APPENDIX 2.

Triage grading system.

CategoryDescriptionExamples
A+For patients who require assessment and treatment on an urgent basis within 24–48 h. Reserved for patients whose physicians personally contact the rheumatologist to outline clinical details.
  • Septic arthritis

  • Giant cell arteritis

  • CTD with major organ decompensation

AFor patients who require assessment and treatment on an emergent basis within 2–4 weeks. Reserved for patients with a recent onset inflammatory arthritis where early intervention is critical to a successful outcome.
  • New onset IA

  • Severe IA with impact on ADL

  • CTD

  • Vasculitis

  • PMR

BFor patients who require assessment and treatment on an elective basis within 2–4 mos. Reserved for patients with information that suggests an inflammatory syndrome where immediate intervention is not necessarily as important, but treatment is necessary.
  • Established IA

  • Undiagnosed or subacute or probable IA

  • Crystalline arthritis

  • Severe OA with a major impact on ADL

CFor patients who require assessment and treatment on an elective basis within the next 6–12 mos. Reserved for patients with stable treated inflammatory disorders or non-inflammatory disorders.
  • Previously diagnosed rheumatic disease (stable) referred for diagnostic re-evaluation or review of treatment

  • FM not previously seen by rheumatologist

  • Possible IA, but not deemed highly likely

  • OA which may benefit from consultation

DFor patients with a problem which is best assessed by another healthcare provider. Appointments are not given unless discussed with referring physician. Reserved for patients with established chronic pain conditions who would be better treated by specialists in orthopedics, chronic pain, or rehabilitation.
  • Diagnosed FM

  • Chronic MBP

  • Soft tissue pain

  • CTD: connective tissue disease; IA: inflammatory arthritis; PMR: polymyalgia rheumatica; ADL: activities of daily living; OA: osteoarthritis; FM: fibromyalgia; MBP: mechanical back pain. From: Graydon SL, Thompson AE. J Rheumatol 2008;35:1378–83.