Weekly outline

  • WELCOME TO MSK 250

    Integrated Clinical Clerkship in the Musculoskeletal System

    This course involves rotation in three (3) departments: Orthopedics, Rehabilitation Medicine and Division of Rheumatology, Department of Medicine, with supervised participation in the diagnosis, management and prevention of common musculoskeletal conditions. It is team-taught with emphasis on interdisciplinary approach.

    This is a 2-week course for a total of 76 hours (38hours/week).

    This course is designed primarily to cover the following outcomes:

    1. clinical competence:  particularly in the clinical and laboratory diagnosis of musculoskeletal disease, in the management and prognostication of common conditions 
    2. effective communication skills:  relevant to eliciting and synthesizing clinical information from a patient with musculoskeletal disease, and in providing appropriate information to these patients
    3. system-based practice:  utilize the necessary health network to provide for continuing care of patients with musculoskeletal disease
    4. professionalism:  relate to patients with sensitivity and empathy, and a reflective understanding of their individual needs 
    5. advocacy for social equity:  appreciate the difficulties and challenges of patients with musculoskeletal disease

    Planned instructional content are as follow:

    1. 10 minute video on the symptomatology of musculoskeletal complaints
    2. 10 minute video on approach to a patient with musculoskeletal symptoms
    3. 10 minute video on the MSK screening examination (Gait, Arms, Legs, Spine)
    4. 7 minute video on using the P-drug concept in choosing drugs for patients with musculoskeletal disease
    5. 6 minute video capturing patient experiences by showing portions of a day in their lives
    6. Daily dose video on the following 
      1. Ankylosing spondylitis 
      2. Gout 
      3. Osteoporosis 
      4. Painful shoulder 
      5. Rehab strategies for painful joints 
      6. Scoliosis 
      7. lumbar pain 
    7. A video Lecture on Telerehabilitation 

     

    COURSE MATERIALS

    All materials and learning resources will be available online. If you have problems connecting to the internet please email @up.edu.ph or call +6328  8675309 for assistance. We will have our alumni send course materials to you.

     

    COURSE REQUIREMENTS

    1.     Community Infographic on MSK 250 (10% of the final grade)

    2.     Special Exam Video Recording (15% of the final grade)

    3.     Applying the algorithm (10% of the final grade) 

    4.     Practical Radiology test  (5% of the final grade)

    5.     Case discussion  (30% (each activity) of the final grade)

    6.     Final Exam (30% of the final grade)

     

    1. Infographic activity

    The learners are grouped by 5 and are tasked to create an infographic for one specific condition assigned to them. Infographic is tailored to fit a target community. Submission is on the second Tuesday of the rotation.

    2. Special exam video recording 

    The learners are grouped by twos. They are assigned to demonstrate and annotate a special test for MSK assessment. Online submission is on the first Friday of the rotation.

    3. Applying the algorithm

    The learners are grouped in 4 to 5 and are given 5 different clinical scenarios. They will each map the clinical scenario following the algorithm set. Is the algorithm always correct ? We shall see.

    4.Practical Radiology Test

    The learners are given an online written exam on practical radiology. Proper test requests, and radiographic interpretation is assessed.

    5.Case Discussion

    We invested one week to review and build on your knowledge, now its time to go the clinics!

    Actual patients will be seen or online patients will be introduced using an Econsult/OCRA platform.  

    6. Final Exam

    Online summative exam to assess how well we performed our jobs as facilitators to your learning

    References : 

    List of References:  Required readings are taken from the following recommended textbooks:

        1. Harrison’s Textbook of Internal Medicine 17th edition(Ch 308-309, 313-314, 316-321, 325-331)
        2. Bates: A guide to Physical Examination and History taking 10th edition
        3. Hoppenfield: Physical Examination of the Spine and Extremities

     Additional References 

      1. Braddom Principles of Physical Medicine and Rehabilitation 3rd edition (ch37-44)
        2. De Lisa’s Physical Medicine and Rehabilitation Principles and Practice 4

    th

      edition (Ch26-38)
      1. Pharmacology by Goodman and Gillman
      2. Turek SL. Bone Infections, In Orthopedics: Principles and their Application 4th edition volume 1 pp 258-282; 442-444. Vol 1: 1984.  n

  • ORIENTATION

  • Videos for PE of the spine and Extremities

    i want you to watch this before attending the didactics on PE of the Spine and Extremities .

    The following are the list of videos on special tests. 

    Empty can test: https://youtu.be/DeO50UTxwoo

    Apprehension test: https://youtu.be/jZ29dAXKA5M
    Scapular winging: https://youtu.be/btp9l6vD330

    • Video on Approach to a patient with musculoskeletal diseases Page

      This part of the course guides the student on how to elicit important details related to the chief complain of the patient. The most common symptom that brings the patient with MSK disease is PAIN. There are over one hundred diseases that present with pain. Other complaints can be deformity and disability. 

      Video 1 consists of details important to elicit in the history and physical examination.

      At the end of the video are two cases and questions to answer. This will be submitted.

    • Spine Quiz
      Opened: Friday, 4 July 2014, 11:39 AM

  • Algorithm in the diagnosis of MSK diseases

    Video 2 contains an algorithm to the diagnosis of rheumatic diseases modified from the Harrison's Textbook in Internal Medicine 20th edition. Please read this portion of the text book to complete the details of the algorithm.

  • PE of the Spine and Extremities

    This lecture focuses on the common special tests being done on patients complaining of MSK complaints like pain /swelling or injury or limited movement . 

    Students are required to demonstrate the special test with their assigned pairing. 

    The expected output from the students : 

    Submission of video on appropriate special test  based on case analysis .

  • CLINICS 1 RHEUMATOLOGY

    THIS IS A 4 HOURS SESSION WITH AN ACTUAL PATIENT AND AN ATTENDING FACULTY. THE FIRST HOUR OR 2 IS WITH A PATIENT AND THE NEXT 2 HOURS CONSISTS OF DISCUSSION OF THE CASE WITH THE FACULTY. DISCUSSION POINTS INCLUDE:

    1. HISTORY AND PE FINDINGS WITH DEMONSTRATION OF PE FINDINGS

    2. DIFFERENTIAL DIAGNOSIS AND WORKING DIAGNOSIS

    2. DIAGNOSTIC EXAMINATIONS

    3. TREATMENT PLAN

    RESOURCES TO BRING:

    1. BP APPARATUS

    2. TAPE MEASURE

    3. STETHOSCOPE

    4. NOTEPAD AND PENS

    AT THE END OF THE EXERCISE, PLEASE PROCEED TO SUBMISSION OF WRITE-UP. 

  • MSK 250 DAILY DOSE

    The students will be provided with daily dose on MSK conditions like gout , Scoliosis, LBP ,etc

    Daily Dose includes : 

    Day 2 - Ankylosing Spondylitis 

    Day 3 - Gout 

    Day 4- Osteoporosis 

    Day 5 - Shoulder pain 

    Day 6 - Rehab Strategies 

    Day 7 - Scoliosis 

    Day 8 - LBP 

  • SPECIAL LECTURE ON TELEREHABILITATION MEDICINE

    Telerehabilitation flourished during this pandemic . This is the technology at present to gather information about patient's condition and even therapy sessions were given virtually by respective paramedical personnel.  Even before COVID19 , students were provided with Orientation on Telerehabilitation . 

  • CLINICS IN ORTHOPEDICS

    This will be replace by paper case and case Preceptorial. 

    A paper case will be provided where individual student will have to answer and submit on 2nd Monday of the 2 week rotation.

    Meeting the mentors will be arranged on Monday for clarifications. The time will be announced via VLE or SMS (c/o LO) 

  • OPD

    • ( Dr Manu Perjes' Case) Individual Case Discussion of a Musculoskeletal Rehabilitation Medicine Case: Cold Shoulder Quiz

      Instructions to Students:

      This is an interactive case discussion. This paper case was developed to simulate a common actual patient’s case. The objective of this activity is to develop your thought process skills when presented with a common musculoskeletal case. It will measure your ability to take the history and physical examination and your understanding to the given case - how to arrive at the final diagnosis, how to manage the patient conservatively through medical and rehabilitation treatment and/or surgically. 

      Parts of the history and physical examinations are divided into 6 handouts and should be done chronologically. After the end of each handout, you will be asked to answer a series of questions in an essay/tabulated format and to do tasks by watching videos about the physical /diagnostic examination done in the case. 

      You are given 5 hours to answer all the questions provided on each handout. You can only take the course once, so read and finalize your answer before clicking the "submit all and finish" button. Kindly read the answer feedback thoroughly given after each handout. For the videos, just click the given link and watch.  You are given 2 weeks to finish this case, but it is advisable to finish the activity within your 1 week rotation to avoid backlog on your next rotation. 

      Required Reading Materials: Braddom (Chapter 1 and 35) and/or De Lisa (Chapter 35). 

      Tips and Suggestions: Since this is done individually and requires you to answer in essay/tabulated format, it may take a lot of your time particularly if you have unstable internet access. Read the required chapters of the books before answering this case - will lessen your time to answer. VLE site tends to automatically sign you out after being idle for a few hours - make a draft and save your answer in a different worksheet (i.e MS word) then just attach it to your answer sheet. 

      For any questions and clarifications, just inform your Liaison Officer. He/she will contact the course coordinators.

      Unless you are ready to start answering, DO NOT open the "Cold Shoulder: Part I" below.  

    • Cold Shoulder Part I Quiz
      Opened: Monday, 20 April 2020, 8:00 AM
    • Cold Shoulder Part II Quiz
      Opened: Monday, 20 April 2020, 6:00 PM
      Restricted Not available unless: The activity Cold Shoulder Part I is marked complete
    • Cold Shoulder Part III Quiz
      Opened: Monday, 20 April 2020, 6:00 PM
      Restricted Not available unless: The activity Cold Shoulder Part II is marked complete
    • Cold Shoulder Part IV Quiz
      Opened: Monday, 20 April 2020, 6:00 PM
      Restricted Not available unless: The activity Cold Shoulder Part III is marked complete
    • Cold Shoulder Part V Quiz
      Opened: Monday, 20 April 2020, 6:00 PM
      Restricted Not available unless: The activity Cold Shoulder Part IV is marked complete
    • Cold Shoulder Part VI Quiz
      Opened: Monday, 20 April 2020, 6:00 PM
      Restricted Not available unless: The activity Cold Shoulder Part V is marked complete
    • (Dr Sharon Ignacio's Case) Group Case Management Plan of a Musculoskeletal Rehabilitation Case: "A Milestone on my Neck" Assignment
      Opened: Thursday, 23 April 2020, 12:00 AM
      Restricted Not available unless: The activity ( Dr Manu Perjes' Case) Individual Case Discussion of a Musculoskeletal Rehabilitation Medicine Case: Cold Shoulder is marked complete

  • UPMVLE Musc 250 (iTuro) E-Learning Experience Evaluation Form

    • UPMVLE Musc 250 (iTuro) E-Learning Experience Evaluation Form Assignment
      Opened: Tuesday, 28 April 2020, 12:00 AM
      Due: Monday, 17 May 2021, 12:00 AM
      Restricted Not available unless: The activity (Dr Sharon Ignacio's Case) Group Case Management Plan of a Musculoskeletal Rehabilitation Case: "A Milestone on my Neck" is marked complete

      The whole course is still under redevelopment and upgrading to make your virtual learning experience with Rheumatology-Orthopedic-Rehabilitation Medicine worthwhile.  In line with this, we would highly appreciate it if you would answer the E-learning experience evaluation form to help us improve the course.