

Services and clinics available

Services provided are:

  • Outpatient clinic consultations for diagnosis and management
  • Inpatient consultations
  • Inpatient admission
  • Joint aspiration
  • Rheumatological ultrasonography.

Rheumatology outpatients

Although many rheumatological conditions require supervision from a rheumatologist long term, wherever possible, the objective of a rheumatology outpatient appointment is to provide an assessment of the patient, an opinion regarding the key clinical issues and advice to the patient and the referring practitioner over one to two visits followed by formal discharge from the clinic.

This particularly applies to lesser priority conditions which may have a longer waiting time for an appointment and for which specialised drug therapies and/or disease monitoring are not indicated.

A variety of 'themed' clinics are held. Patients are generally seen by a Consultant Medical Officer, either directly or in an overseeing role following inputs from a Registrar and/or a Specialist Nurse or Allied Health Professional depending on the reason for referral and the patient’s ongoing care needs.

Day Clinic (all at RAH) Doctors Conditions seen
Monday Spondyloarthritis Dr Peter Penglis Ankylosing spondylitis
Psoriatic arthritis
Reactive arthritis
Tuesday Rheumatology/ immunology Prof Les Cleland
A/Prof Susanna Proudman
A/Prof Vidya Limaye
Dr Tiffany Hughes(Immunologist)
A/Prof Jenny Walker
Dr Fiona Goldblatt
Lupus
Sjogren's syndrome Systemic sclerosis
Inflammatory myopathies
Systemic inflammatory disease
Wednesday Early arthritis clinic A/Prof Susanna Proudman
Dr Anita Lee
Dr Mihir Wechalekar
Recent onset joint Inflammation/ rheumatoid arthritis
Thursday Assessment clinics Dr Vidya Limaye
Prf Les Cleland
New referrals
Friday Rheumatological ultrasound
General rheumatology
Dr Anita Lee
Dr Peter Penglis
Joint inflamation, regional MSK conditions, US guided injections
Established rheumatoid arthritis

Bulk bill clinics

Prof Les Cleland

A/Prof Susanna Proudman (Scleroderma and early arthritis)

A/Prof Vidya Limaye

A/Prof Jenny Walker (Scleroderma)

Dr Fiona Goldblatt (SLE)

Dr Mihir Wechalekar (early arthritis).

Referral process

Immediate referral process

Where consultation is “same day” urgent, the rheumatology registrar or the on call medical registrar if after hours, should be contacted via the RAH switchboard (08) 7074 0000 to discuss the patient. 

A written referral marked urgent should then be faxed to (08) 7074 6247 or sent with the patient if urgent assessment arranged. If the condition is life-threatening, the patient should be sent to the nearest emergency department.

Less-urgent referrals

Preferred method of referral is by fax or letter.

Fax number: (08) 7074 6247

All referrals including those urgently requiring consultation must be in writing and a named referral is preferred. Please fax written referral to (08) 7074 6247.

Less-urgent referrals will be allocated to the next available appointment. Non-urgent referrals may incur a wait. The waiting time for appointment will vary and be dependent on the demand for this service and the medical urgency of the patient’s condition.

Rheumatological problems not considered high priority (see eligibility and referral criteria) may wait a longer time for an appointment. Please consider other options and do not refer to multiple providers regarding the same presenting complaint.

Should changes occur to a patient’s medical condition during the waiting time for an appointment, referrers should send updated clinical information and where appropriate, contact the rheumatology registrar via the Royal Adelaide Hospital Switchboard (08) 7074 0000.

Clinical features indicative of potentially serious pathology (PDF 108KB)

Referrals unlikely to be offered an appointment

Referrals for outpatient appointments from the Emergency Department will not be accepted.

The rheumatology unit does not provide second opinions for patients already under the care of other rheumatologists. 

Transfer of care from another specialist may be accepted. A referral for continuing care (indefinite referral) from a general practitioner is addressed by name to a RAH rheumatologist is preferred.

Referrals from other outpatient clinics in the Royal Adelaide Hospital may not be accepted unless specific rheumatological input is required for the condition for which the patient is already attending a hospital outpatient clinic.

Consultants and registrars of other clinics should consider whether incidental non-threatening musculoskeletal problems could be managed by a patient’s general practitioner and whether the problem merits specialist input in competition for access to scarce specialist resources by other patients with threatening inflammatory diseases.

For further information on eligibility and referral processes see the outpatient referral process page.

Alternate care options / health information for low priority conditions while waiting for an appointment or if no appointment is made

Not all patients with musculoskeletal conditions can be offered appointments in the CALHN Rheumatology clinics.

In most cases, the key to appropriate management is a detailed history and examination. Options for obtaining further information regarding various rheumatological conditions and to provide guidance for assessment including investigations and management are listed under Rheumatology Clinical Information Sheets below.

Rheumatology priorities 

Urgency category Maximum wait time
Immediate Immediate admission to ward or Emergency Department
Urgent Likely to be seen within 1 to 2 weeks
Semi urgent Likely to be seen within 1 month
Intermediate Likely to be seen within 3 months
Non urgent Low priority for appointment

Rheumatology priorities are based on clinical urgency as displayed below:

Immediate priority Rheumatology examples
(not an exhaustive list)

Rheumatological emergencies with threat to major organs.

Acute rheumatological disease where admission is required. 

Direct to an Emergency Department.

Acute monoarthritis where sepsis cannot be excluded.

Acute ill-health where patient is clinically unstable.

For example, giant cell arteritis, systemic vasculitis, acutely unwell SLE.

Rheumatological drug complications (for example, methotrexate pneumonitis).

Referral process: must be discussed with the rheumatology registrar or the on call medical registrar if after hours, via RAH switchboard on (08) 7074 0000. 

A written referral marked URGENT should then be faxed to (08) 7074 6247 or sent with the patient if urgent assessment arranged.If the condition is life-threatening, the patient should be sent to the nearest Emergency Department.

Urgent priority Rheumatology examples
(not an exhaustive list)

Condition has the potential to require more complex or emergency care if assessment is delayed.

Condition has the potential to have significant impact of quality of life if care is delayed.

New onset or severely disabling flares of: 

  • polyarthritis/rheumatoid arthritis
  • polymyalgia rheumatica
  • polyarticular gout
  • Systemic vasculitis
  • SLE
  • Giant cell arteritis.

Referral process: Monday to Friday, 9.00 am to 5.00 pm. Must be discussed with the rheumatology registrar on call via RAH switchboard on (08) 7074 0000 to obtain appropriate prioritisation and then a referral letter marked URGENT faxed to (08) 7074 6247. 

After hours: medical registrar on call via RAH switchboard (08) 7074 0000.

Semi urgent priority Rheumatology examples
(not an exhaustive list)

Condition is unlikely to require more complex care if assessment is delayed.

Condition has the potential to have some impact of quality of life is care is delayed.

Persistent inflammatory condition resulting in moderate functional impairment:

  • rheumatoid arthritis
  • systemic vasculitis
  • connective tissue disorders
  • inflammatory muscle disease
  • spondyloarthritides.

Severe metabolic bone disease:

  • symptomatic and severe osteoporosis
  • severe Pagets disease.

Major GP diagnostic problems of musculoskeletal type especially with intercurrent disease elsewhere:

  • suspected connective tissue disease
  • possible paraneoplastic syndromes.

Persistent inflammatory conditions especially where independence and livelihood is compromised:

  • patients with a dependent spouse
  • patients with multiple medical problems also casing disability
  • patients unable to continue in employment.

Referral process: referrals should be faxed to (08) 7074 6247. 

Early assessment may be facilitated by addressing the referral to a rheumatology consultant by name as this opens additional assessment opportunities.

Intermediate priority Rheumatology examples
(not an exhaustive list)

Condition is unlikely to deteriorate quickly.

Condition is unlikely to require more complex care if assessment is delayed.

Patients with stable rheumatological conditions and able to function in the community

  • Acute exacerbation of osteoarthritis
  • Soft tissue rheumatism
  • Recurrent gout
  • Assessment for rehabilitation.
Referral process: referrals should be faxed to (08) 7074 6247.
Non urgent priority Rheumatology examples
(not an exhaustive list)
Low priority.

Do not usually need to see a rheumatologist unless there are atypical features.

  • Fibromyalgia
  • Other chronic pain syndromes
  • Chronic osteoarthritis.
Referral process: referrals should be faxed to (08) 7074 6247. Low priority for appointment.

Note: It is important to note these guidelines indicate what is clinically desirable, not what is always feasible in terms of delivery.

Rheumatology clinical information sheets

The following information sheets about presentations commonly seen in Rheumatology outpatients provide the minimum information required for assessing a referral under the headings of: eligibility, priority, differential diagnosis, clinical information and investigations required, pre-referral management strategies and discharge criteria.

Post discharge guidelines and information

If the patient or their general practitioner is concerned about a deterioration in the medical condition (see clinical information sheets and table of clinical features indicative of potentially serious pathology) and rheumatological assessment is required earlier than planned, a phone call to the Rheumatology Unit on (08) 8222 5190 will allow this to be discussed with one of the rheumatologists.

Patients whose medical condition has stabilised or resolved and for whom no further appointment has been made will be formally discharged. If rheumatological assessment is required again, a new referral, preferably a named referral (see consultant list) should be faxed to the Rheumatology Unit on (08) 7074 6247.

^ Back to top