Bone and joint diseases

The course will highlight the main clinical features of orthopaedics, rheumatology /clinical immunology/allergy and physical rehabilitation medicine to provide a comprehensive overview of the basic clinical presentations and treatment options of patient presenting with clinical history and evaluation suggesting orthopaedics or rheumatological problems. Further, the course will provide a comprehensive view of the semantics of the associated conditions and determine their common mechanisms and unique features.
The module of Orthopaedics introduces the students to clinical practice on patient evaluation and interpretations of specific investigations i.e. X-ray, CT scans, MRI for all different pathologies. Students are trained to the most updated knowledge on the commonest orthopaedic problems. The module of rheumatology, clinical immunology, and allergy tackles the approach to patients with an inflammatory, immune, allergic disease through a multidisciplinary approach based on history, physical examination, laboratory tests, and imaging. The characteristics of autoimmunity and chronic inflammation will be discussed, along with a general approach to the main complaints of patients with these conditions. The array of classification criteria included in the practice of rheumatology is one of the bases of the block, as well illustrated by rheumatoid and seronegative arthritis. Of note, clinical immunology is largely overlapping with rheumatology and manifests some peculiar interests such as immune deficiencies and shared grounds such as connective tissue diseases. Finally, the approach to allergies is discussed with a specific interest for the diagnostic tools and therapeutic approaches. Attention will be dedicated also to the numerous comorbidities shared by immune-mediated diseases, including cardiovascular disease and reproductive defects.
The module of Physical and Rehabilitation Medicine introduces the students to the basic techniques of assessment of passive mobility, strength and coordination, and to the essentials of treatment of orthopaedic and rheumatic disorders with therapeutic exercise and physical agents.

Students are expected to:
- Provide general terminology, anatomy, biomechanics, and function of the body major joints.
- Learn to recognize the most common articular problems from patients' complaints, clinical history and patients' physical examination.
- Learn to recognize the most common trauma problems and limb or life threatening injuries (trauma emergencies)
- Understand the pathological joints biomechanics and identify them on correct further investigations (XRAY; CT; MRI etc.)
- Reach the ability to recognize the entity of the disease (classifications) and start a correct therapeutic approach accordingly.
- Reach some basic understanding of the difference between a growing and a mature skeleton.
- Recognize some of the most common congenital deformities.
- Provide the general terminology and reporting for the major complaints of patients in a rheumatology clinic;
- Understand the main groups of serum autoantibodies and laboratory tests to be used in clinical practice;
- Understand the mechanisms of action of the main anti-inflammatory, disease-modifying, and anti-allergy medications and their adverse events;
- Apply the classification criteria for the discussed conditions;
- Understand the limits and strengths and provide a basic understanding of the imaging techniques (ultrasound, X rays, MRI, and CT scans) used in rheumatology;
- Provide a general approach to the diagnosis, management, and treatment of patients with a rheumatological, immunological, or allergic disease.
- Learn the correct kinesiology definition of joint movements;
- Learn how to assess joint mobility;
- Learn how to assess force, based on knowledge of muscle anatomy and physiology, and of the joint leverage;
- Learn the basic physiology of walking and how to steer its clinical observation;
- Learn the basic criteria for personalized prescription of therapeutic exercise and therapies with physical agents;
- Basic physiology of human walking with some hints on diagnosis of walking impairments.