Should I refer to a rheumatologist?

Early warning signs of inflammatory rheumatic diseases

Up to one million people suffer from inflammatory rheumatic conditions in the UK, and that number jumps to over eight million when you include osteoarthritis. With numbers this large, prioritising referrals can become difficult.

Signs of rheumatic disease can be symptomatic of different disorders and can be difficult to identify.

Flags to help you prioritise your referrals


  • Presence of swelling in the joints, especially multiple joints
  • Weakness, such as new onset difficulty rising from a chair, along with elevated ESR and creatine kinase
  • New blue or white color changes in the fingers and toes, particularly with ulcers
  • New headaches, with our without visual disturbance, and an elevated ESR
  • New fixed swelling and tightness of the skin of the hands and feet
  • New butterfly rash and joint pain (or fevers)
  • Elevated ESR with joint pain, swelling, fevers, rash, or weakness
  • Sudden wrist or foot drop, with fevers and rash
  • Morning stiffness lasting more than 45 minutes
  • Back pain that is worse in the morning, better with activity


Why refer?

While the over 30 types of inflammatory rheumatic conditions have varying symptoms, they all share one common element: the first weeks and months following the onset of their symptoms are known as the window of opportunity. It is crucial that patients get appropriate treatment in that time period to avoid long-term complications.

Window of opportunity

People with rheumatic conditions have a short window of opportunity (just 12 weeks from symptom onset for some). By ensuring timely and appropriate referrals, you will help your patients with rheumatic conditions get early and aggressive treatment within their window of opportunity.

The benefit of referrals


Early and appropriate referral to a rheumatologist can result in many benefits for you and your patients, including:
  • reducing disability
  • reducing impact on family members and co-workers
  • overall health improvement
  • saving time and money on unnecessary tests/surgery
  • reducing medical costs

How you can help

Referring a patient with symptoms to a rheumatologist is an essential component in first rate health care. You can help over one million people suffering from rheumatic conditions by referring patients with prolonged inflammation and other rheumatic condition symptoms to a rheumatologist. By working together, you can maximise your patients’ window of opportunity, and dramatically improve their prognosis and quality of life.