<p> Rheumatology Referral Recommendation</p><p>Diagnosis Information Tests Needed Prior to Treatment Tried Referral if: Needed prior to To Consult Consult Joint pain/ LAB TESTING NSAIDs or other analgesics Refer patients with Rheumatoid  Current Medication List For patients with suspected as a first line drug therapy. osteoarthritis and other Arthritis inflammatory arthritis - CBC, musculo-skeletal pain  Labs & Radiology pertinent creatinine, liver enzymes, ESR,  Utilize syndromes when they to diagnosis CRP, RF, ANA WITH glucocorticoids as are refractory to PATTERN, uric acid last resort attempts to treat.  Office Notes Related to Assessment and Diagnosis IMAGING Assess and manage other Refer if any of the If symptoms >1 year then x-ray metabolic conditions such as designated lab tests are Need to assess the following: using the PA/Open Book diabetes or thyroid and positive. Views. (Look for hooked assure these are under good 1. Characteristics, location, osteophytes and joint erosions) control. duration and extent of the present pain complaint</p><p>2. Is pain bilateral?</p><p>3. Any joint swelling?</p><p>4. Assess MCP/MTP joint involvement by doing a squeeze test to assess for ( > 3 swollen joints)</p><p>5. If MTP pain; does it feel like walking on pebbles</p><p>6. Morning predominant symptoms > 30 minutes (possible improvement throughout the day/can worsen at night)</p>