Advice to GP’s on using MSK Proforma Upper Body

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Presentation transcript:

Advice to GP’s on using MSK Proforma Upper Body Shoulder Pain Neck Pain Inflammatory Non-inflammatory Inflammatory Non-inflammatory Rheumatology All other presentations Previous surgery # dislocator Rheumatology ICATS (MSK Triage) ICATS (MSK Triage) Orthopaedics Non Surgical management Surgical Management SUMMARY – All non-inflammatory shoulder pain refer to ICATS (MSK triage) except previous surgery/# or previous dislocation Inflammatory – refer rheumatology SUMMARY – All neck pain refer to ICATS (MSK triage) ICATS= Integrated clinical assessment and treatment service (= MSK Triage or Airedale NHST)

Advice to GP’s on using MSK Proforma Upper Body Elbow Pain Hand Pain Inflammatory Non-inflammatory Inflammatory Non-inflammatory Rheumatology Rheumatology Diagnosis Unsure Definite Soft tissue problem Tenosynouitis Carpel Tunnel Syndrome Trigger Finger Ganglion Other Conditions Refer Orthopaedics Refer ICATS (MSK Triage) Refer ICATS (MSK Triage) Refer Orthopaedics ICATS= Integrated clinical assessment and treatment service (= MSK Triage or Airedale NHST)

Advice to GP’s on using MSK Proforma Lower Body - KNEE Knee pain Inflammatory Non-Inflammatory Rheumatology Young Knee Old knee for replacement Middle aged knee (Under discussion with Orthopaedics) Previous # or surgery No trauma Traumatic Ref Orthopaedics Wishes surgery Not fit/ does not wish surgery ICATS (MSK Triage) ICATS (MSK Triage) Orthopaedics Refer orthopaedics ICATS (MSK Triage) Non Surgical Intervention Surgical Intervention Palliative Management SUMMARY –All knee pain to be referred to MSK Triage except: Traumatic/ Joint Knee OA Ready/ Fit for surgery Previous #/ Surgery ICATS= Integrated clinical assessment and treatment service (= MSK Triage or Airedale NHST)

Advice to GP’s on using MSK Proforma Back Pain Inflammatory Non-inflammatory Rheumatology Radicular Signs Chronic Non Specific ICATS (MSK Triage) New Radicular Pain Service - autumn 2009 New Chronic Pain Management Service - autumn 2009 ICATS= Integrated clinical assessment and treatment service (= MSK Triage or Airedale NHST)

Advice to GP’s on using MSK Proforma Lower Body – Foot and Ankle Pain Inflammatory Non-inflammatory Rheumatology Previous # or surgery All other conditions Orthopedics Refer ICATS (MSK Triage) Will include joint Podiatry autumn 2009 ICATS= Integrated clinical assessment and treatment service (= MSK Triage or Airedale NHST)

Advice to GP’s on using MSK Proforma Lower Body – Hip Hip Pain Inflammatory Non-inflammatory Rheumatology Hip OA Confirmed Diagnosis Unclear Previous Surgery / # Fit for surgery Not fit for surgery Refer ICATS (MSK Triage) Refer Orthopedics Refer Orthopedics Refer ICATS (MSK Triage) SUMMARY – All non-inflammatory shoulder pain refer to ICATS (MSK triage) except previous surgery/# or previous dislocation Inflammatory – refer rheumatology ICATS= Integrated clinical assessment and treatment service (= MSK Triage or Airedale NHST)

MSK Red Flags Requiring Urgent Referral MSK Symptom + Cauda Equina Symptoms Previous H/O Cancer Weight Loss Systemic Illness Orthopedics Or Spinal Surgeon Cancer Specialist Refer for Investigation weight loss not orthopedics Refer general Physician or urgent rheumatology ICATS= Integrated clinical assessment and treatment service (= MSK Triage or Airedale NHST)