Rheum consult communication
How to Consult Rheumatology
What to include when calling Rheumatology about vasculitis, inflammatory arthritis, lupus flare, GCA, myositis, steroid timing, or infection-vs-flare uncertainty.
Lead With the Decision
What inflammatory syndrome, organ threat, diagnostic uncertainty, immunosuppression decision, or steroid-timing question do you need Rheum to help with?
Not sure whether the consult is appropriate? Start with the Should I Consult Rheum? triage page, then return here before calling.
Before the call
Have These Details Ready
- Syndrome and organ threat: arthritis, rash, renal, pulmonary, neurologic, ocular, vascular, muscle, constitutional, or suspected GCA/vasculitis.
- Time course, prior rheum diagnosis, baseline meds, immunosuppression, steroid exposure, biologics, adherence, and recent infections.
- Objective data: exam pattern, inflammatory markers, urinalysis/proteinuria, creatinine, CBC, CK, complements, antibodies already sent, imaging, and biopsy status if relevant.
- Infection exclusion status when immunosuppression or flare is being considered.
- Specific question: diagnosis, workup, admission/transfer, steroid timing, immunosuppression safety, biopsy route, or outpatient follow-up.
Exam focus
Document the Specialty-Relevant Exam
- Joint distribution with swelling vs pain only, range of motion, warmth, symmetry, and functional limitation.
- Skin findings, ulcers, purpura, livedo, Raynaud/digital ischemia, temporal artery tenderness, vision symptoms, weakness pattern, pulmonary/renal clues, and neurologic findings.
- Medication list and immune status, including current and recent steroids or biologics.
Phone or secure-chat script
A Cleaner Rheum Consult Message
I am calling about a [age]-year-old with concern for [rheum syndrome/organ threat]. The time course is [duration], history includes [rheum diagnosis/meds/immunosuppression]. Objective findings are [exam/labs/UA/imaging]. Infection evaluation is [status]. My question is [diagnosis/workup/steroid timing/immunosuppression/admission/biopsy/follow-up].
Common pitfalls
Avoid Low-Signal Consults
- Calling a positive ANA alone without syndrome, exam findings, and clinical question.
- Asking for steroids without stating infection evaluation and organ-threat concern.
- Using Rheum as a broad “autoimmune?” consult without objective data or a focused question.
Reference links
Useful Background
Educational tools only. SIC provides clinician-facing educational consult-triage references. SIC does not diagnose, treat, prevent, cure, or mitigate disease and is not a substitute for clinical judgment, local guidelines, institutional referral pathways, or recommendations from the relevant specialty department. See disclaimer and how SIC works.