Presentations
- Hyperalgesia
- Impingement syndrome
- Pain:
- back / neck:
- with radiculopathy
- without radiculopathy
- joint:
- during activity
- limiting function
- otherwise unexplained
- sensitisation
Conditions
- Axial diseases, such as:
- coccydynia
- osteitis pubis
- spinal canal stenosis
- spondylosis, with or without radiculopathy:
- Complex regional pain syndrome
- Fibromyalgia
- Nerve compression syndromes, such as:
- Osteoarthritis
- Regional musculoskeletal disorders, such as:
- adhesive capsulitis
- costochondritis
- lateral epicondylitis
- plantar fasciitis
- rotator cuff tear
- trigger fingers and Dupuytren contractures
- trochanteric bursitis
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigation
- consider the impact of illness and disease on patients and families, and their quality of life
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Conditions
- Ehlers–Danlos syndrome (EDS) and EDS spectrum disorder
- Marfan syndrome
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigation
- consider the impact of illness and disease on patients and families, and their quality of life
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Anatomy of musculoskeletal regions
- Epidemiology of the conditions listed, including age and sex prevalence and incidence
- Pain as a complex interaction of factors, including:
- central nervous system (CNS) dysregulation
- neuropathic
- nociceptive
- psychosocial
- psychosomatic mechanisms
- Risk factors, including:
- modifiable, such as:
- obesity
- physical activity
- psychosocial
- sociodemographic
- non-modifiable, such as:
- Triggers for symptoms, including:
- activity
- injury
- psychosocial factors
Therapeutics and management principles
- Evidence-based approach to the management of symptoms and disease through non-pharmacological and pharmacological approaches
- Non-pharmacological measures, such as:
- addressing psychosocial contributing factors
- exercise and physical activity
- interventional pain procedures, such as:
- nerve blocks
- radiofrequency ablation
- management of obesity
- multidisciplinary input, such as from:
- occupational therapists
- physiotherapists
- psychologists
- the use of aids, such as braces and splinting
- Patient-specific evidence-based education
- Pharmacological measures, including intra-articular, oral, and topical medication
Investigations
- Bone scan
- CT
- MRI
- Relevant laboratory investigations to rule out other rheumatic diseases
- Ultrasound
- X-rays
Procedures
- Intra-articular cortisone injection
- Functional and psychosocial consequences of chronic pain / fibromyalgia, such as:
- distress
- immobility
- isolation
- maladaptive illness behaviours
- poor sleep
- Multidisciplinary approach with specialists, such as:
- geneticists
- occupational therapists
- pain specialists
- physiotherapists
- psychologists
- Opioid use in chronic, non-cancerous pain management
- Role of patient education and empowerment in:
- chronic pain management
- managing lifestyle factors including weight / obesity and physical inactivity
