Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • nil

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Category 1 — appointment clinically indicated within 30 days

  • women postpartum ≤ 6 months, OR third trimester pregnancy symptoms ≤ 8 weeks

Category 2 — appointment clinically indicated within 90 days

  • severe unrelieved pain after administering of minimum two corticosteroid injections and with splintage and hand therapy input

Category 3 — appointment clinically indicated within 365 days

  • symptomatic De Quervain’s tenosynovitis unresponsive to maximal medical management, use of splints/immobilisers and two corticosteroid injections, symptoms may include:
    • stiffness
    • locking
    • tenderness
    • pain ≥ 6 months

For more on outpatient referrals, see the general referral information.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • complete past medical history including relevant surgical history
  • current medication list
  • private health cover/compensable status e.g. WorkCover claims
  • management history including:
    • onset and duration
    • pain
    • associated feature, e.g. functional impairment
    • immobiliser/splint/cast
    • allied health management reports
    • information on gestation or post-partum timeframes (in weeks)
  • previous management trialled
  • functional range of motion (ROM)
  • plain X-ray anterior posterior/lateral views, include radiological details/accession number

Clinical management advice

Please note that hand and wrist referrals can be managed by the following specialist services:

Consideration of risks versus benefits of surgical intervention may include:

  • age
  • frailty
  • additional comorbidities
  • patient expectations of outcome
  • patient suitable for surgery, engagement in self-management
  • body mass index (BMI) and weight loss
  • smoking/vaping status - if active, strongly consider referral for smoking/vaping cessation.

Optimisation of chronic medical conditions should occur as part of initial assessment and conservative management as this may impact on suitability for surgical intervention.

Clinical resources