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Shoulder and elbow conditions


Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Suspicion of malignancy
    • First episode of shoulder dislocation in a patient with suspected or identified cuff tear
    • Acute full thickness cuff tear with loss of active ROM
  • Category 2
    (appointment within 90 calendar days)
    • First episode of shoulder dislocation in a patient without suspected or identified cuff tear
    • Recurrent dislocated shoulder/shoulder instability
    • Instability associated with structural pathology in a patient e.g. SLAP lesion, large Bankart lesion
  • Category 3
    (appointment within 365 calendar days)
    • Functional impairment and/or pain of shoulder/elbow and failed maximal medical management
    • AC joint conditions
    • Chronic weakness and degenerative rotator cuff
    • Rotator cuff tendinopathy
      • sub-acromial impingement
    • Pain/stiffness in elbow not responding to maximal medical management
    • Elbow tendonitis
    • Shoulder adhesive capsulitis (frozen shoulder)

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • History of symptoms – including duration, recurrence of injury and mechanism, severity or evolution of injury, pain and functional impairment, activities of daily living
  • Arm ROM with any neurological examination/signs
  • XR results - AP & lateral shoulder/elbow
  • USS results if suspected rotator cuff pathology

3. Additional referral information Useful for processing the referral

  • Management to date
  • Relevant allied health report (if available)
  • According to clinical suspicion
    • CT/MRI results
  • According to clinical suspicion
    • protein electrophoresis
    • immunoglobulins
    • calcium and phosphate
    • rheumatoid serology
  • If inflammation/ infection suspected
    • FBC ESR CRP results

4. Request

Last updated: 13 June 2023