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For more information, go to www.arthritisresearchuk.org

Referral and further action

Back to Widespread musculoskeletal pain

You should consider referring your patient to rheumatology or to an early arthritis clinic for a number of reasons:

Diagnosis

Refer the patient if there is doubt about the diagnosis.

Treatment

Refer your patient if they have a condition that's usually managed in primary care (such as osteoarthritis, gout, polymyalgia rheumatica) but they're not responding to usual treatments.

Diagnosis and treatment

Refer your patient if it's likely that they have a rheumatological condition that requires secondary care input, such as:

  • most inflammatory arthritides (for example rheumatoid arthritis, psoriatic or reactive arthritis, ankylosing spondylitis, arthritis associated with inflammatory bowel disease)
  • connective tissue disease.

They should also be referred if their history suggests they might have palindromic rheumatism as up to one third of these cases may progress to persistent inflammatory arthritis.

Download our flowchart of referral recommendations (PDF, 187 KB).

Kim's action plan

You should refer Kim because there's good evidence that early treatment offers prognostic benefits. Most patients with inflammatory arthritis will need treatment while waiting for a specialist opinion.

Fahmida's action plan

For patients like Fahmida with a diagnosis of fibromyalgia, a skilful explanation of the condition can significantly improve outcomes. You'll need to decide on a treatment plan.

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