Phys Clinical Cases · rheumatological
Osteoarthritis — DCE Clinical Case
DCE long-case and short-case station for Osteoarthritis.
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Target exams
FRACP DCEMRCP PACES
Prompt
DCE long-case and short-case station for Osteoarthritis.
Osteoarthritis — Clinical Case
DCE Long Case
Patient brief
Patient: A middle-aged or older adult with multimorbidity and a presentation centred on Osteoarthritis. [1]
Presenting complaint: Subacute or acute symptoms referable to Osteoarthritis, with enough detail to force prioritisation. [1] [2]
Past history: Common cardiometabolic and organ comorbidities that interact with the plan. [2]
Medications: A polypharmacy list that includes at least one interaction or dosing issue. [2]
Examination: Key positives and critical negatives for dangerous differentials. [1]
Investigations: A small set of results that change management. [1] [2]
Tasks
- Present a prioritised problem list. [1]
- Defend investigations and immediate therapy. [1] [2]
- Provide safety-net and follow-up advice. [2]
Model discussion points
- Working diagnosis and acuity. [1]
- Differentials and discriminators. [2]
- Treatment sequence and monitoring. [1] [2]
- Multimorbidity and communication. [2]
References2ShowHide
- [1]Kolasinski SL, Neogi T, Hochberg MC et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee Arthritis care & research, 2020.PMID 31908149
- [2]Katz JN, Arant KR, Loeser RF Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review JAMA, 2021.PMID 33560326