OSTEOARTICULAR APPARATUS DISEASES
Academic year and teacher
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- Versione italiana
- Academic year
- 2017/2018
- Teacher
- LEO MASSARI
- Credits
- 10
- Didactic period
- Primo Semestre
Training objectives
- RHEUMATOLOGY
This course will equip the student with a broad view of aetiology and physiopathology of inflammatory and degenerative rheumatic and connective tissue diseases. On this background, clinical symptoms of the diseases will be systematically described in order to achieve a good diagnostic (clinical, laboratory and imaging) and the rationale for the most appropriate therapeutic approach. Special emphasis will be placed upon early diagnosis and therapy (including biologic drugs) for the systemic life-threatening diseases.
The educational aim is focused on promoting knowledge in: a) the early recognition of the diseases; b) the symptoms that could arise the suspect of a relevant diseases (so-called "red flags") ; c) the ability to identify predictive factors of "outcome" of the diseases; d) the development of a critical appraisal of a diagnostic pathways; e) the basic therapeutic approach.
Furthermore, students will acquire notions on the interpretation of the most relevant laboratory and diagnostic procedures. Finally, the student will be able to illustrate to the patient the relevant aspects of the diseases and to suggest the right behaviour in order to prevent or minimize the risk.
ORTHOPAEDICS AND TRAUMATOLOGY
At the end of the course the student will know the anatomy and the physiology of the . musculoskeletal system.
They also will know the most important malformative, degenerative, traumatic and tumoral diseases of the musculoskeletal system, using the anamnestic data, the clinical signs and the instrumental diagnostic tools. Furthermore they will know the most used conservative and surgical therapies.
PHYSICAL AND REHABILITATION MEDICINE
This course will equip the student with basic principles of rehabilitation, restoration of function and reintegration into the community. Special emphasis will be placed on the hallmark of rehabilitation Medicine: ICF - International Classification of Functioning, Disability and Health (World Health Organization).
At the end of the course the student will know the modern modalities and instruments of patient evaluation, the interdisciplinary team care in the joint and musculoskeletal diseases considering that the disability cannot be isolated from preexisting and concurrent medical problems.
The student must be aware that there is no one-to-one correlation between a disease and the spectrum of disability problems that may be associated with it. The disability is dependent on the patient’s total requirements.
PATHOLOGICAL ANATOMY
Basic knowledge of epidemiology, pathogenesis and morphology of the most frequent inflammatory diseases and neoplasms of bones, joints and soft tissues, with correlations with their clinical features. Prerequisites
- Knowledge of anatomy, physics, physiology, pathology.
The student needs to have good knowledge of the anatomy and physiology of the musculo-skeletal system as well as basic knowledge of other relevant organs and systems. Furthermore, it is necessary to have good knowledge of the cellular biology and physiology, immunology, with particular emphasis for the immuno-mediated inflammation and autoimmunity, genetic and molecular biology. Basic knowledge of medical, physical and instrumental, semeiotic is also required. Course programme
- RHEUMATOLOGY
GENERAL PART: classification and epidemiology of rheumatic diseases.
Semeiotics of musculo-skeletal pain. Basic semeiotics of musculo-skeletal system.
Interpretation of basic lab test (inflammation tests and diagnostic tests) and of the relevant imaging techniques (conventional Rx, ultrasound, CT, MRI, scintigraphy).
Early diagnosis of systemic rheumatic diseases and the so-called "red-flags".
Reasoned diagnostic pathways in rheumatology.
Symptomatic therapies (analgesic, NSAIDs, physical therapy). Steroids. Disease-modifying anti-rheumatic drugs including biotechnological agents.
SPECIAL PART: Septic and post-infective arthritis.
Chronic inflammatory arthritis (Rheumatoid arthritis, Spondylo-entesoarthritis).
Connective tissue diseases (SLE, Systemic sclerosis, Systemic Vasculitis, Polymyositis-dermatomyositis, Sjogren syndrome, Polymyalgia Rheumatica, Antiphospholipid antibodies syndrome, Undifferentiated connective tissue diseases).
Osteoarthritis.
Crystal induced arthropathies (gout, chondrocalcinosis).
Soft tissue rheumatisms and fibromyalgia.
Low back pain.
Metabolic bone diseases (osteoporosis, Paget's disease, aseptic necrosis).
Main paraneoplastic syndromes of rheumatological interest.
Additional professional skills related to the different topics to be acquired during practical exercises: basic semeiotics maneuvers in rheumatology, introduction to clinimetry in rheumatology,.
Attend to the following procedures: joint injection and arthrocentesis, capillaroscopy, joint and tendons ultrasound, bone densitometry, synovial fluid analysis
ORTHOPAEDICS AND TRAUMATOLOGY
Classifications and types of fractures. Healing processes of the fractures. Fractures’ complications. Fractures of the joints. Femoral neck fractures. Vertebral fractures.
Osteoarthritis of the hip, knee, spine. Congenital dysplasia of the hip. Meniscal and ligamentous lesions of the knee. Femoral head necrosis. Herniated disk. Scoliosis. Shoulder tendinopathy. Benign and malignat tumors of the skeleton and metastases.
PHYSICAL AND REHABILITATION MEDICINE
Basic principles of rehabilitation.
ICF - International Classification of Functioning, Disability and Health.
Rehabilitation mode with the implementation of the individual rehabilitation project based on a bio-psycho-social approach that also considers gender differences.
The interdisciplinary team in Rehabilitation Medicine.The comprehensive treatment team in rehabilitation
Evaluation and treatment of the principal neuromusculoskeletal movement-related disorders, related to the type of disablement, age and gender of the person.
Indications of Therapeutic Physical Agents: heat and cold; electrotherapy, hydrotherapy, electromagnetic fields.
ANATOMIC PATHOLOGICY
1 – Bones and joints
Developmental and acquired disorders of bone and cartilage.
Healing of fractures.
Infection, inflammation, necrosis. Infective and seronegative arthritis. Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis.
Bone-forming tumors, cartilage- forming tumors, tumors of unknown origin.
2 - Soft Tissue Pathology
General characteristics and classification of soft tissue tumors. Grading and staging of sarcomas.
Adipocytic tumors, fibrous tumors, fibrohistiocytic tumors, smooth-muscle tumors, skeletal- muscle tumors, vascular tumors, nerve sheath tumors, tumors with uncertain histogenesis. Didactic methods
- RHEUMATOLOGY
The course forecasts 16 hours of teaching (frontal lectures) and 1 professionalizing CFU provided in practical exercises to be achieved (o the basis of scheduled calendar) bedside, in day hospital and outpatients acticvities, in the UOC di Reumatologia dell’Azienda Ospedaliero-Universitaria S. Anna di Cona.
ORTHOPAEDICS AND TRAUMATOLOGY
The course forecasts 24 hours of teaching (frontal lectures) and 1 professionalizing CFU provided in practical exercises dedicated mainly to the vision and description of radiographic and instrumental images
ANATOMIC PATHOLOGY
Lectures Learning assessment procedures
- RHEUMATOLOGY
Oral exam: average 1-2 questions about the course programme, mean duration 15 min. (it will be evaluated clarity, link ability, strictness and communication capability)
ORTHOPAEDICS AND TRAUMATOLOGY
Oral exam: an average of 2 questions on the program, one of which on a given disease, and 1 on the vision and identification of a specific radiographic image (approximately 15 minutes). Assessing the clarity of the ability to link the rigor and communication skills
PHYSICAL AND REHABILITATION MEDICINE
Multiple-choice test (one correct answer out of four or five options). There will be at least 20 test items. Only the correct answers count.
ANATOMIC PATHOLOGY
Written test with one open-ended questions. The available space for the three answers is 60 lines. Time: 30 minutes. To evaluate the answers will be assessed the relevancy to the question, control of the topic and completeness of the information. To the script will be assigned a score in thirtieth.
THE FINAL GRADE RESULTS FROM THE ARITHMETIC AVERAGE OF THE MARKS OBTAINED IN EACH TEST.
The final outcome will depend also on the practice sessions. Reference texts
- RHEUMATOLOGY
UNIREUMA: Reumatologia per studenti e medici di medicina generale, Idelson-Gnocchi ed., 2008
Todesco S., Gambari P.F., Malattie reumatiche 3° ed., McGraw-Hill Companies ed., 2011
QUICK REVIEW REUMATOLOGIA a cura di F. Trotta e M. Govoni. Edizioni EdiSES 2014
For a further in deep knowledge:
EULAR Textbook on Rheumatic Diseases (in lingua inglese) BMJ Group 2012 Editor JWJ Bijlsma
CORE CURRICULUM – Reumatologia . L. Punzi, A. Doria. McGrawHill Education 2014
R. Perricone, Malattie autoimmuni sistemiche, Società Editrice Universo 2013
ORTHOPAEDICS AND TRAUMATOLOGY
Grassi F.A., Pazzaglia U.E., Pilato G., Zatti G., Manuale di Ortopedia e Traumatologia, Elsevier Ed. 2012
PHYSICAL THERAPY AND REHABILITATION
N. Basaglia (Ed). Medicina Riabilitativa. 4 volumi. Napoli: Idelson-Gnocchi, 2009
N. Basaglia (Ed). Progettare la Riabilitazione. Il lavoro in team interprofessionale. Milano: EdiErmes, 2002
PATHOLOGICAL ANATOMY
Robbins and Cotran Pathological Basis of Diseases. Ninth edition, Elsevier 2015 (or previous editions)
Rubin, Anatomia patologica, 2014, Piccin Nuova Libraria
Mariuzzi G. M., Anatomia patologica e correlazioni anatomo-cliniche,2006, Piccin Nuova Libraria
