Peripheral entrapment neuropathies including CTS (Orthopaedics)
Adult

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Useful Management Information

Carpal Tunnel Syndrome (CTS) can be referred to the following specialities but will be triaged in a unified manner by all specialities concerned:
- Orthopaedics
- Plastic and Reconstructive surgery
- Neurosurgery
- General Surgery
Chronic disease requires to be optimised prior to referral or the patients may not proceed to surgery

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)	Upper limb radiculopathy in the presence of suspected cervical spine pathology/malignancy Severe disabling symptoms with weakness and wasting and Nerve Conduction Studies (NCS) confirmation of diagnosis Common peroneal nerve injury
Category 2 (appointment within 90 calendar days)	Very frequent/continuous symptoms without weakness or wasting and any one of: Rapid progressive deterioration Recurrence after surgical decompression Failed maximum medical management
Category 3 (appointment within 365 calendar days)	Intermittent symptoms without weakness or wasting after 6 months maximum medical management Ulnar entrapment neuropathy without weakness or wasting and no response to ≥ 6 months of maximal management
If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service.

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Detailed clinical examination with sensory mapping, presence of neurological deficit and functional assessment (include impacts on ADL and employment)

Management to date (include allied health input and steroid injections)
Duration and rate of progression of symptoms
Nerve Conduction Studies (NCS) required for Cat 1 cases only (where available and does not cause significant delay to patient accessing outpatient service)
CT spine (only where suspecting central compression pathology)

If a specific test result cannot be obtained due to access, financial, religious, cultural or consent reasons a clinical override may be requested. This reason must be clearly articulated in the body of the referral.

Additional Referral Information

XR results - AP and lateral (of region) (if available)
Nerve conduction studies (where available and not cause significant delay to patient accessing outpatient service)
OT/Physio report (if available)

Send Referrals To

Related HealthPathways

No directly related pathways found

HealthPathways home page

Service Availability

Facilities

No facilities listed

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Peripheral entrapment neuropathies including CTS (Orthopaedics)Adult