GEM - Curriculum statement 15.9 Rheumatology problems including trauma

Knowledge Base for the nMRCGP

Curriculum Statement 15.9 Rheumatology problems including trauma

Symptoms:

• Symptoms:
  • Inflammation - pain, swelling, redness, warmth
  • Lack of function - weakness, restricted movement, deformity and disability
  • Injuries - cuts, bruises, wounds
  • Systemic manifestations - rashes, tiredness, nerve compression, etc.
    • basic knowledge rheumatology section from GPnotebook
    • clinical features of rheumatology section from GPnotebook

Common and/or important conditions:

• Acute back/neck pain
  • back pain section from GPnotebook
  • neck pain section from GPnotebook
• Chronic back/neck pain
  • back pain section from GPnotebook
  • neck pain section from GPnotebook
• Shoulder pain
  • shoulder pain section from GPnotebook
• Knee pain
  • knee pain section from GPnotebook
• Soft-tissue disorders
  • soft tissue damage section from GPnotebook
• Osteoarthritis
  • osteoarthritis section from GPnotebook
• Osteoporosis
  • osteoporosis section from GPnotebook
• Somatisation/fibromyalgia and allied syndromes
  • fibromyalgia section from GPnotebook
  • somatisaton disorder section from GPnotebook
• Pain management
• Acute arthropathies
  • arthritis section from GPnotebook
• Chronic inflammatory arthropathies
  • inflammatory arthropathies section from GPnotebook
• Polymyalgia rheumatica and allied conditions
  • polymyalgia rheumatic section from GPnotebook
• Awareness of rare diseases
• Chronic disability
• Common injuries. NB: these topics should be considered throughout the age range including children.

Investigation:

• Indications for plain radiography, ultrasound, CT and MR scan including the use of tools such as the -Ottawa Rules'
  • Ottawa Rules section from GPnotebook
• General rules of X-ray interpretation
• Implications of 'Misses' on X-rays, common errors
• Indications for additional investigations, for example blood tests.

Treatment:

• Understand the principles of treatment for common conditions managed largely in primary care including the use and monitoring of NSAIDs and disease-modifying drugs
• Knowledge of when joint injections and aspirations are appropriate in general practice and the ability to perform when appropriate, e.g. shoulder and knee joints and injections for tennis and golfer's elbow
  • shoulder joint injection section from GPnotebook
  • tennis elbow section from GPnotebook
  • golfer's elbow section from GPnotebook
• Understand the roles of allied health professionals (nursing, physiotherapy, chiropody, podiatry, occupational therapy, counselling and psychological services)
• Chronic disease management including systems of care, multidisciplinary teamwork and shared-care arrangements.

Emergency care:

• The initial management of the patient who has been burnt
  • burns section from GPnotebook
• To be aware of the safety of the patient, the scene of the incident and medical staff
• To be aware of how to summon help in an emergency
• Be competent in basic life support (adult and paediatric), the use of simple airway adjuncts (for example oropharyngeal airway and pocket mask) and the safe use of a defibrillator
  • basic life support section from GPnotebook
• Be competent in stopping haemorrhage
• Be competent in reducing pain by the use of analgesia or other methods
• Be aware of the principles of major incident management
• Recognise referrals requiring emergency action to save life or prevent serious long-term sequelae
• GPnotebook section relevant to all trauma topics
  • trauma topics section from GPnotebook

Prevention:

• Advise regarding appropriate levels of exercise
• Heath promotion regarding accident prevention