Advice to GP’s on using MSK ProformaUpper Body

Previous surgery # dislocator

All other presentations

Shoulder Pain Neck Pain

ICATS(MSK Triage)

Orthopaedics

Non Surgical management

ICATS(MSK Triage)

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)

Inflammatory Non-inflammatory

RheumatologyInflammatory

Rheumatology

Non-inflammatory

Advice to GP’s on using MSK ProformaUpper Body

Elbow Pain

DiagnosisUnsure

Definite Soft tissue problem

Refer Orthopaedics

Refer ICATS(MSK Triage)

Hand Pain

TenosynouitisCarpel Tunnel Syndrome

Trigger FingerGanglion

Other Conditions

Refer ICATS(MSK Triage)

Refer Orthopaedics

ICATS= Integrated clinical assessment and treatment service (= MSK Triage or Airedale NHST)

Inflammatory

Rheumatology

Non-inflammatoryNon-inflammatoryInflammatory

Rheumatology

Advice to GP’s on using MSK ProformaLower Body - KNEE

ICATS(MSK Triage)Wishes surgery

Traumatic

Refer orthopaedics

ICATS(MSK Triage)

Not fit/ does not

wish surgery

No trauma

Young KneeMiddle aged knee (Under discussion with Orthopaedics)

Old knee for replacement

Knee pain

OrthopaedicsICATS

(MSK Triage)

Palliative Management

Ref Orthopaedics

Previous # or surgery

SUMMARY –All knee pain to be referred to MSK Triage except:

Traumatic/ Joint Knee

OA Ready/ Fit for surgery

Previous #/ Surgery

Non Surgical Intervention

SurgicalIntervention

ICATS= Integrated clinical assessment and treatment service (= MSK Triage or Airedale NHST)

Inflammatory

Rheumatology

Non-Inflammatory

Advice to GP’s on using MSK ProformaBack Pain

ChronicNon Specific

RadicularSigns

Back Pain

ICATS(MSK Triage)

New Radicular Pain Service -autumn 2009

New ChronicPain Management

Service - autumn 2009

ICATS= Integrated clinical assessment and treatment service (= MSK Triage or Airedale NHST)

Non-inflammatory

Rheumatology

Inflammatory

Advice to GP’s on using MSK ProformaLower Body – Foot and Ankle

Foot and AnklePain

All other conditions

Refer ICATS(MSK Triage)

Will include jointPodiatry autumn 2009

Orthopedics

Previous #or surgery

ICATS= Integrated clinical assessment and treatment service (= MSK Triage or Airedale NHST)

Inflammatory

Rheumatology

Non-inflammatory

Advice to GP’s on using MSK ProformaLower Body – Hip

Hip Pain

Hip OAConfirmed

DiagnosisUnclear

Fit for surgeryNot fit for surgery

PreviousSurgery / #

ICATS= Integrated clinical assessment and treatment service (= MSK Triage or Airedale NHST)

Refer ICATS(MSK Triage)

Refer Orthopedics

Refer Orthopedics

Refer ICATS(MSK Triage)

Inflammatory

Rheumatology

Non-inflammatory

SUMMARY – All non-inflammatory shoulder pain refer to ICATS (MSK triage) except previous surgery/# or previous dislocationInflammatory – refer rheumatology

MSK Red Flags Requiring Urgent Referral

MSK Symptom +

Cauda EquinaSymptoms

Previous H/OCancer

Weight Loss Systemic Illness

OrthopedicsOr

Spinal SurgeonCancer Specialist

Refer forInvestigation

weight loss notorthopedics

Refer generalPhysician or

urgent rheumatology

ICATS= Integrated clinical assessment and treatment service (= MSK Triage or Airedale NHST)