Please see the Knee Pain page for advice on management of all types of knee pain.
Patients should only be referred to an acute knee clinic directly (not via MSK interface service) if referral criteria are met.
Referral Criteria
Exclusions
These patients should be referred via the Musculoskeletal Interface (MSKI) Service.
Procedures Performed
Suitable patients will undergo assessment as appropriate which may include: investigation, diagnostic/ therapeutic injection, arthroscopic/ open surgery including repair and reconstruction for cartilage, ligament and meniscal knee injuries.
Imaging
If a fracture is suspected from history or examination the patient should be seen in UTC or ED and undergo x-ray. See the Ottawa Knee rules for guidance.
Otherwise, imaging is not required before referral. MRI scans are not required prior to referral but if performed, results should be included.
Referral
The acute shoulder clinic is an urgent service available at NBT to assess and manage acute soft tissue shoulder injuries.
This is not an emergency service and if the patient needs to be seen on the day or day after you should refer to the Emergency Department or discuss with Trauma and Orthopaedics on call, depending on the concern.
Conditions treated
Investigations
Patient must have a shoulder 3 view x-ray (AP/lateral and axilla) – this should not show any fractures
Soft tissue imaging (MRI & US) should NOT be requested prior to XR imaging and are not required prior to referral.
Criteria for referral:
Exclusion Criteria:
These patients should be referred via the local MSKI service for further assessment.
Procedures Performed:
Clinical assessment/further investigation and treatment as appropriate
How to Refer
Sirona MSKI have advised that due to the acute nature of these clinics that referrals do not need to be submitted via the MSK Interface Service
Practices should submit these direct through e-Referral Service: Acute Shoulder Service- Orthopaedics – Southmead RVJ
Note – all referrals to Acute Shoulder Clinic will be clinically triaged on ERS to assess referral criteria and appropriateness.
See the Fracture Clinic section for details on referring to the individual fracture clinics at NBT and UHBW.
Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.
Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.