Box 2.

Possible response to the potential referral letter to the rheumatology clinic in Box 1; Dr A

Dear Doctor,
re Patient A
Thank you for your helpful letter about Patient A. The referral was triaged through the regional referral management service to our EA (early arthritis) clinic and I reviewed her this week.
The history is as you described, with a long history of ill-defined musculoskeletal pain. On examination, there was no evidence of either inflammatory or degenerative arthritis. I note the normal blood count results, low C-reactive protein and negative latex test.
I think we can be confident that this patient does not have a serious musculoskeletal condition. In particular, there is nothing to suggest rheumatoid arthritis, a seronegative arthritis or lupus.
I was able to reassure her that this was the case, and I have discharged her from the clinic.
Yours etc