20 Care of people with musculoskeletal problems Applicable guidelines Relevant NICE guidelines and pathways: https://pathways.nice.org.uk/pathways/musculoskeletal- conditions SIGN guidelines (www.sign.ac.uk): 136 Management of chronic pain The British Institute of Musculoskeletal Medicine: www.bimm.org.uk The Primary Care Rheumatology Society: www.pcrsociety.org.uk Arthritis Research UK: www.arthritisresearchuk.org The British Association of Sport and Exercise Medicine: www.basem.co.uk/ The UK Anti-Doping website: https://ukad.org.uk/medications-and-substances/about-TUE/ The National Osteoporosis Society: www.nos.org.uk FRAX tool to evaluate fracture risk: www.shef.ac.uk/FRAX The Disabled Living Foundation: www.dlf.org.uk RCGP Inflammatory Arthritis Toolkit: www.rcgp.org.uk/clinical-and- research/resources/toolkits/inflammatory-arthritis-toolkit.aspx A resource to help GPs assess fitness for work: http://fitforwork.org Material for patient www.arthritisresearchuk.org has PILs available to download www.backcare.org.uk – charity for back health www.ccaa.org.uk – Children’s Chronic Arthritis Association www.bssa.uk.net – British Sjögren’s Syndrome Association CSA Cases Workbook for the MRCGP, 3e © 2019, Scion Publishing Ltd www.lupusuk.org.uk – lupus charity www.nass.co.uk – National Ankylosing Spondylitis Society www.nras.org.uk – National Rheumatoid Arthritis Society www.pmrandgca.org.uk – Polymyalgia Rheumatica and Giant Cell Arteritis Scotland www.sruk.co.uk – Scleroderma and Reynaud’s UK www.rsiaction.org.uk – national repetitive strain injury charity www.physioroom.com – online physio resources for common injuries www.sheffieldachesandpains.com – helps patients to manage musculoskeletal pain Geeky Medics shoulder examination video: youtu.be/TDs1IOFYnMo Geeky Medics hip joint examination video: youtu.be/KAgRJTsXHrU Geeky Medics knee examination video: youtu.be/B76oGAFKb28 Geeky Medics spine examination video: youtu.be/CJVGpciEMoI Geeky Medics hand examination video: youtu.be/xKNBfIxRlCs Geeky Medics GALS (gait / arms / legs / spine) examination video: youtu.be/g8-dMuzWal4 Case 20.1 Gout: patient.info/doctor/gout-pro NICE CKS on Gout: https://cks.nice.org.uk/gout Case 20.2 Plantar fasciitis: patient.info/doctor/plantar-fasciitis-pro NICE CKS on Plantar fasciitis: https://cks.nice.org.uk/plantar-fasciitis Exercise PIL: https://www.arthritisresearchuk.org/arthritis-information/exercises-to-manage- pain/foot-pain-exercises.aspx Case 20.3 Ankylosing spondylitis: patient.info/doctor/ankylosing-spondylitis-pro patient.info/doctor/low-back-pain-and-sciatica – useful for listing red flag symptoms for back pain NICE Spondyloarthritis overview: https://pathways.nice.org.uk/pathways/spondyloarthritis NICE Low back pain and sciatica overview: https://pathways.nice.org.uk/pathways/low-back-pain- and-sciatica Case 20.4 How to perform McMurray, Apley and Thessaly tests: www.racgp.org.au/afp/2012/april/meniscal- tear/ Full knee examination (including ligament testing, McMurray and Apley tests): https://www.youtube.com/watch?v=MgdkcX7koAg&list=PLAD99E958AC0F43B1 Thessaly test: https://www.youtube.com/watch?v=Psupbr9CpFE Meniscal tears: https://patient.info/health/sports-injuries/meniscal-tears-knee-cartilage-injuries CSA Cases Workbook for the MRCGP, 3e © 2019, Scion Publishing Ltd Case 20.5 Impingement tests: www.physio-pedia.com/index.php?title=Subacromial_Impingement_Cluster BJSM shoulder examination: https://www.youtube.com/watch?v=p60X8fADTeg&feature=youtu.be Shoulder pain: patient.info/doctor/shoulder-pain-pro Further reading: Resources for performing a focused shoulder exam can be found at: www.youtube.com/watch?v=C2EUrB4Tr6k www.shoulderdoc.co.uk CSA Cases Workbook for the MRCGP, 3e © 2019, Scion Publishing Ltd .