Core Adult Internal Medicine Disciplines

Rheumatology

Topics

• Familiarity with the classification, clinical features, laboratory findings, and pathophysiology of joint disease as well as the natural history and physical and psychological impact of both inflammatory and noninflammatory joint disorders, including:
  • Rheumatoid arthritis.
  • Infectious arthritis.
  • Osteoarthritis.
  • Ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel disease.
  • Systemic lupus erythematosus, Sjogren's syndrome, poly- and dermatomyositis, scleroderma (systemic sclerosis).
  • Vasculitis, including temporal arteritis and polymyalgia rheumatica.
  • Gout, pseudogout, and chondrocalcinosis.
  • Rheumatic manifestations of diseases in other medical specialties, e.g. cancer, diabetes, viral infections (including AIDS).
  • Osteoporosis, osteomalacia, and Paget's disease.
  • Low back pain and soft tissue rheumatism.
• Use of anti-inflammatory, disease modifying and immunosuppressive drugs: their adverse effects and safety monitoring procedures.
• The management of acute rheumatological emergencies, including:
  • The evaluation of an acutely hot joint.
  • Acute low back pain.
  • Management of vasculitis (in association with a connective tissue disorder).
  • Management of patients with temporal arteritis.
  • Development of cervical myelopathy in rheumatoid arthritis.
  • Assessment and evaluation of fever in a patient with an underlying connective tissue disease.
• Basic knowledge of the epidemiology and socio-economic impact of musculoskeletal disorders.
• Rheumatology should provide a format for the management of chronic progressive disorders, e.g. rheumatoid arthritis, including:
  • Appropriate use of medical therapy (analgesia, anti-inflammatory medication, disease modifying agents), relative role of orthopaedic surgery, the workings of a multidisciplinary team (including physiotherapy, nursing, occupational therapy, social work).
  • Means of evaluating and addressing disability and handicap (including the provision of aids, adaptations, and social support).
  • Providing psychological support.

Practical Skills for all Trainees

• Knee joint aspiration.
• Ability to carry out polarising light microscopy and analysis of synovial fluid for crystal induced disease.

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