Metabolic bone disease - rheumatology

Metabolic bone disease - rheumatology — referral criteria for Rheumatology services.

Eligibility

At least one must be met for the patient to be eligible for referral.

Clinically suspected or confirmed metabolic bone disease - rheumatology with initial primary-care work-up completed

Routine referral criteria

Determine Category 2 or 3 urgency.

Suspected metabolic bone disease that is not osteoporosis (for example: Paget’s disease, fibrous dysplasia, osteomalacia, osteogenesis imperfecta)

Persistent osteoporosis despite maximum treatment

Osteoporosis in women younger than 50 years or men younger than 60 years

Intolerance to, or contraindication for, maximum treatment

Metabolic bone disease associated with — treatment with glucocorticoid medicines

Metabolic bone disease associated with — inflammatory disorders

Metabolic bone disease associated with — chronic kidney disease

Metabolic bone disease associated with — post-transplant

Metabolic bone disease associated with complications associated with treatment — atypical femoral fracture

Metabolic bone disease associated with complications associated with treatment — osteonecrosis of the jaw

Advice on, or review of, management plan in patients with stable metabolic bone disease after 5 years of treatment

Usually managed in primary care

Recommendation

Referral criteria not met

Patient does not meet Statewide Referral Criteria. Reassess if condition changes.