Emergency and elective orthopaedics, including subspecialty clinics in spine, shoulder and elbow, foot and ankle, hip and knee (including sports medicine).

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Referral

By referral letter from a medical practitioner.

Routine referrals:  Send a referral letter to NSLHD-AccReferrals@health.nsw.gov.au, or fax to (02) 9463 1065 

Urgent cases

Medical professionals can page on-call orthopaedic registrar through Royal North Shore Hospital switchboard 02 9926 7111.

Orthopaedic Shoulder/Elbow Clinic

Mandatory referral information

Referrals should include patient details, provision diagnosis and reason for referral, finding/treatment to date, how this affects patient, significant medical history and any relevant social information. Please indicate preferred language if an interpreter is required.

Please attach results of any investigations to the referral and ensure the patient brings hard copies to their appointment. This will help avoid unnecessary duplication of tests, additional appointments and delay.

Referrals with insufficient information will be returned to the GP until further information is provided to the clinic.

The following conditions should be immediately referred to the Emergency Department

  • Septic arthritis
  • Bone or joint infection
  • Suspected infection or sudden pain in arthroplasty
  • Acute fracture that is unable to be appropriately managed in general practice
  • Acute dislocation

Exclusion criteria

The RNSH Orthopaedic Clinic is unable to provide a clinic for the following:

  • Fibromyalgia (refer to Rheumatology)
  • Gout (refer to Rheumatology)
  • Osteoporosis in the absence of an acute injury (refer to Rheumatology)

Out of Area - Referrals may not be accepted based on patient location

Resident of Northern Sydney Local Health District Catchment ​Yes (referral accepted)
Referral from other specialist, for specialist opinion​Yes (referral accepted)
Resident of other LHD that DOES NOT provide the clinical service e.g. rural, outer metro​Yes, but service or problem needs to be documented on referral
Continuing care of existing condition we already manage​Yes, provided existing or related condition documented on referral
Demonstrated complexity requiring services of RNS hospital Ambulatory Care Centre​Yes but must be explicitly documented on referral
Compassionate circumstances (e.g. family proximity, staff)​Yes but must be explicitly documented on referral
Resident of other LHD/hospital that offers the service​Refer to your local LHD/hospital for ease of patient access in first instance

Check if the home address is within Northern Sydney Local Health District here: https://www.health.nsw.gov.au/lhd/Pages/lhd-maps.aspx

NSLHD consultant referral options

The following Orthopaedic Surgeons work at RNSH. They also have private rooms, which patients can be referred to and usually have a shorter waiting period. There is likely an out of pocket cost for the consultation at the private rooms.

Consultant RNSH ClinicLocation of rooms
Dr Terence MoopanarShoulder/Elbow

AMA House

Suite 203, Level 2
69 Christie St
St Leonards 2065

Ph: (02) 9460 9100, Fax: (02) 9437 3789

Indications for referral and management for conditions

Presenting complaintGP evaluation prior to referralGP management prior to referralReferral accepted when:
Should pain and stiffness
  • Standard history and examination, particularly neurological examination
  • X-rays (AP + lat shoulder) in patients with reduced range of motion, particularly with severe pain and after trauma
  • U/S scan
  • Consider FBE, ESR and CRP

Anti-inflammatories

Physiotherapy (including an exercise program)

Consider cortisone injection (U/S guided by radiologist)

No improvement or worsening symptoms after a minimum of 3 months of conservative management, unless evidence of weakness suggestive of a gross acute rotator cuff tear.
Recurrent shoulder dislocation or instability
  • MRI report must be included in referral
  • Standard history and examination, particularly neurological examination
  • X-rays (AP + lat shoulder)
  • Advice to avoid activities with high risk of dislocation
  • Physiotherapy (including an exercise program)

Recurrent functional instability and/or pain and has not responded to 3 months of a good stability program.

AC joint problems
  • MRI report must be included in referral
  • X-rays (standard views; zanca view or basmania view)
  • Consider FBC and ESR if inflammation suspected
  • ​Physiotherapy (including an exercise program)
  • Anti-inflammatories
  • Cortisone injections
Failed to respond to 6 months of  conservative management
Tennis/golfer's elbow
  • MRI report must be included in referral
  • Consider FBE, ESR and CRP if inflammation suspected.
  • X-ray for recalcitrant cases
  • ​Bands
  • Anti-inflammatories
  • Activity modification
  • Physiotherapy (including an exercise program)
  • No cortisone.
Failed to respond to 6 months of conservative management
Elbow pain / stiffness / locking
  • ​Consider FBE, ESR and CRP if inflammation suspected.
  • X-ray in patients with significant loss of elbow motion or function, or who have sustained significant trauma to the elbow
  • ​Anti-inflammatories
  • Physiotherapy (including an exercise program)
  • Failed to respond to 6 months of conservative management
  • Loose bodies seen on x-ray
Olecranon bursitis
  • ​FBE, ESR and CRP
  • X-ray and ultrasound report must be included in referral.
  • Consider aspirating for symptomatic relief if acute. Do not incise.
  • Consider steroid injection if chronic.
  • Failed to respond  to 6 months of conservative management

 

 

 

Address - Allows authors to enter rich text content.  Address

Postal Address: Department of Orthopaedics,
Level 7, Acute Services Building
Royal North Shore Hospital
St Leonards 2065

Clinic Location:
Ambulatory Care Centre Check-In E, Level 3
Royal North Shore Hospital
Reserve Rd, St Leonards 2065

Map - Allows authors to insert HTML snippets or scripts.  Map

Contact Us - Allows authors to enter rich text content.  Contact Us

Ph: (02) 9463 1400 (for patient appointments)

(02) 9463 1771 (Department of Orthopaedic Surgery)