5. Secondary Care Themed Days

5.2. Day 3 Theme: Rheumatology & Orthopaedics

 Introduction – Rheumatological conditions are relatively common both in the primary care setting and within the hospital.

 

Challenge Box: List some common rheumatological conditions. Why may patients be admitted to hospital rather than being cared for in the primary care setting? Why is the MDT so important in this area of medicine?

 

 

Rheumatologists are responsible for the diagnosis and ‘medical’ treatment of a vast spectrum of conditions ranging from the common osteoarthritis and rheumatoid arthritis to the less common systemic vasculitides. Many of these conditions are still poorly understood and their treatment remains largely palliative. However, recent advances in immunological and molecular biological sciences have helped to elucidate some of the pathophysiology underlying these complex conditions and have led to the development of new treatment strategies.

 

Orthopaedic surgery remains an important treatment option for those with chronic, degenerative arthritis as well as for those involved in acute trauma. Orthopaedic surgery is one of the most ‘instant’ medical subjects with patients often having immense pain and disability pre-operatively replaced by ability and freedom from pain almost immediately post-operatively. In both specialties the MDT play a very important role in both treatment and rehabilitation.

 

Learning Issues

  • Why is the Physiotherapist so vital in both rheumatology and orthopaedics?
  • What are the roles of the other members of the MDT in the management of elective and acute orthopaedic patients?
  • What are the unique and common clinical skills used by the Plaster technician?
  • What are the experiences of the patients you have met today regarding their inpatient and outpatient care?

 

Suggested Learning Tasks

  • Record the mechanism of injury and / or the course of the arthritis from the patients you have met today.
  • Chart the post-operative course of one orthopaedic patient, recording the MDT interventions.
  • Other than analgesia, which prophylactic medications should be recorded for all older patients with a fractured neck of femur? What side effects may they have?