Musculoskeletal Curriculum Map

Topic Reading Guidelines and BNF Exam skills Data comments

Pathways medications Interpretation
1A Topics
Shoulder: sprain/strain Oxford Handbook of Clinical N/A Ibuprofen Shoulder Shoulder X-ray
Surgery(OHCS).(490-493) Paracetamol Examination
Atlas of Human
Anatomy(AHA)
The Easy Guide to OSCEs for
Specialities (EGO)
Gray’s Anatomy for Students
(GAS)
Kumar and Clark’s Clinical
Medicine(K+C) Oxford
Handbook of General
Practice(OHGP) Ross and
Wilson Anatomy and
Physiology in Health and
IllnessR+WA+P)
Wrist/Hand: OHCS – 490-493 N/A Ibuprofen Examination X-ray of the
sprains/strains AHA, GAS, K+C, OHGP, Paracetamol of the wrist hand and wrist
R+WA+P. and hand
Wrist/Hand: AHA, GAS, K+C, OHGP, N/A Ibuprofen Examination Special tests
Tenosynovitis R+WA+P. Paracetamol of the wrist
and hand
Epicondylitis AHA, GAS, K+C, OHGP, N/A Ibuprofen Examination Speaical tests
R+WA+P. Paracetamol of the elbow
Back/Spine: back OHCS (492,550-5 NICE:Low back Ibuprofen Examination X-ray of the
strain/sprain AHA, GAS, K+C, OHGP, pain in adults: Paracetamol of the back spine
R+WA+P.56) early Codeine and spine CT of the spine
management Tramadol MRI of the
(CG88)May Diazepam spine
2009 Muscle
relasants
back/neck pain, injury OHCS (492,550-556) “ “ “ “
(differential diagnosis – AHA, GAS, K+C, OHGP,
musc/neuro R+WA+P.
Knee: Osgood-Schlatter OHCS – 490 N/A Ibuprofen Examination X-ray of the
disease AHA, GAS, K+C, OHGP, Paracetamol of the knee knee
R+WA+P.
Knee: sprains/strains; OHCS – 490 “ “ “ “
AHA, GAS, K+C, OHGP,
R+WA+P.
Ankle/Foot: OHCS – 490 N/A Ibuprofen Examination X-ray of the foot
sprains/strains AHA, GAS, K+C, OHGP, Paracetamaol of the foot and ankle
R+WA+P. and ankle
Musculoskeletal Curriculum Map

Rheumatological Acute Medicine: Clinical Cases Fibromyalgia NSAID Widespread Blood tests ESR
Conditions: fibromyalgia Uncovered (AM:CCU) Criteria 2010, Paracetamol Pain Index
AHA, GAS, K+C, OHGP, The American Codeine (WPI)
R+WA+P. College of Tramadol
Rheumatology Prednisolone
Rheumatological AM:CCU, AHA, GAS, K+C, British Society NSAID Examination X-ray
Conditions:gout OHGP, R+WA+P. for Colchicine of joints interpretation
Rheumatology Corticosteroid of joints. Blood
and British Allopurinol tests: FBC,
Health Electrolytes,
Professionals in Urea,
Rheumatology Creatinine, ESR,
Guideline for
CRP, Urate,
the
Calcium
Management of
Gout 2007

Rheumatological AM:CCU, AHA, GAS, K+C, BSR and BHPR Bisphosphonate General Blood tests:
Conditions: polymyalgia OHGP, R+WA+P. guidelines for Callcium examination FBC, ESR, CRP,
rhematica the management Vitamin D Urea,
of polymyalgia Prednisolone Electrolytes,
rheumatica LFTs, Calcium,
ALP, Protein
Electrophoresis,
Bence Jones
Protein, TFTs,
Creatine kinase,
rheumatoid
factor, ANA.
Chest X-ray
Dipstick
urinalysis
Osteoarthritis OHCS – 490 NICE: NSAIDS(oral and Examination X-rays of joints
AM:CCU, AHA, GAS, K+C, Osteoarthritis:C topical), COX_2 of joints and and spine.
OHGP, R+WA+P. are and inhibitors, back.
management Paracetamol,
Feb 2014 Codeine,Trama
dol
Osteoporosis OHCS – 490, 502 NICE Pathway- Bisphosphonate General DEXA Scan FRAX score
AM:CCU, AHA, GAS, K+C, Osteoparosis s, Calcium and QFracture
OHGP, R+WA+P. (CG146) Vitamin
Supplements
Topic Reading NICE Guidelines BNF Exam skills Data comments
and Pathways medications Interpretation
1B Topics
Musculoskeletal Curriculum Map

Shoulder: OHCS – 490, 494- 503, 524- N/A Entonox, Shoulder Shoulder X-ray
fractures/dislocations 528 Morphine, examination
AHA, GAS, K+C, OHGP, Codeine,
R+WA+P. Paracetamol,
NSAIDS
Shoulder: adhesive AM:CCU, AHA, GAS, K+C, N/A NSAIDS Shoulder Shoulder X-ray Physiotherapy
capsulitis OHGP, R+WA+P. Paracetamol examination an important
Codeine part of
Tramadol treatment.
Lidocaine
Corticosteroids
Forearm/Wrist/Hand: OHCS – 490, 494- 503, 504-
fractures/dislocations 509
AHA, GAS, K+C, OHGP,
R+WA+P.
Colles’ OHCS – 490, 494- 503, 512 Fractures (non- NSAIDS Wrist and Wrist and hand
AM:CCU, AHA, GAS, K+C, complex): Paracetamol hand X-Ray
OHGP, R+WA+P. assessment and Codeine examination
management Tramadol
NICE guidelines Lidocaine
[NG38] Entonox
Published date: Morphine
February 2016
Humeral OHCS – 490, 494 -503, 518 “ NSAIDS Shoulder and Shoulder and
AHA, GAS, K+C, OHGP, Paracetamol arm humerus X-rays
R+WA+P. Codeine examination FBC, Urea,
Tramadol Electrolytes,
Morphine Goup+Save
pulled elbow AHA, GAS, K+C, OHGP, NSAIDS Paediatric Elbow X-Ray
R+WA+P. Paracetamol elbow
examination
Scaphoid OHCS – 490, 494- 503, 508- Fractures (non- NSAIDS Hand and Hand and wrist
509 complex): Paracetamol wrist X-Ray
AHA, GAS, K+C, OHGP, assessment and Codeine examination MRI wrist
R+WA+P. management Tramadol CT wrist
NICE guidelines
[NG38]
Published date:
February 2016
Tenosynovitis AHA, GAS, K+C, OHGP, NSAIDS Shoulder Shoulder X-Ray
R+WA+P. Paracetamol examination
Codeine
Tramadol
carpal tunnel syndrome OHCS – 570 NSAIDS Hand and Nerve
AM:CCU, AHA, GAS, K+C, Paracetamol wrist conduction
OHGP, R+WA+P. Codeine examination studies
Musculoskeletal Curriculum Map

Tramadol
de Quervain’s tenosynovitis AM:CCU, AHA, GAS, K+C, NSAIDS Hand and
OHGP, R+WA+P. Paracetamol wrist
Codeine examination
Tramadol
elbow tendonitis AM:CCU, AHA, GAS, K+C, NSAIDS Elbow
OHGP, R+WA+P. Paracetamol examination
Codeine
Tramadol
Disorders of Back/Spine:
kyphosis/scoliosis AM:CCU, AHA, GAS, K+C, NSAIDS Examination X-Ray of spine
OHGP, R+WA+P. Paracetamol of the back
Codeine and spine
Tramadol
Morphine
herniated disk pulposis AM:CCU, AHA, GAS, K+C, NSAIDS Examination X-Ray of spine
OHGP, R+WA+P. Paracetamol of the back
Codeine and spine
Tramadol
Morphine
fractures back/neck OHCS - 492,550-556 NSAIDS Examination X-Ray of spine
AM:CCU, AHA, GAS, K+C, Paracetamol of the back
OHGP, R+WA+P. Codeine and spine
Tramadol
Morphine
Disorders of the Hip:
fractures/dislocations OHCS - 492,536-537 NSAIDS Examination X-ray of the Hip
AHA, GAS, K+C, OHGP, Paracetamol of the hip
R+WA+P. Codeine
Tramadol
Morphine
slipped upper femoral OHCS – 460 NSAIDS Examination X-ray of the Hip
epiphysis AM:CCU, AHA, GAS, K+C, Paracetamol of the hip
OHGP, R+WA+P.
Disorders of the Knee
bursitis AM:CCU, AHA, GAS, K+C, NSAIDS Examination X-Ray of the
OHGP, R+WA+P. Paracetamol of the knee knee
Codeine
Tramadol
fractures/dislocations
meniscal injuries AM:CCU, AHA, GAS, K+C, NSAIDS Examination X-Ray of the
OHGP, R+WA+P. Paracetamol of the knee knee
Codeine
Tramadol
chondromalacia AM:CCU, AHA, GAS, K+C, NSAIDS Examination X-Ray of the
OHGP, R+WA+P. Paracetamol of the knee knee
Musculoskeletal Curriculum Map

Codeine
Tramadol
Disorders of the
Ankle/Foot
fractures/dislocations OHCS – 490, 494-503,544-548 NSAIDS Examination X-Ray of the
AHA, GAS, K+C, OHGP, Paracetamol of the foot foot and ankle
R+WA+P. Codeine and ankle
Tramadol
Morphine
Musculoskeletal Infectious
Diseases
septic arthritis OHCS – 562 NSAIDS Examination FBC, Urea,
AM:CCU, AHA, GAS, K+C, Paracetamol of joints Electrolytes,
OHGP, R+WA+P. Codeine LFTs, CRP, ESR,
Tramadol Blood cultures
Morphine

acute osteomyelitis OHCS – 55 NSAIDS MSK MSK X-rays,

AM:CCU, AHA, GAS, K+C, Paracetamol examination CT,FBC, Urea,
OHGP, R+WA+P.8 Codeine Electrolytes,
Tramadol LFTs, CRP, ESR,
Morphine Blood cultures
chronic osteomyelitis OHCS - 560 NSAIDS MSK MSK X-rays,
AM:CCU, AHA, GAS, K+C, Paracetamol examination CT,FBC, Urea,
OHGP, R+WA+P. Codeine Electrolytes,
Tramadol LFTs, CRP, ESR,
Morphine Blood cultures
Other Musculoskeletal
Problems:
metabolic bone disease
Paget’s disease OHCS – 582 NSAIDS MSK MSK X-Rays
AM:CCU, AHA, GAS, K+C, Paracetamol examination
OHGP, R+WA+P. Codeine
Tramadol
Morphine
renal bone disease K+C NHS Greater Vitamin D Paediatric X-rays of the Nutritional
- Fanconi Syndrome Glasgow and Calcitriol examination long bones rickets,
- Renal Osteodystrophy Clyde Woman Calcidiol General Bloods: Vitamin Congenital
and Children’s Phosphate examination D, Ca, rickets,
Directorate binders Phosphate, FBC, Rickets of
Ur, Es+CR, TFTs prematurity,
Urinalysis Vitamin D
Guidelines for resistance
Management of (type I and
Nutritional type II)
Vitamin D Neoplastic
Deficiency In rickets,Hypo
Musculoskeletal Curriculum Map

Children & phosphatemi

Adolescents c rickets
Drug-
induced
rickets
vascular- K+C Sickle cell Antimetabolites General/MSK Bloods: Sickle
sickle cell disease: : Hydroxyurea examination cell screening
managing acute Opioid Respiratory HbS, Hb
painful episodes analgesics (eg, Cardiac electrophoresis,
in hospital oxycodone/ASA Abdo FBC, Es+CR,
NICE guidelines , methadone, Neuro LFTs, Cultures,
[CG143] morphine Opthalmic ABG, secretory
Published date: sulfate, phosphokipase
June 2012 oxycodone/APA A2(sPLA2)
P, fentanyl, Blood smear.
nalbuphine, Pulmonary
codeine, function tests
APAP/codeine) Lumbar
Nonsteroidal puncture
analgesics (eg, X-ray –MSK,
ketorolac, ASA, chest
APAP, MRI –
ibuprofen) ?osteomyelitis,
Antibiotics (eg, bone marrow
cefuroxime, changes
amoxicillin/clav CT scanning -
ulanate, ?osteonedrosis
penicillin VK, Bones Scanning
ceftriaxone, Transcranial
azithromycin, doppler
cefaclor)
• Vaccines (eg,
PCV7,
PPV23
,
menin
gococ
cal,
influe
nza,
recom
mend
ed
sched
uled
childh
Musculoskeletal Curriculum Map

ood/a
dult
vaccin
ations
)
Vitamins (eg,
folic acid)

2A Topics
Disorders of the Shoulder
rotator cuff disorders AHA, GAS, K+C, OHGP, NSAIDS Shoulder Shoulder X-Ray
R+WA+P. Paracetamol examination Shoulder
Codeine ultrasound/
Tramadol MRI
Morphine
subluxation AHA, GAS, K+C, OHGP, NSAIDS Shoulder Shoulder X-Ray
R+WA+P. Paracetamol examination
Codeine
Tramadol
Morphine

Rheumatological
Conditions:
pseudogout AM:CCU, AHA, GAS, K+C, NSAIDS Joints Uric acid
OHGP, R+WA+P. Paracetamol
Codeine
Tramadol
Morphine
rheumatoid arthritis AM:CCU, AHA, GAS, K+C, NSAIDS joints ESR
OHGP, R+WA+P. Paracetamol Rheumatoid
Codeine factor
Tramadol
Morphine
Methotrexate
DMARDS
Other Musculoskeletal
Conditions
vitamin D deficiency AM:CCU, AHA, GAS, K+C, Calci-condroitin
OHGP, R+WA+P.

2B Topics
Forearm/Wrist/Hand:
fractures/dislocations:
Musculoskeletal Curriculum Map

Boxer’s; OHCS – 490, 494- 503, 504- NSAIDS Hand and Hand and wrist
509 Paracetamol wrist X-Rays
AHA, GAS, K+C, OHGP, Codeine examination
R+WA+P. Tramadol
Disorders of Back/Spine:
spinal stenosis AM:CCU, AHA, GAS, K+C, NSAIDS Back and Spinal X-Rays,
OHGP, R+WA+P. Paracetamol spine Spinal MRI and
Codeine Examination CT scans
Tramadol
Morphine
cauda equine AM:CCU, AHA, GAS, K+C, NSAIDS Back and Spinal X-Rays,
OHGP, R+WA+P. Paracetamol spine SPianl MRI and
Codeine Examination CT scans.
Tramadol
Morphine
ankylosing spondylitis AM:CCU, AHA, GAS, K+C, NSAIDS Eamination of X-ray of the
OHGP, R+WA+P. Paracetamol the pelvis and pelvis and spine
Codeine spine
Tramadol
DMARDS
Topic Reading NICE Guidelines BNF Exam skills Data comments
and Pathways medications Interpretation
Reiter’s syndrome/ AM:CCU, AHA, GAS, K+C, United NSAIDS MSK – Large Bloods – WCC, Joint
Reactive arthritis OHGP, R+WA+P. Kingdom Corticosteroids joints ESR, CRP, IgA aspiration and
National Antibiotics (for Skin and nails antibodies. synovial fluid
Guideline on the Chlamydia Opthalmology Serology and analysis may
Management of related – GU tract cultures of also be
Sexually Tetracylcines GI tract blood, urine, helpful.
Acquired are common) Cardiac stool, cervix, ECG may be
Reactive
DMARDs urethra needed in
Arthritis
(Sulfasalazine, (Chlamydia aptients with
2008,Clinical
Effectiveness methotrexate, screwwn) prolonged
Group (CEG) anti- TNF eg HLA-B27 course.
British,Associat infliximab) Tuberculin skin
ion of Sexual test
Health and HIV HIV
(BASHH) Urinalysis
X-ray
interpretation
of joints
Polyarteritis nodosa AM:CCU, AHA, GAS, K+C, American Corticosteroids General Bloods – ESR,
OHGP, R+WA+P. College of Cyclophospham examination CRP, WCC, FBS,
Rheumatology ide Full neurology Hep B and C, E+
Criteria for (Infliximab and examinations Cr, LFTs, IgG.
rituximab Skin Urinalysis
GI tract BP
Musculoskeletal Curriculum Map

diagnosis currently being GU tract

(1990) studied) Cardiac
Anti-virals for Opthalmology
Hepatitis
related PAN (eg.
Interferon,
vidarabine)
polymyositis AM:CCU, AHA, GAS, K+C, Bohan and Corticosteroids General Bloods – FBC,
OHGP, R+WA+P. Peter criteria Methortexate examination ESR, CRP, CK,
for the Joint E+Cr,
diagnosis of examination Myoglobins,
polymyositis Muscle power Autoantobodies
and dermo GI tract , Rheumatoid
Respiratory Factor,
Cardiac Aldolase, ANA
antirbody assay
scleroderma AM:CCU, AHA, GAS, K+C, ACR/EULAR Corticosteroids Skin, Eyes Bloods – FBC,
OHGP, R+WA+P. Classification Azathiopreine, ,Ears, Nose CK, ESR,
Criteria for Methotrexate, and Throat, Natriuretic
Systemic Cyclophospham Vascular, peptide,
Sclerosis (SSc, ide, General MSK, Autoanatibody
Scleroderma) Mycophenolate, Respiaratory, assays.
Rituximab GI tract, GU GI
PenacillamineD tract, Cardiac, Oesophagogatr
MARDs –(not Neurology oduodenoscopy
licensed – still , pH and
under manometry
investigaton for studies, gastric
use in emptying study,
scleroderma)En colonoscopy.
dothelin Respiratory
receptor Chest X-Ray, CT
antogonists chest,
(Bosentan, Pulmonary
Ambrisentan, function testing,
Macitentan) bronchoscopy,
PAH, PDE-5 Cardiac
Inhibitors NT-pro-Brain
(Tadalafil, Natriuretic
Sildenafil) peptide,
Troponin, ECG,
Transthoracic
echocardiogram
MSK
Musculoskeletal Curriculum Map

Extremity X-
raysMandibular
X-ray
Sjogren’s syndrome AM:CCU, AHA, GAS, K+C, Sjogren’s Artificial saliva, Eyes, Nose Bloods – ESR,
OHGP, R+WA+P. Syndrome Cevimeline, and throat, FBC, IgG, ANA,
Foundation – Artificial tears, mouth, skin, RF, anti-alpha-
diagnosis Hydroxychloroq GI tract, fodrin antibody,
criteria uine (used Respiratory, E+Cr, LFTs.
American when Joints, Schirmer test
College of associated neurological, Salivery testing
Rheumatology arthritis
Classification unresponsive to
Criteria for NSAIDs)
Sjögren’s Cyclophospham
ide (used if
major organ
manifestation
occurs)
Immunomodula
tor –
cyclosporine,
Corticosteroids,
Retuximab.
Topic Reading NICE Guidelines BNF Exam skills Data comments
and Pathways medications Interpretation
juvenile rheumatoid AM:CCU, AHA, GAS, K+C, American NSAIDS Joint Bloods: FBC, Also referred
arthritis OHGP, R+WA+P. College of DMARDS examinations ESR, CRP, LFTs, to as juvenile
Rheumatology. Corticosteroids in children E+Cr, Urea, idiopathic
2013 update of General ANA, arthritis
the 2011 examination Rheumatoid
recommendatio Skin factor.
ns for the Additional
treatment of studies: total
Juvenile protein,
Idioparthic albumin,
Arthritis fibrinogen,
ferritin, d-
dimer, ACE,
antistreolysin 0,
anti-DNAse B,
urinalysis.
X-rays – joints
CT, MRI.
Arthrocentosis,
synovial biopsy.
Musculoskeletal Curriculum Map

Pericardiocente
sis.
systemic lupus AM:CCU, AHA, GAS, K+C, NICE: Biologic General Bloods: FBS, Can affect
erythematosus OHGP, R+WA+P. Belimumab for DMARDs:Belim examination Complement almost any
treating active umab, Joints levels, LFTs, CK, organ system
autoantibody- rituximab, IV Soft tissues Spot protein/
positive immune Skin spot creatinine
systemic lupus globulin Neuro ratio,
erythematosus Non-biologic Respiratory Autoantibody
Arthritis DMARDs: Abdo tests.
Research UK Cyclophospham Cardio X-rays: Joints,
EULAR ide, Chest
recommendatio methotrexate, CT-chest
ns for the azathioprine, Echocardiograp
management of mycophenolate, hy.
systemic lupus cyclosporine Brain MRI
erythematosus. NSAIDS Cardiac MRI
Report of a Task Corticosteroids: Arthrocentesis
Force of the methylprednisol Lumbar
EULAR Standing one, prednisone Puncture
Committee for Antimalarials: Renal biopsy
International hydroxychloroq
Clinical Studies uine
Including
Therapeutics
American
College of
Rheumatology:
Clinical Practice
Guidelines.
Musculoskeletal Neoplastic AM:CCU, AHA, GAS, K+C, Bone Sarcomas: NSAIDS MSK X-rays
Disease: bone OHGP, R+WA+P. ESMO Clinical Paracetamol examination CT - lungs
cysts/tumours, Practice Codeine General MRI
osteosarcoma Guidelines Tramadol examination Total body bone
Morphine scanning
Incision biopsy/
Core bone
biopsy