Rheumatology

Referral criteria

Category A
Local Expertise
Category B
Clinical review, advice and
guidance from MMC
Category C
Care led by MMC
(UCLH unless stated otherwise)
Uncomplicated* rheumatoid arthritisRheumatological disease requiring biologic therapyActive lupus nephritis (see Kidney Pathway) (RFH)
Uncomplicated* seronegative arthritis:
• Ankylosing spondylitis
• Psoriatic arthritis
• Reactive arthritis
• IBD related arthritis
Rheumatological not controlled on current treatmentLarge and medium vessel vasculitis
Uncomplicated* connective tissue disease:
• Lupus
• Scleroderma (restricted disease)
• Sjogren’s
Rheumatological disease with restrictive
lung disease and FVC >50% (see
Rheumatological disease with restrictive
lung disease and FVC ≤50%
OsteoarthritisRheumatological disease with kidney involvement (see Kidney Pathway)New small vessel vasculitis or small vessel vasculitis on immunosuppression
Obstetric antiphospholipid syndrome (see Haematology Pathway)Thrombotic antiphospholipid syndrome (see Haematology Pathway)Vascular Ehlers Danlos
Hypermobile Ehlers Danlos (type III)Other Ehlers Danlos syndromes**Scleroderma renal crisis (Royal Free)
Diffuse sclerodermaAntisynthetase syndrome
Small vessel vasculitis in remission, no longer on treatment
Polymyositis-dermatomyositis
Behcet’s syndrome***

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