Modules

• Year 1
  • Introduction to Year 1 and Year Outcomes
  • Fundamentals of Medicine
  • Cardiorespiratory 1
  • Metabolism 1
  • Locomotor 1
  • Brain and Behaviour 1
  • Human Development 1
  • Medicine in Society 1
  • Clinical Communication Skills
  • Student Selected Component (SSC)
• Year 2
  • Introduction to Year 2 and Year Outcomes
  • Cardiorespiratory 2
  • Metabolism 2
  • Brain and Behaviour 2
  • Human Development 2
  • Human Sciences and Public Health 2
  • Locomotor 2
  • Cancer Week
  • Moving and Handling Training
  • Year 2 Lifesaver Programme
  • Clinical Communication Skills
  • Medicine in Society 2
  • Extended Patient Contact
  • Student Selected Component (SSC)
• Year 3
  • Introduction to Year 3 and Year Outcomes
  • Clinical Science and Professionalism (Weeks 1-3)
  • Cardiovascular, Respiratory and Haematology (CR3)
  • Gastroenterology and Cancer (MET3A)
  • Public Health
  • Endocrinology and Renal Medicine (MET3B)
  • General Practice and Community Care
  • Student Selected Component (SSC)
  • Clinical and Communication Skills
• Year 4
  • Introduction and Year 4 Outcomes
  • Obstetrics and Gynaecology
  • Child Health
  • HIV & Sexual Health
  • Musculoskeletal
  • Health Care of the Elderly
  • Neuroscience
  • Dermatology
  • General Practice and Community Care
  • Psychiatry
  • Ear, Nose and Throat
  • Global Health and Ethics
  • Ophthalmology
  • Clinical & Communication Skills
  • Student Selected Component (SSC)
• Year 5
  • Introduction to Year 5 and Year Outcomes
  • Teaching Week 1
  • Teaching Week 2
  • Anaesthesia & ITU (AN & ITU)
  • Breaking Bad News
  • Clinical Pharmacology & Therapeutics
  • Community Care
  • Doctors as Teachers and Educators (DATE)
  • Emergency Medicine (EMERG MED)
  • General (Internal) Medicine (G(I)M)
  • Immediate Life Support (ILS)
  • Student Assistantship
  • Simulation
  • Surgery
  • Student Selected Component (SSC)
• Year GEP 1
  • Cancer Week
  • Movement and Posture
  • Carriage of Oxygen
  • Human Sciences and Public Health
  • Digestion, Growth and Metabolism
  • Infection and Immunity
  • Ethics
  • Brain and Behaviour
  • Human Development
  • Clinical Communication Skills
  • Medicine in Society (GEP)

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Year 4 MusSkel4: Musculoskeletal

• Prof Bruce Kidd
• b.l.kidd@qmul.ac.uk

Teaching Material for this Module

Introduction

The modules aims to develop students understanding of the diagnosis and management of the common rheumatological and orthopaedic conditions including fractures.

The program consists of introductory lectures,  small group tutorials in both rheumatology and orthopaedics, attendance in outpatient clinics and theatre sessions

Key learning outcomes

1. Can apply to medical practice, the biomedical scientific principles, method and knowledge relevant to musculoskeletal disease  (GMC TD 8)
2. Can demonstrate knowledge of relevant drug actions: therapeutics and pharmacokinetic: drug side effects and interactions (GMC TD 8f)
3. Can carry out a consultation with a patient with a musculoskeletal disease  (GMC TD 13)
4. Can diagnose and understand the basic management of a patient with a musculoskeletal disease  (GMC TD 14)
5. Can carry out, under supervision, specified practical procedures (GMC TD 18)

Sessions

• Lecture: Rheumatoid Arthritis

  Teaching Material for this Session

  1. Can list a differential diagnosis for a patient presenting with acute polyarthritis
  2. Can list a differential diagnosis for a patient presenting with persistant polyarthritis.
  3. Knows the pathophysiology, and clinical and radiological features of rheumatoid arthritis
  4. Knows how to diagnose and treat a patient with rheumatoid arthritis
• Lecture: Connective Tissue Disease & Vasculitis
  1. Discuss the clinical features, pathology and systemic manifestations of systemic lupus erythematosus
  2. Can describe the clinical features and treatment of the anti-phospholipid syndrome
  3. Describe clinical features and diseases associations of Sjogrens syndrome
  4. Can describe the clinical features and management of systemic sclerosis / scleroderma
  5. Understands the clinical features, diagnosis and overall management of polymyositis and dermatomysoitis
  6. Can list the clinical features and basic management of the major vasculitides
• Lecture: Monarthritis & Myalgia
  1. Can list a differential diagnosis for a patient presenting with a hot swollen joint.
  2. Can list the causes and clinical features of gout
  3. Can differentiate between acute treatment and chronic prophylaxis of gout
  4. Can describe the clinical and radiological features, and treatment, of calcium pyrophosphate arthropathy (pseudogout)
  5. Can list a differential diagnosis for a patient presenting with myalgia
  6. Describe the clinical features, pathology, diagnosis and treatment of polymyalgia rheumatica
  7. Can describe how to diagnose and treat giant cell arteritis
  8. Can list a differential diagnosis for a patient with chronic widespread musculoskeletal pain
  9. Can diagnose and treat a patient with chronic widespread pain / fibromyalgia
• Lecture: Osteoarthritis, Osteoporosis & Metabolic Bone Disease
  1. Can describe the pathology, clinical & radiological features and treatment of osteoarthritis
  2. Can discuss the pathogenesis, clinical features, treatment and complications of osteomalacia
  3. Can describe the pathogenesis, clinical features, treatment and complications of osteoporosis
  4. Understand the aetiology, clinical features, pathology and complications of Paget's disease of bone
• Lecture: Regional Pain & Soft Tissue Disorders
  1. Can describe the clinical features and treatment of carpal tunnel syndrome, wrist ganglions, DeQuervain's tenosynovitis, Dupuytrens contracture, trigger finger
  2. Can describe the features and treatment of bunions, plantar fasciitis, achilles tendinitis and Mortons neuroma
  3. Can describe the features and treatment of frozen shoulder, rotator cuff tendinopathy, subacromial bursitis and biceps tendinopathy
  4. Can describe the clinical features and treatment of lateral and medial epicondylitis, olecranon bursitis and ulnar berve entrapment (cubital tunnel syndrome)
  5. Can describe the features and treatment of meniscal tears, anterior cruciate ligament tear, medial collateral ligament sprain, Osgood-Schlatters disease, iliotibial band syndrome, patellofemoral pain syndrome
  6. Can describe the features and treatment of trochanteric bursitis, transient synovitis of the hip, OA of the hip
• Lecture: Back Pain & Spondyloarthropathy
  1. Can describe the common causes of back pain
  2. Understands the concept of red and yellow flags
  3. Can describe the clinical features and complications of the cauda equina syndrome
  4. Knows the clinical and radiological features of spondylosis, spondylolisthesis and spondylolysis
  5. Can describe the clinical and radiological features and treatment of ankylosing spondylitis
  6. Can describe the clinical features and treatment of reactive arthritis
  7. Can describe the main patterns of joint disease in psoriatic arthritis and their radiological features
• Lecture: Orthopaedics, Infections and Malignancy
  1. Can describe the clincal features and management of the common paediatric orthopaedic disorders (DDH, CTEV, Perthe's disease, SUFE)
  2. Can describe the clinical features and management of bone and joint infections
  3. Can describe the surgical approach to degenerative joint disease
• Lecture: Trauma & Fractures
  1. Can describe the clinical features and management of olecranon fracture, radial head fracture and dislocation
  2. Can describe the causes, clinical features and management of compartment syndrome (any site), neurovascular injury (any site), septic arthritis, open fractures and cauda equina
  3. Can identify the characteristic radiological abnormailities, complications and management of the common upper limb fractures, including: Clavicle, Humeral head/neck/shaft, Supracondylar, Olecranon, Radius and Ulnar, and Scaphoid.
• Clin & SDL: History and Examination
  1. Can obtain a detailed musculoskeletal history from a patient presenting with either arthralgia, mylagia, back pain or chronic widespread disease
  2. Can identify, using the GALS (Gait, Arms, Legs Spine) screen, normality and regional abnormality of the musculoskeletal system
  3. To identify and characterize, through enquiry and regional examination, the symptoms and signs of arthropathy (joint inflammation and/or damage), common periarticular lesions (bursitis, tendonitis, tenosynovitis, enthesopathy) at the shoulder, elbow, wris
  4. Can perform a detailed examination of the peripheral joints and spine
• Clin & SDL: General rheumatology topics
  1. Can describe the distribution of the major nerve roots and peripheral nerves
  2. Can describe the functional anatomy of synovial joints and the spine
  3. Can identify the characteristic radiological abnormailities of the common rheumatic diseases including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, pseudogout, psoriatic arthritis and disorders affecting the spine
  4. Can describe the diagnositic features of synovial fluid in the common rheumatological disorders (RA, OA, gout) as well infection
  5. Can describe the microscopic features of synovial fluid in gout
• Clin & SDL: Rheumatoid Arthritis
  1. Knows about the use of disease modifying anti-rheumatic drugs (DMARDs) in RA
• Clin & SDL: CTD & Vasculitis
  1. Describe the autoantibodies commonly associated with the connective tissue disorders
  2. Can outline a simple classification of vasculitis
• Clin & SDL: OA and Metabolic Bone Disease
  1. Understands the pharmacology and use of the following medications for Osteoporosis: Biphosphonates - Alendronate; Vitamin D; Calcium; Hormone Replacement Therapy - Oestrogen; Testosterone; Selective Oestrogen Receptor Modulators
  2. Is able to identify risk factors for Osteoporosis and give appropriate prophylaxis (non-pharmacological and pharmacological)
  3. Understands the causes of elevated and reduced serum calcium levels, the pathophysiology of vitamin D deficiency, and the effects of parathyroid disorders on the musculoskeletal system
• Clin & SDL: Back pain & related topics
  1. Can describe the pathogenesis of an acute disc prolapse
  2. Can describe the features and predisposing causes of discitis
  3. Can describe the difference between referred and radicular symptoms
  4. Can describe six red flag features and understand their diagnostic value
  5. Understands the association between genetic (HLA B27) and environmental factors in spondyloarthropathy
• Clin & SDL: General Orthopaedic topics
  1. List local and general complications post orthopaedic surgery
• Clin & SDL: Orthopaedics: Trauma & Fractures
  1. Can describe the features and management of distal radius fracture, scaphoid fracture, mtacarpal/phanageal fracture and tendon injuries
  2. Can describe the features and management of fractured neck of femur and pubic ramus fracture
  3. Can describe a classification scheme for fractures
• Clin & SDL: Orthopaedics: Paediatric orthopaedics
  1. Understand the different age presentations of the three childhood hip conditions
• Clin & SDL: Orthopaedics: Meniscal and liagament injuries
  1. Can describe the features and treatment of recurrent shoulder dislocation, AC joint separation, clavicle fracture and biceps tendon rupture
  2. Can describe the features and management of meniscal tears, anterior cruciate ligament tear, medial collateral ligament sprain, patella fracture
  3. Can describe cfeatures and managment of ankle fractures, metatarsal stress fractures, Lisfranc injury and Achilles tendon rupture
• Clin & SDL: Musculoskeletal Malignancies
  1. Can describe the diagnosis and management of the more common benign and malignant bone tumours
  2. Understand the diagnosis and management of other malignant conditions, such as myeloma and other haematological conditions, that can affect the musculoskeletal system
• Clin & SDL: Musculoskeletal Infections
  1. Can outline the aetiology, pathology and sequelae of osteomyelitis and septic arthritis
  2. Understands how to investigate musculoskeletal infection and how to interpret the results including synovial fluid analysis
• Clin & SDL: Pain management
  1. Be able to distinguish between the following terms and conditions: Pain secondary to inflammation; Neuropathic pain; Pain secondary to malignancy; WHO analgesic ladder
  2. Know how to select the type, route, dose and frequency of analgesia to maximise efficacy and reduce harm
  3. Knows the indications for choosing, giving and monitoring the following medications: Aspirin; Non-steroidal anti-inflammatory drugs (NSAIDs) - Ibuprofen, Naproxen, Diclofenac; Cyclo-oxygenase 2 selective inhibitors (Coxibs) eg Celecoxib; Local Anaesthesi

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