Rheumatology Consult 🦴

Guide for rheumatology consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.

📋 Key Info to Have Ready

Patient identifiers: name, DOB, location, MRN
Admission details: may not be rheumatology-related
Reason for consult: joint pain, swelling, stiffness, rash, systemic symptoms (e.g. fatigue, fever, weight loss)
Duration and pattern of symptoms: acute vs. chronic, mono/oligo/polyarthritis, symmetry, morning stiffness
Past rheumatological or autoimmune diagnoses (e.g. RA, SLE, PsA, gout, vasculitis)
Relevant medications: steroids, DMARDs, biologics, NSAIDs
Any recent infections or trauma
Relevant imaging: XRays, US, MRI of affected joints if available
Recent bloods: FBC, U&E, LFTs, CRP, ESR, urate, ANA, RF, anti-CCP, ANCA if relevant
Synovial fluid analysis if available
What you're asking rheumatology to help with (e.g. ?inflammatory arthritis, ?flare, advice on steroids or DMARDs)

Hi, this is [Your Name], the intern on [Ward/Team]. I'm calling to refer a [Age] year-old [M/F] with [reason for admission], now with concern for [e.g. inflammatory arthritis / lupus flare / ?gout].
They have a background of [e.g. RA diagnosed 3 years ago, currently on methotrexate], presenting with [e.g. 3-day history of swollen, painful MCP joints, morning stiffness >1 hour].
CRP is [value], ESR [value], ANA is [positive/negative], urate is [value], and X-rays show [findings if relevant].
We're hoping for your advice on diagnosis and management — would you be able to review? I can send through the bloods and imaging if needed.

Be clear whether this is a new diagnosis or a known patient with a flare
Clarify any immunosuppression, especially steroid use and recent infection
If requesting urgent input (e.g. ?septic joint), flag this early and ensure basic investigations are already underway
Knowing the pattern of joint involvement and systemic features helps narrow the differential

Guide for rheumatology consultation and referral. Key information to provide, common indications, and referral scripts for NCHDs.

Patient identifiers: name, DOB, location, MRN
Admission details: may not be rheumatology-related
Reason for consult: joint pain, swelling, stiffness, rash, systemic symptoms (e.g. fatigue, fever, weight loss)
Duration and pattern of symptoms: acute vs. chronic, mono/oligo/polyarthritis, symmetry, morning stiffness
Past rheumatological or autoimmune diagnoses (e.g. RA, SLE, PsA, gout, vasculitis)
Relevant medications: steroids, DMARDs, biologics, NSAIDs
Any recent infections or trauma
Relevant imaging: XRays, US, MRI of affected joints if available
Recent bloods: FBC, U&E, LFTs, CRP, ESR, urate, ANA, RF, anti-CCP, ANCA if relevant
Synovial fluid analysis if available
What you're asking rheumatology to help with (e.g. ?inflammatory arthritis, ?flare, advice on steroids or DMARDs)

Hi, this is [Your Name], the intern on [Ward/Team]. I'm calling to refer a [Age] year-old [M/F] with [reason for admission], now with concern for [e.g. inflammatory arthritis / lupus flare / ?gout].
They have a background of [e.g. RA diagnosed 3 years ago, currently on methotrexate], presenting with [e.g. 3-day history of swollen, painful MCP joints, morning stiffness >1 hour].
CRP is [value], ESR [value], ANA is [positive/negative], urate is [value], and X-rays show [findings if relevant].
We're hoping for your advice on diagnosis and management — would you be able to review? I can send through the bloods and imaging if needed.

Be clear whether this is a new diagnosis or a known patient with a flare
Clarify any immunosuppression, especially steroid use and recent infection
If requesting urgent input (e.g. ?septic joint), flag this early and ensure basic investigations are already underway
Knowing the pattern of joint involvement and systemic features helps narrow the differential