MSK – KFP public report review 2016-2024 topics in exam

Shoulder Conditions

1. Frozen Shoulder

• Key Areas:
  • Diagnosing frozen shoulder
  • Confirmatory examination findings
  • Initial management of frozen shoulder
• Common Errors:
  • General overview statements such as ‘rest’ or ‘avoid lifting’ instead of specific patient education
  • Lack of specific physiotherapy referrals or procedural interventions

2. Shoulder Pain Management and Employment Concerns

• Key Topics Discussed:
  • Differential diagnoses
  • Examination findings
  • Management of fitness to work
• Candidate Performance:
  • Incomplete clinical assessment
  • Inadequate fitness to work management
• Improvement Areas:
  • Comprehensive musculoskeletal examination
  • Tailored advice on work fitness

3. Acute Shoulder Pain Post-Injury

• Key Topics Discussed:
  • Diagnosis
  • Investigations
  • Management of acute shoulder injury
• Candidate Performance:
  • Incorrect diagnoses
  • Irrelevant investigations
  • Inappropriate medication prescriptions
• Improvement Areas:
  • Accurate injury assessment
  • Relevant diagnostic investigations
  • Evidence-based management strategies

4. Shoulder Injury Management

• Key Topics:
  • Diagnosis and management of shoulder injuries
  • Patient information requests
• Candidate Performance:
  • Non-specific management plans
  • Insufficient information provided to the patient’s queries
• Improvement Areas:
  • Developing tailored management plans
  • Effectively communicating recovery expectations to patients

5. Acute Shoulder Injury Management and Complaint Handling

• Key Topics Discussed:
  • Physical examination signs for shoulder injuries
  • Risks associated with subacromial injections
  • Addressing patient complaints
• Candidate Performance:
  • Inadequate management of patient complaints and misunderstanding of clinical context
• Improvement Areas:
  • Specific identification of shoulder injury signs
  • Clear communication of procedure risks
  • Effective complaint resolution strategies

Foot and Heel Conditions

1. Woman with Foot and Heel Pain

• Key Areas:
  • Diagnosing Morton’s neuroma and Achilles tendinopathy
  • Management of Morton’s neuroma
  • Non-pharmacological management of Achilles tendinopathy
• Common Errors:
  • Misdiagnosing Achilles tendinopathy as plantar fasciitis or calcaneal apophysitis
  • Providing insufficient detail about reasons for referrals
  • Duplicating answers by giving similar responses in different ways
  • Non-specific answers that do not demonstrate understanding of appropriate clinical care

2. Ruptured Achilles Tendon

• Key Topics:
  • Diagnosis
  • Supporting examination findings
  • Managing considering comorbidities
• Improvements Needed:
  • Accurate diagnosis of Achilles tendon rupture
  • Appropriate management planning

3. Interdigital Neuroma

• Key Topics:
  • Diagnosis and management of foot pain suggestive of an interdigital neuroma
• Candidate Performance:
  • Difficulty in identifying examination findings
  • Appropriate management
• Improvement Areas:
  • Precise diagnosis
  • Tailored management strategies for musculoskeletal foot disorders

Hand and Wrist Conditions

1. Finger Injury and Healthcare Access

• Insight:
  • Importance of a thorough examination to diagnose finger injuries correctly
  • Understanding cultural competencies to improve healthcare access for Aboriginal and Torres Strait Islander men
• Strengths:
  • Proposing specific strategies to encourage healthcare access
• Improvements:
  • Avoid assumptions about the patient’s history
  • Improve knowledge on finger examination techniques

2. Management of Wrist Injury and Prevention of Future Fractures in an Elderly Woman

• Key Topics Discussed:
  • Initial management of wrist injury
  • Managing unresolved clinical features
  • Fracture risk reduction
• Candidate Performance:
  • Non-evidence-based management strategies
• Improvement Areas:
  • Adhere to evidence-based guidelines for injury management and fracture prevention strategies

3. Management of a Workplace Hand Injury

• Key Topics Discussed:
  • Diagnosis based on clinical context and X-ray results
  • Immediate management actions
  • Handling requests for opiate medications for ongoing symptoms
• Candidate Performance:
  • Lack of specificity in diagnosis and management
  • Inadequate consideration of the rural context
• Improvement Areas:
  • Enhance diagnostic accuracy
  • Provide clear management plans
  • Develop strategies for managing chronic symptoms and medication requests

Back Conditions

1. New-Onset Back Pain with a Focus on Serious Underlying Conditions

• Key Topics Discussed:
  • Clinical presentation indicative of serious conditions
  • Appropriate investigations
  • Prognosis regarding return to work
• Candidate Performance:
  • Non-specific responses and unclear relevance to clinical scenarios
• Improvement Areas:
  • Identify specific clinical indicators of serious conditions
  • Choose relevant investigations
  • Assess factors influencing prognosis for work return

2. Acute Back Pain

• Medical Heading: Orthopedics or musculoskeletal medicine
• Candidates Did Well On:
  • Identifying likely differential diagnoses
• Improvement Areas:
  • Avoiding broad or irrelevant differential diagnoses
  • Focusing on next steps after investigations relevant to managing a musculoskeletal injury

3. Lower Thoracic Pain

• Topic Discussed:
  • Investigation and non-pharmacological management of acute onset lower thoracic midline pain in an elderly patient
• Candidates Did Well On:
  • Selecting appropriate investigations for the initial presentation
• Improvement Areas:
  • Many candidates recommended pharmacological treatments instead of focusing on non-pharmacological management strategies

Knee Conditions

1. Hot, Tender, Swollen Knee in a Young Girl

• Medical Heading: Pediatrics, Rheumatology
• Key Topics:
  • Diagnosis of a knee condition in a pediatric patient
  • Immediate and appropriate management
  • Skin condition management
• Candidate Performance:
  • Misalignment with patient age in management strategies
  • Focus on secondary care rather than initial, urgent care
• Improvement Areas:
  • Align management strategies with pediatric considerations
  • Provide immediate, appropriate care tailored to primary settings

2. Acute Knee Pain and Fever in an Aboriginal Child

• Key Topics Discussed:
  • Differential diagnoses
  • Initial investigations
  • Immediate management
• Candidate Performance:
  • Inappropriate management actions for the urgency of clinical presentation
• Improvement Areas:
  • Recognize and address the acuity and urgency of clinical presentations in management plans

3. Acute and Recurrent Knee Pain

• Key Topics Discussed:
  • Differential diagnosis based on investigation results
  • Pharmacological management of recurrent knee pain
• Candidate Performance:
  • Errors included overcoding by listing multiple management options within the same line
  • Lack of specificity in pharmacological management
• Improvement Areas:
  • Prioritize specificity in management plans
  • Avoid redundancy in pharmacological options

Elbow Conditions

1. Swollen Elbow Diagnosis and Underlying Pathology

• Medical Heading: Rheumatology, Sports Medicine
• Key Topics:
  • Accurate diagnosis of elbow swelling
  • Understanding of underlying pathology
  • Appropriate management
• Candidate Performance:
  • Failure to specify underlying pathology
  • Inappropriate use of abbreviations in management plans
• Improvement Areas:
  • Clarify understanding of specific conditions leading to elbow swelling
  • Provide explicit management plans without relying on abbreviations