Presentations
- Arthralgia
- Back pain
- Bone:
- deformity / enlargement
- tenderness
- Musculoskeletal symptoms in the absence of, or discordant with, objective evidence of disease
- Reduced range of movement in axial and peripheral joints
- Referral from another specialty for shared care or opinion
Conditions
- Avascular necrosis
- Bone disease related to kidney failure
- Bone disorders
- Diffuse idiopathic skeletal hyperostosis
- Hypertrophic osteoarthropathy
- Osteochondritis dissecans
- Osteomalacia
- Osteoporosis
- Paget’s disease of bone
- Rheumatological manifestations of:
- diseases overlapping with other specialties
- neoplasms and tumour-like lesions:
- benign
- malignant
- paraneoplastic
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
- Charcot arthropathy
- Haematologic disease-associated rheumatic disorders
- Haemoglobinopathies
- Haemophilia
- Lymphoma
- Macrophage activation syndrome / Haemophagocytic lymphohistiocytosis
- Osteoporosis, transient, such as:
- pregnancy-related osteoporosis
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
- Impact of minimal trauma fractures, osteopenia, and osteoporosis
- Physiology and pathophysiology of bone remodelling
- Physiology of calcium metabolism
- Prevalence of osteoporosis in patients over the age of 50
Therapeutics and management principles
- Non-pharmacological and pharmacological osteoporosis management, with allied health professional input
Investigations
- Laboratory, radiologic, and other investigations for evaluation of listed conditions
Procedures
- Biopsy – bone marrow
- Synovectomy:
- radiation (yttrium)
- surgical
- Bone health in other rheumatic diseases
- Burden of disease of osteoporosis, such as disability-adjusted life years (DALY) and healthcare expenditure
- Hospitalisation
- Overlap of rheumatic diseases with other specialties, necessitating collaborative care
- Psychosocial determinants and comorbidity in musculoskeletal presentations
