Presenting Complaint Patient history

Content

"The inflamed and angry..."

Welcome to the CHEC-CESC Virtual Patient Case - The inflamed and angry ...

This case is intended for medical students and PGY1 residents in Internal Medicine rotating through Rheumatology. The case is designed as an outpatient scenario in the Rheumatology department and incoporates a typical EMR. We hope that this case provides an enjoyable learning experience.

Intended learning outcomes

By the end of the virtual patient case, the student should be able to:

  1. Differentiate between different types of mono-articular inflammatory arthritis and their etiologies.
  2. Identify the pertinent questions, physical examinations, and investigations needed to diagnose a patient presenting with mono-articular joint pain.
  3. Demonstrate the skills needed to manage chronic medical conditions such as gout, pseudogout, septic arthritis.
  4. Demonstrate the incorporation and utilization of electronic medical records (EMR) in patient care.
  5. Demonstrate effective management skills through the judicious and cost-effective use of investigations and resources.

Instructions

Please read the virtual patient case instructions. Points are awarded or deducted based on the selection of different actions (e.g. history questions, physical exam maneuvers, investigations ordered). In addition, with each action there is a time-cost associated. The goal of the virtual patient case is to take a focused history, physical exam and judicious ordering of investigations, in the most cost-effective way. Don't skip over pertinent questions even if you think you know the diagnosis!

At the end of the case, feedback will be provided about the pertinent actions, possible diagnoses and management options.

We hope that this case will provide an interesting modality to stimulate your thinking and prepare you for real patient care!

Now, on to the case:

Acknowledgements

Wallace Wee, Medicine CC3, University of Toronto
Dr. Sharron Sandhu, Rheumatology Fellow, Sunnybrook Hospital
Dr. Mary Bell, Rheumatology Staff, Sunnybrook hospital
Dr. Gordon Tait, Staff Scientist, Toronto General Hospital

This case was created with the Virtual Interactive Case (VIC) System (http://pie.med.utoronto.ca/vic) developed by the Perioperative Interactive Education team in the Department of Anesthesia and Pain Management at Toronto General Hospital.

Creative Commons License CC BY-NC-SA 2.5) http://creativecommons.org/licenses/by-nc-sa/2.5/ca/