Rheumatology
Draft proposed by Dr Eric KW Lee
Reviewed by Dr NC Fong
Essential Skills
Domain 1 Professional Values & Behaviour
Domain 2 Communication
Domain 4 Patient Management
Domain 6 Leadership & Team Working
Additional desirable skills are listed in each proposal. These recommended skills are to be acquired as opportunity arises
Basic Training
Basic principles in rheumatology
Application of pGALS musculoskeltal assessment
Application of various autoimmune markers in diagnoses of rheumatological diseases
Juvenile idiopathic arthritis (JIA)
Classification of JIA
Clinical presentations (articular & extra-articular) of different type of JIA, and diagnosis
Investigations
Management plan (medications including methotrexate, disease modifying anti-rheumatic drugs [DMARD], biologics; & joint rehabilitation)
Systemic lupus erythematosus (SLE)
Clinical presentation, diagnostic criteria, investigations, medical treatment of SLE (including steroid, immunosuppressant, biologics), and monitor for side effects
Clinical presentation, diagnosis and management of neonatal lupus erythematosus
Infection related arthritis
Clinical presentation, diagnosis, and management of infective arthritis
Differential diagnosis of reactive arthritis
Diagnoses and manages acute rheumatic fever and post-streptococcal reactive arthritis, and can provide prophylaxis for these conditions
Vasculitis
Clinical presentation, diagnosis and management of Henoch-Schonlein Purpura
Clinical presentation, diagnosis and management of Kawasaki disease
Paediatric rheumatological emergencies
Recognise the clinical presentation of rheumatological emergencies in children
Recognise the presentation of infection in a patient who is immunocompromised
from symptoms of severe rheumatic disease and/or treatment side effects, and management
Non-inflammatory musculoskeletal conditions
Clinical presentation, diagnosis and management of hypermobility syndrome
Differential diagnosis of musculoskeletal pain investigation and management
Other rheumatological diseases
Clinical presentation, diagnosis of juvenile dermatomyositis
Clinical presentation, diagnosis of polymyositis
Clinical presentation, diagnosis of juvenile ankylosing spondylitis
Higher Training
Principles in Rheumatology
Application of biologics or new therapeutic modalities in different rheumatological disesaes, and monitoring of side effects
Principal and application of plasmapheresis in rheumatological disease
Familiar with the tools or assessment scale of disease activity, specific functional score, and quality of life for different rheumatological conditions
Juvenile idiopathic arthritis
Multidisciplinary collaborative management plan involving physiotherapist, paediatric orthopedics surgeon, ophthamologist
Systemic lupus erythematosus & other systemic connective tissue diseases
Understand other systemic connective tissue disease and undifferentiated connective tissue disease:
Clinical presentation, diagnosis and management
Vasculitis
Clinical presentation, diagnosis, and management of other paediatric vasculitic disease besides HSP and Kawasaki disease
Paediatric rheumatological emergency
Management of rheumatological emergencies (including macrophage activation syndrome, catastrophic antiphospholipid syndrome, severe Raynaud’s phenomenon)
Other rheumatological diseases
Management plan and rehabilitation including multidisciplinary approach for dermatomyositis, polymyositis and junvenile ankylosing spondylitis
Desirable skills
1. Intra-articular injection
2. Skin biopsy for vasculitis