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.
- acute inflammation, e.g. hemarthrosis or tense effusion
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
- Frozen shoulder (adhesive capsulitis)
Category 1 — appointment clinically indicated within 30 days
- suspected malignancy
Category 2 — appointment clinically indicated within 90 days
- shoulder dislocation with or without suspected or confirmed cuff tear including acromioclavicular and glenohumeral joints
- instability associated with bone structural pathology or ‘bony Bankart lesion’
- calcific tendonitis
Category 3 — appointment clinically indicated within 365 days
- recurrent dislocated shoulder
- shoulder instability
- shoulder osteoarthritis following trial of corticosteroid injection
- elbow tendonitis (golfers/tennis elbow)
- superior labrum anterior to posterior/Bankart lesion
For information on referral forms and how to import them, please view 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
- identify within your referral 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
- current medication list
- body mass index (BMI)
- previous surgery
- private health cover/compensable status e.g. WorkCover claims
- management history including:
- injury/trauma if relevant
- onset and duration
- associated features, e.g. functional impairment
- use of immobiliser/splint/cast
- allied health reports
- neurological/neurovascular assessment
- functional range of motion (ROM)
- ultrasound (US) for suspected rotator cuff injury
- plain X-ray anterior posterior/lateral views include radiological details/accession number
Additional information to assist triage categorisation
- complete blood examination (CBE)
- electrolytes, urea, creatinine (EUC)
- liver function tests (LFTs)
- estimated glomerular filtration rate (eGFR)
- erythrocyte sedimentation rate (ESR)
- C-reactive protein (CRP)
- rheumatoid factors
- uric acid
Clinical management advice
Consideration of risks versus benefits of surgical intervention may include:
- 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.
Ensure alternative causes for shoulder pain have been considered, these may include inflammatory arthritis, or suspected multiple myeloma.
History of inflammatory disease; consider referral to rheumatology.
- HealthPathways SA - Frail But Stable Older Adults (log in required)