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OSTEOARTICULAR APPARATUS DISEASES

Academic year and teacher
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Versione italiana
Academic year
2022/2023
Teacher
LEO MASSARI
Credits
10
Didactic period
Primo Semestre

Training objectives

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Modulo: 015483/6 - MEDICINA FISICA E RIABILITATIVA
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This course will equip the student with basic rehabilitation principles, restoration of function and reintegration into the community. Special emphasis will be placed on the hallmark of rehabilitation Medicine: ICF - International Classification of Functioning, Disability and Health (World Health Organization).
At the end of the course, the student will know the modern modalities and instruments of patient evaluation the interdisciplinary team care in joint and musculoskeletal diseases considering that the disability cannot be isolated from preexisting and concurrent medical problems.
The student must be aware that there is no one-to-one correlation between a disease and the spectrum of disability problems that may be associated with it. The disability is dependent on the patient’s total requirements.

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Modulo: 019595/4 - REUMATOLOGIA
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RHEUMATOLOGY
This course will equip the student with the essential instruments for a correct and wide reasoned clinical approach to the patient aimed to achieve the correct diagnosis, to establish the prognosis and discern the rationale for the most appropriate therapeutic approach. The most relevant aetiologic and physiopathologic basis of the inflammatory, autoimune and degenerative rheumatic disease will be provided. On this background, clinical symptoms of the diseases will be systematically described in order to achieve a good diagnostic approach using clinical, laboratory and imaging information. Special emphasis will be placed upon early diagnosis and therapy (including biologic drugs) for the systemic life-threatening diseases.
The educational aim is focused on promoting knowledge in: a) the early recognition of the diseases; b) the symptoms that could arise the suspect of a relevant diseases (so-called "red flags") ; c) the ability to identify predictive factors of "outcome" of the diseases; d) the development of a critical appraisal of a diagnostic pathways; e) the basic therapeutic approach.
Furthermore, students will acquire notions on the interpretation of the most relevant laboratory and diagnostic procedures. Finally, the student will be able to illustrate to the patient the relevant aspects of the diseases and to suggest the right behaviour in order to prevent or minimize the risk modifiable factors. Differences in term of sex/gender and age, in terms of diagnostic approach, prognosis and response to the treatment of the main rheumatic diseases, will be illustrated.

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Modulo: 21277 - DIAGNOSTICA PER IMMAGINI
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Modulo: 47784 - MALATTIE APPARATO LOCOMOTORE
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ORTHOPAEDICS AND TRAUMATOLOGY
At the end of the course the student will know the anatomy and the physiology of the . musculoskeletal system.
They also will know the most important malformative, degenerative, traumatic and tumoral diseases of the musculoskeletal system, using the anamnestic data, the clinical signs and the instrumental diagnostic tools.
Furthermore they will know the most used conservative and surgical therapies.
The must onsider the role of gender differences in terms of diagnostic approach, prognosis and response to the treatment of the main Muskulo-skeletal diseses, both degenerative and traumatic, also in relation to gender differences.

Prerequisites

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Modulo: 015483/6 - MEDICINA FISICA E RIABILITATIVA
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None

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Modulo: 019595/4 - REUMATOLOGIA
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Conoscenze di base di anatomia, biologia molecolare, genetica, fisiopatologia e patologia generale
Conoscenze di anatomia e fisiologia dell'apparato locomotore e dei principali organi ed apparati. Buone conoscenze di biologia e fisiologia cellulare, di immunologia, con particolare riguardo per i processi flogistici immuno-mediati, le malattie autoinfiammatorie e l’autoimmunità. Nozioni generali di farmacologia. Conoscenze di semeiotica medica generale sia fisica che strumentale.
Basic knowledge of anatomy, molecular biology, genetics, physiopatholy and gerel pathology.
The student needs to have good knowledge of the anatomy and physiology of the musculo-skeletal system as well as basic knowledge of the other organs and systems. It is necessary to have good knowledge of the cellular biology and physiology, immunology, with particular emphasis for the immuno-mediated inflammation, autoinflammatory diseases and autoimmunity. Basic knowledge of medical, physical and instrumental, semeiology are required.

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Modulo: 21277 - DIAGNOSTICA PER IMMAGINI
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Modulo: 47784 - MALATTIE APPARATO LOCOMOTORE
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Knowledge of anatomy, physics, physiology, pathology.
The student needs to have good knowledge of the anatomy and physiology of the musculo-skeletal system as well as basic knowledge of other relevant organs and systems. Furthermore, it is necessary to have good knowledge of the cellular biology and physiology, immunology, with particular emphasis for the immuno-mediated inflammation and autoimmunity, genetic and molecular biology. Basic knowledge of medical, physical and instrumental, semeiotic is also required.

Course programme

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Modulo: 015483/6 - MEDICINA FISICA E RIABILITATIVA
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Basic principles of rehabilitation. ICF - International Classification of Functioning, Disability and Health. Rehabilitation mode with the implementation of the individual rehabilitation project based on a bio-psycho-social approach that also considers gender differences. The interdisciplinary team in Rehabilitation Medicine. The multidisciplinary rehabilitation team and the definition of the Individual Rehabilitation Project.

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Modulo: 019595/4 - REUMATOLOGIA
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GENERAL PART: classification and epidemiology of rheumatic diseases.
Semeiology of musculo-skeletal pain and clinical approach to the joint and osteoarticular pain.
Interpretation of basic lab test (inflammation tests and diagnostic tests) and of the relevant imaging techniques (conventional Rx, ultrasound, CT, MRI, nuclear medicine).
Early diagnosis of systemic rheumatic diseases and the so-called "red-flags".
Reasoned diagnostic pathways in rheumatology.
Symptomatic therapies (analgesic, NSAIDs, physical therapy). Steroids. Disease-modifying anti-rheumatic drugs including biotechnological and targeted synthetic drugs.
Sex / gender and age related differences in main systemic autoimmune rheumatological diseases.
SPECIAL PART:
Chronic inflammatory arthritis (Rheumatoid arthritis, Spondylo-entesoarthritis: psoriatic arthritis and anlylosing spondylitis).
Connective tissue diseases (SLE, Systemic sclerosis, Systemic Vasculitis, Polymyositis-dermatomyositis, Sjogren syndrome,Antiphospholipid antibodies syndrome, Undifferentiated connective tissue diseases).
Polymyalgia Rheumatica
Infectious arthrtitis
Osteoarthritis.
Crystal induced arthropathies (gout, pyrophosphate arthropathy).
Hints about localized soft tissue rheumatisms and fibromyalgia.
Low back pain (mechanical and inflammatory).
Metabolic bone diseases (osteoporosis)
Hints about main paraneoplastic syndromes of rheumatological interest.
Additional professional skills related to the different topics to be acquired during practical exercises: patient's history, basic semeiological maneuvers in rheumatology, introduction to clinimetry in rheumatology,.
Attend to the following procedures: joint injection and arthrocentesis, capillaroscopy, joint and tendons ultrasound, bone densitometry, synovial fluid analysis

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Modulo: 21277 - DIAGNOSTICA PER IMMAGINI
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Modulo: 47784 - MALATTIE APPARATO LOCOMOTORE
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ORTHOPAEDICS AND TRAUMATOLOGY
Classifications and types of fractures. Healing processes of the fractures. Fractures’ complications. Fractures of the joints. Femoral neck fractures. Vertebral fractures.
Osteoarthritis of the hip, knee, spine. Congenital dysplasia of the hip. Meniscal and ligamentous lesions of the knee. Femoral head necrosis. Herniated disk. Scoliosis. Shoulder tendinopathy. Benign and malignat tumors of the skeleton and metastases.

Didactic methods

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Modulo: 015483/6 - MEDICINA FISICA E RIABILITATIVA
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Lectures.

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Modulo: 019595/4 - REUMATOLOGIA
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The course forecasts 16 hours of teaching (frontal lectures) and 1 professionalizing CFU provided in practical exercises to be achieved (o the basis of scheduled calendar) bedside, in day hospital and outpatients acticvities, in the UOC di Reumatologia dell’Azienda Ospedaliero-Universitaria S. Anna di Cona.

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Modulo: 21277 - DIAGNOSTICA PER IMMAGINI
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RHEUMATOLOGY
The course forecasts 16 hours of teaching (frontal lectures) and 1 professionalizing CFU provided in practical exercises to be achieved (o the basis of scheduled calendar) bedside, in day hospital and outpatients acticvities, in the UOC di Reumatologia dell’Azienda Ospedaliero-Universitaria S. Anna di Cona.
ORTHOPAEDICS AND TRAUMATOLOGY
The course forecasts 24 hours of teaching (frontal lectures) and 1 professionalizing CFU provided in practical exercises dedicated mainly to the vision and description of radiographic and instrumental images
ANATOMIC PATHOLOGY
Lectures

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Modulo: 47784 - MALATTIE APPARATO LOCOMOTORE
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ORTHOPAEDICS AND TRAUMATOLOGY
The course forecasts 24 hours of teaching (frontal lectures) and 1 professionalizing CFU provided in practical exercises dedicated mainly to the vision and description of radiographic and instrumental images

Learning assessment procedures

RHEUMATOLOGY
Oral exam: average 1-2 questions about the course programme, mean duration 15 min. (it will be evaluated clarity, link ability, strictness and communication capability). The final outcome will depend also on the practice sessions.
ORTHOPAEDICS AND TRAUMATOLOGY
Oral exam: an average of 2 questions on the program, one of which on a given disease, and 1 on the vision and identification of a specific radiographic image (approximately 15 minutes). Assessing the clarity of the ability to link the rigor and communication skills. The final outcome will depend also on the practice sessions.
PHYSICAL AND REHABILITATION MEDICINE
Multiple-choice test (one correct answer out of four or five options). There will be at least 20 test items. Only the correct answers count.
ANATOMIC PATHOLOGY
Multiple-choice test (one correct answer out of four options). There will be 15-20 test items. Only the correct answers count.
THE FINAL GRADE RESULTS FROM THE ARITHMETIC AVERAGE OF THE MARKS OBTAINED IN EACH TEST. Votes = 0,5 are rounded up.
The final outcome will depend also on the practice sessions.

Reference texts

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Modulo: 015483/6 - MEDICINA FISICA E RIABILITATIVA
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N. Basaglia (Ed). Medicina Riabilitativa. 4 volumi. Napoli: Idelson-Gnocchi, 2009
N. Basaglia (Ed). Progettare la Riabilitazione. Il lavoro in team interprofessionale. Milano: EdiErmes, 2002

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Modulo: 019595/4 - REUMATOLOGIA
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UNIREUMA: Reumatologia per studenti e medici di medicina generale, Idelson-Gnocchi ed., 2022
QUICK REVIEW REUMATOLOGIA a cura di F. Trotta e M. Govoni. Edizioni EdiSES 2020

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Modulo: 21277 - DIAGNOSTICA PER IMMAGINI
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Modulo: 47784 - MALATTIE APPARATO LOCOMOTORE
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ORTHOPAEDICS AND TRAUMATOLOGY
Grassi F.A., Pazzaglia U.E., Pilato G., Zatti G., Manuale di Ortopedia e Traumatologia, Elsevier Ed. 2012