Hands On
Reports on the Rheumatic Diseases Series 5
These reports are written by specialists on subjects relevant to primary care. Each issue will contain a variety of additions such as consultant comments, audit ideas, patient leaflets and case histories.
WARNING: THESE PUBLICATIONS ARE INTENDED FOR MEDICAL PRACTITIONERS. SOME OF THEIR CONTENTS MAY BE DISTURBING TO READERS WITH ARTHRITIS OR THEIR CARERS.
pGALS – A Screening Examination of the Musculoskeletal System in School-Aged Children
June 2008 No 15
The majority of causes of MSK presentations in childhood are benign, self-limiting and often trauma-related; referral is not always necessary, and in many instances reassurance alone may suffice. However, MSK symptoms can be presenting features of potentially life-threatening conditions such as malignancy, sepsis, vasculitis and non-accidental injury, and furthermore are commonly associated features of many chronic paediatric conditions such as inflammatory bowel disease, cystic fibrosis, arthritis and psoriasis.
Management of Shoulder Disorders in Primary Care
February 2008 No 14
Shoulder disorders cause pain, limit the ability to perform many routine activities, and can significantly disrupt sleep. Self-reported prevalence of shoulder pain is estimated at between 16% and 26% in the general population. Shoulder disorders are the third most common primary care musculoskeletal presentation (after back and neck pain) and, while most people recover within 3 months, recurrence or chronic symptoms may occur in a significant proportion of patients.
Management of Back Pain in Primary Care
October 2007 No 13
[with 'Information and Exercise Sheet' and video clips] Most of us appreciate the difficulties of people who suffer back pain because 60–80% of us get it at some time in our life. Back pain is one of the commonest reasons for people consulting their GP and taking time off work. Misconceptions surrounding back pain and activity or exercise, often inadvertently reinforced by clinicians, are a major reason for this epidemic.
Diagnosing Inflammatory Disorders
June 2007 No 12
The early recognition of chronic inflammatory arthritis is crucially important as there is increasing evidence of the benefits of early intervention. The concept of a 'window of opportunity' implies that the benefits of early intervention may be disproportionately large and last a long time.
Osteoporosis
February 2007 No 11
Osteoporosis is defined as a progressive, systemic skeletal disorder characterised by low bone mass and microarchitectural deterioration of bone tissue, with consequent increase in bone fragility and susceptibility to fracture.
Common Foot Disorders
October 2006 No 10
The foot is one of the most complex structures, yet is often taken for granted and generally ignored. Many patients develop foot pain which they believe will settle until symptoms become chronic and they seek help. The focus of this article is to outline some of the common conditions and management strategies.
Connective Tissue Disease in Primary Care
June 2006 No 9
Connective tissue diseases (CTD) are chronic inflammatory autoimmune disorders which can affect all connective tissues, i.e. joints, skin, muscles and blood vessels, and therefore have multiple effects on many different organs throughout the body.
Management of Cardiovascular Risk in RA and SLE
February 2006 No 8
Each general practitioner with an average list size has approximately 15 patients with rheumatoid arthritis (RA) and one with systemic lupus erythematosus (SLE). Both diseases are associated with a marked increase in cardiovascular morbidity and mortality.
Hypermobility
October 2005 No 7
Hypermobility (HM) – excessive mobility – can occur in a single joint, or it can be more widespread throughout the body. Usually HM joints cause no problems and are even an asset in sports such as gymnastics and artistic professions such as ballet and music.
An Exercise in Knee Pain Self-Management
June 2005 No 6
[with 'Information and Exercise Sheet'] Throughout our lives our knee joints put up with a lot of (ab)use. About 25% of people over the age of 55 years complain of chronic knee pain – usually diagnosed as osteoarthritis (OA) – and for 10% the pain is disabling.
Chronic Knee Pain in the Elderly
February 2005 No 5
Many older people are troubled by chronic knee pain that can have a major effect on their quality of life. Helping our patients to cope with knee pain can be challenging. Because of an ageing population and increasing obesity, the number of older people with disabling knee pain is set to increase substantially.
Anterior Knee Pain
October 2004 No 4
This term describes acute knee pain for which there is no specific identifiable cause. It is assumed that anterior knee pain is synonymous with the descriptive terms retropatellar and patellofemoral pain.
Carpal Tunnel Syndrome
June 2004 No 3
The carpal tunnel is the space at the base of the wrist bounded on three sides by the carpal bones and covered by the flexor retinaculum. It is approximately as wide as the thumb and has its proximal border deep to the distal wrist skin crease.
Plantar Fasciitis and Heel Pain
February 2004 No 2
[with 'Information and Exercise Sheet'] Painful feet are common. Bunions, corns, metatarsalgia and osteoarthritis abound, and are usually obvious. Pain behind the heel is usually due to Achilles tendinitis and inflammation of the various bursae. This article focuses on those conditions resulting in pain below the heel, of which the commonest by far is plantar fasciitis.
Polymyalgia Rheumatica
September 2003 No 1
The diagnosis of polymyalgia rheumatica (PMR) can present a difficult challenge in primary care as there are no specific diagnostic tests and diagnosis depends on having a high index of suspicion supported by history, examination and raised inflammatory markers.
Click here for Reports on the Rheumatic Diseases Series 6 : Hands On
Click here for Reports on the Rheumatic Diseases Series 4 : In Practice
