We provide diagnosis, treatment and support for people with autoimmune and inflammatory rheumatic conditions such as inflammatory arthritis and systemic autoimmune diseases.
Key points
- We diagnose and treat patients with autoimmune and inflammatory conditions such as inflammatory arthritis and systemic autoimmune diseases
- We do not manage non-inflammatory or non-autoimmune conditions, including osteoarthritis, chronic pain syndromes, fatigue conditions, joint hypermobility, isolated positive antibody tests without symptoms, or osteoporosis.
- Some referrals may instead be offered an appointment in our advanced practice physiotherapy clinic
What we do
Our Rheumatology service provides care for people who need care for:
- Inflammatory arthritis including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile onset inflammatory arthritis and reactive arthritis
- Systemic autoimmune diseases including systemic lupus erythematosus (SLE), scleroderma, Sjogren’s syndrome, myositis, vasculitis, polymyalgia rheumatica and giant cell arteritis
- Autoinflammatory conditions including familial Mediterranean fever
- Crystal arthritis including gout and pseudogout if complex and unable to be managed in the community
Some people with these conditions will require ongoing review by a rheumatologist. However, some people may only need a period of treatment and stabilisation before their care can be handed back to their general practitioner (GP).
Based on the information provided in your referral, you may be offered an appointment in a physiotherapy advanced practice assessment clinic. If this occurs, you will be sent detailed information about the physiotherapy clinic process.
What we do not do
We do not provide care for non-inflammatory or non-autoimmune conditions. This includes:
- Osteoarthritis
- Chronic pain syndromes requiring multidisciplinary pain management or specialist pain input
- Fatigue and chronic fatigue syndrome
- Joint hypermobility, Ehlers-Danlos syndrome (EDS), Marfan syndrome and other connective tissue disorders
- Positive autoimmune antibody tests without clinical symptoms suggestive of an inflammatory or autoimmune disorder
- Osteoporosis
Consider referring your patient to another service if specialty input is required for these conditions.
See our alternative referral options under the 'Health professionals' tab below for more information.
Specialty clinics
We provide a specialised service for inflammatory and autoimmune rheumatology conditions. Each of our clinics is themed to focus on particular conditions:
- Rheumatology Systemic Autoimmune Diseases (SAID) Clinic focuses on the diagnosis and management of conditions such as systemic lupus erythematosus (SLE), scleroderma, Sjogren’s, myositis, polymyalgia rheumatica, giant cell arteritis and vasculitis
- Rheumatology Rheumatoid Arthritis (RA) Clinic focuses on the diagnosis and management of rheumatoid arthritis
- Rheumatology Spondyloarthritis (SpA) focuses on the management of spondyloarthritis, including ankylosing spondylitis and psoriatic arthritis
- Rheumatology Biologics focuses on people who are receiving biologic and targeted synthetic medications for the treatment of their rheumatological condition
- Rheumatology Neuromuscular Clinic focuses on people with complex inflammatory and autoimmune muscle disorders
- Rapid Access Rheumatology Clinic focuses on the assessment, initial management and stabilisation of patients who require rapid rheumatological assessment
Our clinics
| Clinic name | Location | Options |
|---|---|---|
| Rheumatology Systemic Autoimmune Diseases (SAID) Clinic | The RMH Parkville | |
| Rheumatology Rapid Access Clinic Level 1 South | The RMH Parkville | |
| Rheumatology Spondyloarthritis (SpA) Clinic | The RMH Parkville | |
| Rheumatology Biologics Clinic | The RMH Parkville | |
| Rheumatology Rapid Access Clinic | The RMH Parkville |
Our clinics
Referrals
Have you considered Victorian Virtual Specialist Consults (VVSC)?
Victorian Virtual Specialist Consults (VVSC) is an alternative to specialist clinic referrals that offers timely specialist expertise for complex patients in the community.
Learn about VVSC or book a patient consult.
How to refer a patient
We accept GP and specialist referrals:
- Use the RMH referral form or a template from your own system.
- Complete and fax your referral to Specialist Clinics (Outpatients) on (03) 9342 4234.
We do not accept email referrals.
Referral requests should include:
- all minimum information required by the Department of Health
- details of investigations listed under 'Special referral instructions' below
Urgent and after-hours support
Referrals are triaged based on priority. In an emergency, patients can go to the Emergency Department at any time.
For advice, urgent referrals and out of hours support, call The RMH Switchboard on (03) 9342 7000 to page our registrar on call.
We support patients receiving care closer to their homes. Please refer the patient to the nearest rheumatology service. In accordance with statewide referral criteria, second-opinion referrals will be accepted only in exceptional circumstances.
What investigations to include:
- Inflammatory markers including CRP and ESR
- Routine bloods including FBE, U&E and LFTs
- Uric acid if patient is being referred with gout
- Autoantibodies when indicated based on clinical presentation
- Autoantibodies should not be tested in patients with fatigue or other common non-specific symptoms.
- You should only test the antibodies relevant to the patient’s clinical picture rather than doing a full antibody screen.
- Positive ANA is common in the normal healthy population therefore this should not be used as a screening test in patients who do not have clinical features of an autoimmune disease.
- P-ANCA cannot be tested in patients who have a positive ANA as it will show as a false positive.
- HLA-B27 is positive in approximately 8–12% of the Australian population. Testing and referral is only indicated if patients have inflammatory back pain or other clinical features of spondyloarthritis.
- Patients who have features of inflammatory arthritis clinically (for example, inflammatory joint pain, stiffness and synovitis with raised inflammatory markers) should be referred regardless of whether they are RF or CCP positive or negative.
- Other tests which are unlikely to be of clinical significance include:
- ANA with DFS pattern
- Indeterminate or atypical ANCA with negative MPO and PR3
- Low to moderate level elevation of dsDNA when tested by ELISA. The Farr/RIA method is more reliable and should be used to confirm if the dsDNA is indeed positive.
- X-ray or other imaging of affected joint/s if appropriate
- Referrals that do not have adequate clinical information to allow appropriate triage will be declined.
Statewide referral criteria for clinicians strengthens referrals to specialised services in public hospitals and improves access to non-admitted services. You can browse or search by specialty or medical condition.
HealthPathways Melbourne provides guidance on best practice assessment and management of common medical conditions, including when and where to refer patients.
Parkville Connect is a secure web-based portal providing GPs, specialists and other health professionals with information in the Parkville electronic medical record (EMR).
Alternative referral options
Osteoarthritis
- For hip or knee osteoarthritis, shoulder osteoarthritis or other non-inflammatory shoulder problems, consider referral to Orthopaedic surgery. These referrals will be triaged and may be seen in an Advanced Practice Physiotherapy service, including the osteoarthritis hip and knee service (OAHKS) or the shoulder and upper limb clinic.
- For hand osteoarthritis consider referral to the Plastic Surgery unit
- For non-inflammatory spinal pain, consider referral to the Back Assessment Clinic (BAC)
Chronic pain syndromes
For chronic pain syndromes, including fibromyalgia and complex regional pain syndrome (CRPS) requiring multidisciplinary pain management or specialist pain input, consider referral to:
- the RMH Pain Management service
- a local multidisciplinary pain clinic
Visit Fibromyalgia Australia for more information.
Joint hypermobility and Connective Tissue Disorders
Joint hypermobility is common. Only a small subset have the hypermobile form of Ehlers-Danlos syndrome (EDS).
There is no genetic testing for hypermobile EDS and the diagnosis can be made clinically in primary care. The treatment is symptomatic and supportive management with the assistance of allied health.
If there are red flags that suggest a connective tissue disorder for which there is genetic testing, please consider referral to the genetics clinic.
Visit Hypermobility Syndromes Association (HMSA) for more information.
Osteoporosis
Consider referral to the endocrinology metabolic bone disease clinic. See our Diabetes and Endocrinology services.
Need to change or cancel your appointment?
Do one of the following:
- Access Health Hub to change the appointment yourself
- Complete our online form and we'll change it for you
- Call Specialist Clinics (Outpatients) on (03) 9342 7393 and we'll help you over the phone
What to bring
Every time you come
Every time you come in for a test, day procedure, surgery or treatment, you should bring:
- Medicare card
- Health Care card (if you have one)
- Concession card (if you have one)
- Adverse drug alert card (if you have one)
- Medications you are currently taking, including any that you have bought without a prescription
- X-ray films, scans, ultrasounds or any other test results you have which are related to your procedure
- Private health insurance card (if you want to use it)
- Aids (glasses, hearing aid, walking frame)
For a clinic appointment
If you come for a clinic appointment, you should also bring:
- Your appointment letter
- Any special items listed on your letter
- Your appointment book (if relevant)
- TAC or WorkCover claim number
For an overnight or longer stay
If you come for an overnight (or longer stay), you should also bring:
- A dressing gown and slippers, or comfortable day clothes and shoes
- Your toiletries
- Your iPad or tablet and phone, provided you are happy to take responsibility for them
Do not bring (for overnight or longer stay)
And if you're staying overnight or longer, do not bring:
- Your handbag, wallet, purse or large amounts of cash. Just bring a small amount for items such as newspapers, magazines or coffee
- Valuables, such as jewellery, watches or other items of value to you
Interpreters and cultural support
We provide qualified, professional interpreters to help you communicate with us at any time during your stay and at your clinic appointments.
- Μάθετε περισότερα γιά διερμηνείς & υποστήριξη κουλτούρας
- Scopri di più sugli interpreti e sul supporto culturale
- Tercümanlar ve kültürel destek hakkında daha fazla bilgi edinmek için
- Tìm hiểu thêm về thông dịch viên và hỗ trợ văn hóa
- 找出更多翻译与文化支持的信息
- لمزيدٍ من المعلومات عن خدمة الترجمة الشفهية والخدمات الثقافية
Links & documents
Level 7 East
300 Grattan St, Parkville, Victoria