Bone and joint diseases

A.A. 2019/2020
7
Crediti massimi
72
Ore totali
SSD
MED/16 MED/33 MED/34
Lingua
Inglese
Obiettivi formativi
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.
Risultati apprendimento attesi
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.
Programma e organizzazione didattica

Edizione unica

Responsabile
Prerequisiti
To adequately address the course, it is strongly suggested to refresh the macroscopic and histological anatomical bases of the musculoskeletal system and the knowledge of the physiology of the bone tissue.
To take the Bone and Joint Diseases exam, students must have already passed all the exams of the first and second year (Fundamentals of Basic Sciences, Cells, Molecules and Genes 1 and 2, Human Body, Functions and Mechanisms of Diseases).
Modalità di verifica dell’apprendimento e criteri di valutazione
The final assessment will consist of:
1. a written test with 60 multiple-choice questions (30 on orthopaedics, 20 on rheumatology, 10 on physical & rehabilitation medicine) each with only one correct answer. Test duration: one minute will be allowed for each question. The score for each section will be transformed into x/30, proportional to the number of correct answers. No penalties will be given to missing or wrong answers.
2. an oral examination (orthopaedics).
The final mark will take into account the scores achieved in the three sections of the MCQ test and the outcome of the oral test.
The exam is deemed to be passed successfully if the final grade is equal to or higher than 18/30. In the event of a full grade (30/30) honors (lode) may be granted with the consent of all the professors.
Registration to the exam through SIFA is mandatory.
Reumathology
Programma
Lesson 1a. Birth and decay of human frame Part 1: birth
Lesson 1b. Birth and decay of human frame Part 2: decay
Lesson 2a. Congenital malformations Part 1
Lesson 2b. Congenital malformations Part 2
Lesson 3. Bone fractures: biomechanics, imaging and treatment
Lesson 4. Biomechanics of deformities and correction strategies
Lesson 5. Approach to the immune system and rheumatology
Lesson 5a. Laboratory diagnosis and new therapies
Lesson 5b. Clinical cases of rheumatic disease
Lesson 6. The mechanisms of localized and generalized pain
Lesson 7. The role of inflammation in arthritis and spondyloarthritis
Lesson 8. Connective tissue diseases
Lesson 9a. Articular cartilage disease: surgery for cartilage
Lesson 9b. Articular cartilage disease: osteoarthritis
Lesson 10. Bone and soft tissue tumors
Lesson 11. Joint biomechanics and semeiotics: the hip
Lesson 12. Tendons and muscular abuse: sport medicine
Lesson 13. Joint biomechanics and semeiotics: the shoulder
Lesson 14. Joint biomechanics and semeiotics: the knee
Lesson 15. Joint biomechanics and semeiotics: the elbow, wrist and hand
Lesson 16. Joint biomechanics and semeiotics: the foot and ankle
Lesson 17. Vasculitidies
Lesson 18. Immunodeficiencies and allergies
Lesson 19. The physical and rehabilitation medicine approach. Why and what
Lesson 20. The physical and rehabilitation medicine approach. Who and how
Lesson 21. Walking and walking impairments: basic pathophysiology and clinical diagnostics
Lesson 22. Sport / diet and the immune system in health and rheumatic disease
Metodi didattici
Lectures, Clinical examination, OR exposure, Videos. Practical activities will be used, through simulation or in the ward, to consolidate technical and soft knowledge and skills developed during frontal lectures.
Materiale di riferimento
· Oxford Textbook of Rheumatology, 4th edition, 2013; Edited by Richard A. Watts, Philip G. Conaghan, Christopher Denton, Helen Foster, John Isaacs, and Ulf Müller-Ladner
· EULAR Textbook on Rheumatic Diseases: http://www.eular.org/index.cfm?framePage=/edu_textbook.cfm
· Review articles provided throughout the course
Orthopedics
Programma
The course is based on a strong integration of different disciplines, thus the program of the single disciplines cannot be extracted form the program of the whole course which is reported in module Reumathology.
Metodi didattici
Lectures, Clinical examination, OR exposure, Videos. Practical activities will be used, through simulation or in the ward, to consolidate technical and soft knowledge and skills developed during frontal lectures.
Materiale di riferimento
· The pdf version of the slides presented during the course lectures will be available to the students
· Orthopaedics and Traumatology Pocketbook of orthopaedics and fractures - McRae
· Essential orthopaedics and trauma - Dandy, Edwards
· Rheumatology, orthopaedics and trauma at a glance - Swales, Bulstrode
· Adam's Outline of orthopaedics - Hamblen, Simpson
Rehabilitation medicine
Programma
The course is based on a strong integration of different disciplines, thus the program of the single disciplines cannot be extracted form the program of the whole course which is reported in module Reumathology.
Metodi didattici
Lectures, Clinical examination, OR exposure, Videos. Practical activities will be used, through simulation or in the ward, to consolidate technical and soft knowledge and skills developed during frontal lectures.
Materiale di riferimento
CLINICAL IMMUNOLOGY, ALLERGY:
· Specific sections on the Harrison's principles of Internal Medicine
PHYSICAL AND REHABILITATION MEDICINE
· Essentials of Physical Medicine and Rehabilitation, 3rd Edition, 2015. Walter R. Frontera, Julie K. Silver and Thomas D. Rizzo, Jr. Elsevier
· The physiology of the joints (3 volumes). I.A. Kapandji. 6th Edition 2010. Elsevier
· Muscles: Testing And Function With Posture And Pain. 5th Edition 2005. Elizabeth Kendall McCreary and Patrica Geise Provance. Lippincott
Moduli o unità didattiche
Orthopedics
MED/33 - MALATTIE APPARATO LOCOMOTORE - CFU: 4
Lezioni: 48 ore

Rehabilitation medicine
MED/34 - MEDICINA FISICA E RIABILITATIVA - CFU: 1
Lezioni: 12 ore
Docente: Negrini Stefano

Reumathology
MED/16 - REUMATOLOGIA - CFU: 2
Lezioni: 12 ore

Siti didattici
Docente/i
Ricevimento:
lunedi e venerdì dalle 10,30 alle 12 (su appuntamento)
Ospedale G. Pini, piano 7/B
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su appuntamento da concordare via email
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Previo appuntamento da concordare via e-mail - Appointment to be agreed by e-mail
IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milano - Radiologia, piano -2 -
Ricevimento:
Su appuntamento
IRCCS Istituto Ortopedico Galeazzi
Ricevimento:
appuntamento tramite e-mail
appuntamento tramite e-mail
Ricevimento:
previo appuntamento da concordare via e-mail
Ricevimento:
Da concordare via email
IRCCS Istituto Ortopedico Galeazzi, Radiologia, piano -2