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Abstract
Aim The diagnosis of musculoskeletal conditions (such as juvenile idiopathic arthritis, malignancy, infection and muscular dystrophies) continues to present a diagnostic challenge due to lack of awareness of these conditions and insufficient experience of health professionals in examining bones, joints and muscles. Consequently the diagnosis and access to treatments is often delayed, with negative impact on clinical outcome. We have therefore developed a web-based educational resource focused on supporting a range of healthcare professionals in their assessment of children and young people presenting with musculoskeletal problems. Our aim is to raise awareness of these conditions and improve clinical assessment of the musculoskeletal system in order to facilitate timely diagnosis, referral to specialist care and improve clinical outcomes.
Methods We consulted with stakeholder groups in primary care, paediatrics, musculoskeletal specialties, paediatric neurology and medical students to identify essential “core” learning outcomes which form the basis of our website, entitled paediatric musculoskeletal matters –pmm.
Results The website takes into account user preferences (site access, format), utilises various media formats (e.g. videos, interactive cases, signposting, summaries) and adopts a modular approach. Examples of modules are; Clinical assessment, Investigations and management, Limping child, Pain by region, Swollen joints). We have also incorporated video demonstrations of normal and abnormal clinical signs (including red flags) with many “top tips” and links to recommended resources and websites.
Conclusions We believe our collaborative approach to developing the pmm website (www.pmmonline.org) will raise awareness of musculoskeletal conditions and increase the clinician’s confidence in assessment of bones, joints and muscles. Ultimately we hope to improve clinical outcomes, in particular for conditions where early diagnosis is strongly associated with a better clinical outcome (e.g. infection, malignancy, arthritis and muscle diseases). We aim to evaluate the website (dissemination, user experience, clinical impact) and are currently working on a sister website specifically designed for health visitors and nurses.
The PMM group, Newcastle-upon-Tyne includes: Dr Sharmila Jandial (Paediatric rheumatology, Great North Children’s Hospital), Dr Tim Rapley (Social Science, Institute of Health and Society, Newcastle University), Ruth Wyllie (Paediatric rheumatology, Great North Children’s Hospital), Christine English (School of Nursing, University of Northumbria at Newcastle), Barbara Davies (School of Nursing, University of Northumbria at Newcastle), Craig Gerrand (Orthopaedics, Newcastle-upon-Tyne Hospitals NHS Foundation Trust), Iain Goff (General practice adult Rheumatology Northumbria Healthcare NHS Foundation Trust), Michela Guglieri (The John Walton Muscular Dystrophy Research Centre), Kate Bushby (The John Walton Muscular Dystrophy Research Centre) and Helen Foster (Paediatric Rheumatology, Musculoskeletal Research Group).