Key presentations and conditions
Basic Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Presentations
- Acute lower back pain
- Monoarthritis, acute
- Polyarthritis
Conditions
- Arthritis:
- crystal-associated, such as gout and pseudogout
- osteoarthritis, generalised and regional
- rheumatoid
- septic
- Fibromyalgia
- Musculoskeletal conditions, such as:
- rotator cuff tear
- Osteoporosis
- Polymyalgia rheumatica and giant cell arteritis
- Scleroderma, limited and diffuse
- Seronegative spondyloarthropathies, such as:
- ankylosing spondylitis
- enteropathic arthritis
- psoriatic arthritis
- reactive arthritis
- Sjögren syndrome
- Systemic lupus erythematosus
For each presentation and condition, Basic Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients1 and their quality of life
Manage
- provide evidence-based management
For less common or more complex presentations and conditions the trainee must also seek expert opinions - 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
Less common or more complex presentations and conditions
Basic Trainees will understand these presentations and conditions. Basic Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Conditions
- Adult-onset Still disease (AOSD)
- Antiphospholipid syndrome
- Hereditary connective tissue disorders, such as:
- Ehlers-Danlos syndrome
- Marfan syndrome
- osteogenesis imperfecta
- IgG4-related disease
- Myopathies, such as:
- dermatomyositis
- drug-induced
- inflammatory
- metabolic
- polymyositis
- Neuropathic joint disease
- Periodic fever syndromes
- Sarcoidosis
- Tendinopathy
- Vasculitis, such as:
- antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis
- immune complex vasculitis polyarteritis nodosa
- Takayasu arteritis
- Viral arthritis
For each presentation and condition, Basic Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients1 and their quality of life
Manage
- provide evidence-based management
For less common or more complex presentations and conditions the trainee must also seek expert opinions - 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
Epidemiology, pathophysiology and clinical sciences
Basic Trainees will describe the principles of the foundational sciences.
- Epidemiology and pathophysiology of osteoarthritis, osteoporosis, gout, and rheumatoid arthritis
- Extra-articular manifestations of rheumatic disease, such as:
- constitutional symptoms
- dermatological symptoms
- inflammatory eye disease
- internal organ manifestations
- Joint inflammation pathophysiology
- Normal joint structure and physiology
- Principle actions of common immunosuppressive agents
- Principles of innate and adaptive immune responses
- Rheumatoid arthritis treatment options, such as:
- biological drug treatments
- common disease-modifying antirheumatic drugs (DMARDs)
- indications and contraindications of prednisone
- Signs of clinical inflammation and principles of monitoring disease activity in inflammatory rheumatic diseases
Investigations, procedures and clinical assessment tools
Basic Trainees will know the indications for, and how to interpret the results of these investigations, procedures, and clinical assessments tools. Basic Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Investigations
- Electromyography (EMG) and nerve conduction studies
- Laboratory tests, such as:
- ANCA
- angiotensin converting enzyme (ACE)
- anti-beta-2 glycoprotein antibody
- anticardiolipin antibody
- anticyclic citrullinated peptide antibody (anti-CCP)
- anti-double stranded DNA (anti-dsDNA)
- antinuclear antibody (ANA)
- C3 and C4
- C-reactive protein
- erythrocyte sedimentation rate
- extractable nuclear antigen (ENA)
- full blood count (FBC)
- liver function tests
- lupus anticoagulant
- rheumatoid factor (RF)
- urate
- urea, electrolyte, and creatinine
- urinalysis
- viral arthritis serology
- Muscle biopsy
- Musculoskeletal radiology tests, such as:
- CT
- DXA
- dual energy CT scans
- MRI
- nuclear medicine scans
- Synovial fluid analysis
- Ultrasound
- X-ray:
- hands
- hips
- knee joints
- shoulders
- spine and sacroiliac joints
Procedures
- Synovial fluid aspiration of the knee
Important specific issues
Basic Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
- Cardiovascular morbidity associated with inflammatory rheumatic diseases
- Cost and disease burden of musculoskeletal diseases
- Effect of musculoskeletal disorders on mobility and independence
- Principles of treating and monitoring infections in immunosuppressed patients
- References to patients in the remainder of this document may include their families or carers.