Mater Private Specialist Quick Find

Rheumatology - public patients

Clinical Lead - Dr Joseph O'Callaghan

Purpose

This page contains information for general practitioners on how to refer patients aged 16 years and over to the Rheumatology specialist clinic at Mater Hospital Brisbane. These services are offered in our specialist outpatient clinics and for eligible patients aged between 16 and 25 years at Mater Young Adult Health Centre Brisbane.

Catchment criteria applies for referrals for this service. Patient referrals from outside the Mater SEQ Catchment (which includes Metro South and West Moreton Hospital and Health Services) may not be accepted.

Service

The Rheumatology service consists of specialist Rheumatologists, a registrar and a resident. The Rheumotology service at Mater Hospital Brisbane offers inpatient and outpatient services and also offers a Young Adult Clinic (for patients aged 16-25) and a day infusion service for intravenous biologics. 

The Rheumatology service consistently reviews their patients within recommended OPD categorisation times.

How to send a referral

 

Emergency

If any of the following are present or suspected, phone 000 to arrange immediate transfer to the emergency department or seek emergency medical advice if in a remote region:

 

View list of conditions:

Rheumatoid Arthritis

  • Concerns for septic arthritis
  • Complications of disease or therapy requiring emergent review – systemically unwell

Peripheral Spondyloarthritis - Psoriatic arthritis and Reactive arthritis

  • Concerns for septic arthritis
  • Complications of disease or therapy requiring emergent review – systemically unwell

Axial Spondyloarthritis – Ankylosing Spondylitis

  • Concerns for septic arthritis
  • Complications of disease or therapy requiring emergent review – systemically unwell

Crystal Arthritis – Gout and CPPD (pseudogout)

  • Concerns for septic arthritis
  • Severe drug reaction to Allopurinol

Polymyalgia Rheumatica

  • Complications of disease or therapy requiring emergent review – systemically unwell

Connective Tissue Disease - SLE, Scleroderma, MCTD, Sjogren’s Syndrome and undifferentiated or overlap CTDs

  • Complications of disease or therapy requiring emergent review – systemically unwell

Myositis - polymyositis, dermatomyositis, CTD associated myositis and undifferentiated inflammatory myositis

  • Complications of disease or therapy requiring emergent review – systemically unwell

Vasculitis

  • Complications of disease or therapy requiring emergent review – systemically unwell

Giant Cell Arteritis/Temporal Arteritis

  • Presentation to ED if visual disturbance or loss
  • Complications of disease or therapy requiring emergent review

 

Conditions in scope

Axial Spondyloarthritis – Ankylosing Spondylitis

Essential information (Referral will be declined without this)

  • General Referral Information
  • History of symptoms (Severity of back pain/stiffness and peripheral symptoms), evolution and rate of deterioration
  • Features of inflammatory back pain e.g. morning stiffness, young age, nocturnal pain, response to NSAIDs
  • Presence of psoriasis, inflammatory bowel disease, or uveitis
  • If on a biologic DMARD and for PBS review, please state timeframe
  • FBC, E/LFTs, CRP and ESR

Additional referral information (useful for processing the referral)

  • Family history of spondyloarthritis (e.g. psoriasis, inflammatory bowel disease, or uveitis)
  • Details of previous treatment/management offered and assessment of efficacy including relevant PBS documentation
  • HLA-B27
  • Pelvic XR +/- MRI results affected joints

Other useful information for management (not an exhaustive list)

Patient resources

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

No defined category 1 criteria

 

  • Suspected Ankylosing Spondylitis/ Axial Spondyloarthritis with or without peripheral symptoms and/or extra articular manifestations
  • Known Ankylosing Spondylitis/Axial Spondyloarthritis established on treatment including biologic DMARDs

      

No defined category 3 criteria

 

Connective Tissue Disease-SLE, Scleroderma, MCTD, Sjogren's Syndrome and undifferentiated or overlap CTDs

Essential information (Referral will be declined without this)

  • General Referral Information
  • Relevant history, of onset and time since onset
  • Specify symptoms including joints/muscles, ulcers, raynaud’s, alopecia, skin rashes or ulceration, dysphagia or GORD, sicca symptoms
  • Extra-articular manifestations including kidney, lungs, cardiac, neurological
  • FBC, E/LFT, CRP and ESR
  • Rheumatoid Factor or anti-CCP
  • ANA, ENA, dsDNA, C3, C4, CK
  • Urine analysis for MCS, casts and protein

Additional referral information (useful for processing the referral)

  • Skin biopsy histology
  • Imaging results

Other useful information for management (not an exhaustive list)

Patient resources

  • Refer to local Healthpathways or local guidelines
  • Early discussion with Rheumatologist will aid prioritisation, if the patient is unwell and may need to be seen urgently.

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

  • Acute or active organ threatening Connective Tissue Disease

 

  • Connective Tissue Disease on established treatment and stable
  • Likely Connective Tissue Disease requiring assessment and management

 

  • Connective Tissue Disease for exclusion with minimal symptoms

 

 

 

Crystal Arthritis – Gout and CPPD (pseudogout)

Essential information (Referral will be declined without this)

  • General Referral Information
  • History of onset and time of gout onset, recurrence, joints involved (swelling, pain, morning stiffness, number of joints involved and location)
  • Details of treatments offered (if available)
  • FBC, E/LFT, Urate, CRP and ESR

Additional referral information (useful for processing the referral)

  • Synovial fluid microscopy with cell count and crystal analysis
  • Interference with activities of daily living and working ability
  • Imaging of joints (XR/CT/MRI results)
  • Other screening previously performed including rheumatoid factor and anti-CCP (if available)

Other useful information for management (not an exhaustive list)

Patient resources

  • Refer to local Healthpathways or local guidelines

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

No category 1 criteria

 

  • Polyarticular gout
  • Recurrent gout despite treatment, with any of the following:
    • -allopurinol intolerance
    • -maximum tolerated allopurinol dose
  • Chronic tophaceous gout
  • CPPD

 No category 3 criteria   

 

 

Fibromyalgia

Essential information (Referral will be declined without this)

  • General Referral Information
  • Details of treatments offered (if available)
  • Relevant history (Sleep disturbance, morning stiffness/fatigue, widespread myalgias)
  • Clinical examination including widespread tenderness, absence of swollen joints
  • FBC, E/LFTs, ESR, CRP

Additional referral information (useful for processing the referral)

  • Psychosocial evaluation
  • TSH, CK, Iron studies
  • Joint imaging (if available)

Other useful information for management (not an exhaustive list)

Patient resources

 

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

No category 1 criteria

 

No category 2 criteria

Clarification of diagnosis and/or management strategies for fibromyalgia      

 

 

Giant Cell Arteritis/Temporal Arteritis

Essential information (Referral will be declined without this)

  • Relevant history:
    • with age of onset of symptoms greater than 50 years,
    • onset and time since onset of headaches, visual disturbance, jaw claudication, scalp tenderness
  • Details of treatments offered including steroid exposure (if available)
  • FBC, E/LFT, ESR and CRP

Additional referral information (useful for processing the referral)

  • Temporal artery biopsy histology
  • Bone mineral density (if available)
  • Other screening previously performed including HepB, HepC, HIV, QuantiFERON Gold (QFG) (if available)
  • PET CT, CXR or US (if available)

Other useful information for management (not an exhaustive list)

  • Refer to local Healthpathways or local guidelines
  • Early discussion with Rheumatologist will aid prioritisation, if the patient is unwell and may need to be seen urgently.

Patient resources

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

 

Suspected new onset and/or active Giant Cell Arteritis

Stable Giant Cell Arteritis on treatment

No category 3 criteria

 

 

Juvenile Idiopathic Arthritis

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • RF, CCP, ANA, HLA B27 when relevant

Other useful information for management (not an exhaustive list)

  •  Is the patient currently under the care of a paediatric rheumatologist?

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

New onset/active or untreated JIA

 

 Stable JIA

No category 3 criteria

 

Myositis - polymyositis, dermatomyositis, CTD associated myositis and undifferentiated inflammatory myositis

Essential information (Referral will be declined without this)

  • General Referral Information
  • Relevant history, of onset and time of muscle symptoms including weakness and/or pain
  • Details of treatments offered and assessment of efficacy (if available)
  • FBC, E/LFT, ESR and CRP, CK

Additional referral information (useful for processing the referral)

  • Muscle or Skin biopsy histology (if available)
  • Extent of skin, joint, respiratory or other symptoms
  • History of statin use
  • ANA, ENA, dsDNA, C3, and C4
  • Other previously performed MRI, EMG (if available)

Other useful information for management (not an exhaustive list)

  • Refer to local Healthpathways or local guidelines
  • Early discussion with Rheumatologist will aid prioritisation, if the patient is unwell and may need to be seen urgently.

Patient resources

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

 

New onset and/or active myositis including polymyositis, dermatomyositis, Connected Tissue Disease associated myositis and undifferentiated inflammatory myositis

  • Inflammatory myositis on established treatment and stable
  • Possible myositis with weakness for further review

No category 3 criteria

 

Osteoarthritis

Essential information (Referral will be declined without this)

  • General Referral Information
  • Relevant history, of onset, recurrence, acuity, joints involved
  • Details of treatments offered (if available)
  • Interference with activities of daily living and working ability
  • XR affected joints

 

Additional referral information (useful for processing the referral)

  • FBC, U&E, ELFTs, ESR, CRP, Urate

Other useful information for management (not an exhaustive list)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

No category 1 criteria

 

No category 2 criteria

  • Functional impairment and/or joint pain that persists despite optimal management, such as physiotherapy, weight loss and analgesics
  • For diagnostic clarification and/or requiring medical management (not surgical, please see orthopaedics CPC)
  • If diagnosis is established:
    • progressive worsening of disability
    • Interference with activities of daily living and working ability      
 

 

Peripheral Spondyloarthritis - Psoriatic arthritis and Reactive arthritis

Essential information (Referral will be declined without this)

  • General Referral Information
  • History of inflammatory arthritis- symptoms, evolution and rate of deterioration
  • Number and location of swollen, tender joints, tenosynovitis, enthesitis or dactylitis
  • Duration of early morning stiffness (greater or less than 30 minutes)
  • Extra-articular, axial or systemic features
  • Presence of psoriasis, inflammatory bowel disease (IBD), or inflammatory eye disease (uveitis)
  • If on a biologic DMARD and for PBS review, please state timeframe
  • FBC, E/LFTs CRP, ESR

 

Additional referral information (useful for processing the referral)

  • Pain assessment –waking up at night, analgesic consumption, aggravating and relieving factors
  • Interference with activities of daily living and working ability
  • HLA-B27
  • Imaging e.g. XR, MRI/US results of affected joints
  • Details of previous treatment/management offered and assessment of efficacy including relevant PBS documentation
  • Other screening previously performed including CXR, HepB, HepC, HIV, QuantiFERON Gold (QFG), Rheumatoid factor and Anti-CCP

Other useful information for management (not an exhaustive list)

Patient resources

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

 

 

New onset, suspected or recently diagnosed inflammatory arthritis

Active established inflammatory arthritis requiring escalation of management

 

 

Known Spondyloarthritis on established conventional or biologic DMARDs

No category 3 criteria

 

Polymyalgia Rheumatica

Essential information (Referral will be declined without this)

  • General Referral Information
  • Relevant history of onset, recurrence, acuity (muscle pain, morning stiffness, headaches, amaurosis fugax)
  • Details of treatments offered (if available)
  • FBC, E/LFT, ESR and CRP

Additional referral information (useful for processing the referral)

  • TFTs, CK, RF, anti-CCP, Serum EPP
  • Other screening previously performed including CXR, HepB, HepC, HIV, QuantiFERON Gold (QFG), Bone density (if available)
  • Cancer screening information (if available)

Other useful information for management (not an exhaustive list)

Patient resources

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Any concern for concomitant Giant Cell Arteritis/Temporal Arteritis

  • New onset Polymyalgia Rheumatica with typical shoulder/hip girdle features with raised ESR/CRP
  • Known and treated PMR established on steroids requiring further escalation of management
  • No category 3 criteria      
 

 

Rheumatoid Arthritis

Essential information (Referral will be declined without this)

  • General Referral Information
  • History of inflammatory arthritis symptoms, evolution and rate of deterioration
  • Number and location of swollen, tender joints
  • Duration of early morning stiffness (greater or less than 30 minutes)
  • Rheumatoid factor and Anti-CCP
  • If on a biologic DMARD and for PBS review, please state timeframe
  • FBC, E/LFTs CRP, ESR

 

Additional referral information (useful for processing the referral)

  • Extra-articular and systemic features, if any including weight loss
  • Imaging e.g. XR, MRI/US results of affected joints
  • Details of previous treatment/management offered and assessment of efficacy including relevant PBS documentation
  • Pain assessment e.g. waking up at night, analgesic consumption, aggravating and relieving factors
  • Interference with activities of daily living and working ability
  • Other screening previously performed including CXR, HepB, HepC, HIV, QuantiFERON Gold (QFG)

 

Other useful information for management (not an exhaustive list)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

 

 

  • New onset, suspected or recently diagnosed rheumatoid arthritis
  • Active established rheumatoid arthritis requiring escalation of management

 

 

  • Known rheumatoid arthritis on established conventional or biologic DMARDs
  •     No category 3 criteria  

 

Vasculitis (non GCA/Temporal Arteritis)

Essential information (Referral will be declined without this)

  • General Referral Information
  • Relevant history, of onset and time since onset of skin, joint, respiratory, sinus or other symptoms
  • Details of treatments offered (if available)
  • FBC, E/LFT, ESR and CRP
  • ANCAs
  • Urinalysis for MCS, casts, protein

Additional referral information (useful for processing the referral)

  • Skin, artery, respiratory tract or renal biopsy histology
  • RhF or anti-CCP
  • ANA, ENA, dsDNA, C3 and C4
  • CXR (if available)

Other useful information for management (not an exhaustive list)

  • Refer to local Healthpathways or local guidelines
  • Early discussion with Rheumatologist will aid prioritisation, if the patient is unwell and may need to be seen urgently.

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

  • New onset and/or active small, medium or large vessel vasculitis including ANCA associated vasculitis and immune complex vasculitis 

 

  • Vasculitis on established treatment and stable 
  • No category 3 criteria      
 

 

Bulk Billed Clinics

Mater Health Services offers patients the opportunity to attend bulk billed clinics. To provide your patient with the opportunity to attend a bulk billed specialist clinic, please provide a named referral to one of our specialists listed above.

Contact Us

If you would like to discuss a referral, including clinical criteria, or update the status of a current patient please contact our priority GP phone line on 07 3163 2200 

Current Waiting Time for Appointments 

We provide up to date data on how long patients are waiting for their clinic first appointment by specialty here.

Referral Guideline Development

These Mater Referral Guidelines have been developed locally by GPs and specialists to support safe and quality referral to publicly funded specialist outpatient services. 

 

Content last reviewed: 13 December 2023

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