HNY Policy and Pathway Repository - Humber

Pathway to follow when referring for an ultrasound guided steroid injection –NOT SHOULDER

Any red flags refer into the appropriate secondary care speciality

Exclude Red Flag Symptoms

Suspician of malignancy, septic arthritis, inflammatory arthritis

No Guidelines on Management Listed

Referral Steps

1. Assess patient
   • If presenting with shoulder pain – see alternative pathway- Management of Shoulder Pain in Primary Care.
2. Presenting with non-shoulder joint pain:
3. Refer for physiotherapy.
4. If limited or no relief, patient requires landmark injection in primary care
5. Reassess patients a minimum of 6 weeks post landmark injection. If limited or no relief consider referral to ultrasound, radiology:
6. Pre-referral questionnaire and consent to be completed.
   • High risk category patients are to be referred directly to orthopaedics in secondary care
   • Low & Medium risks patient:
7. Complete referral form ticking  physiotherapy , landmark injection  and covid consent boxes. Covid consent to be done using the questionnaire in ERS as a guide. Do not send  patients falling into the high risk category – ultrasound will assume the referrals being sent are low/medium risk and that the consent process has filtered out the high risk patients.
8. Send to ultrasound, radiology via ERS.

DO NOT REFER

Patients under 18 years old.

Patients with shoulder pain.

Patients who have not undergone referral steps above.

Referral Criteria

Patients over 18 years old and confirmation that all referral steps have been completed

Referrals

Send referrals to radiology via eRS

Pre referral Questionnaire and consent form (one form)

GP restart Injections

That physiotherapy, landmark guided  injection and covid consent have been done- tick boxes to indicate this are on the generic ultrasound referral form