Audit of in-patient referrals to Rheumatology department at University Hospital Waterford


Sanjeev Verma, Claire Sheehy, Donnacha O'Gradiagh, Darragh Foley Nolan


Department of Rheumatology/ University Hospital Waterford


Early assessment of patients with rheumatological problem is critical in the establishment of a diagnosis and institution of appropriate therapy. A Rheumatology consult form was introduced, in September 2015, to aid prioritization.


To assess the number and most common inpatients referrals made to rheumatology.


Consults received using the new referral form over 18 months were audited. The referring team’s assessment and diagnosis were recorded.


163 patients were referred using the form; 85 patients were female and 78 male. 15% patients were known patients of the rheumatology service and were referred for review following admission with an unrelated illness. 85% were new referrals. N= 115 from medical team and N= 27 and 12 from ortho. and surgery teams respectively.

The majority of the patients referred were for management of gout and osteoarthritis (n=91), which were managed with intra articular steroid injections and/or NSAIDs and Colchicine. Patients with joint swelling or effusion underwent aspiration +/- intra articular injection. 8 patients were diagnosed with SLE post renal biopsy.. There were 12 newly diagnosed patients with inflammatory arthritis. Most (n=109) of the patients were seen and managed within 2-4 hrs of the referral period. Patients were followed as out-patients as required.


163 patients were referred using the template over 18 months. The majority of referrals were crystal arthritis and osteoarthritis. Further work needed to educate regarding management of crystal arthritis among hospital teams.