Gct c. Osteoma Osteoid osteoma

MODULE 20 MID – TERM TEST Topics : Anatomy of Bone and Muscle Student will be assessed using pcture of bone and muscle. The picture are provided and the student must give the name of bones or muscles acoording to the pointer on the picture MODULE 21 NEOPLASM OF SOFT TISSUE BONE BENIGN Dr. Eka W, Sp.OT AIMS: Establish tentative diagnosis, provide initial management andor refer patient with various soft tissues tumors and tumor-like lesion and benign neoplasm LEARNING OUTCOMES: Establish tentative diagnosis, provide initial management andor refer patient with various soft tissues tumors and tumor-like lesion and benign neoplasm CURRICULUM CONTENTS: 1. soft tissues tumors and tumor-like lesion and

2. Benign neoplasm a. Osteochondrome

b. Gct c. Osteoma

d. Osteoid osteoma

ABSTRACT Bone tumor or tumor from bone is rare case that only 0.2 from all tumors. Bone tumors are benign and malignant. Cancers of bone can be primarily from bone itself, or secunderly from another site. Udayana University Faculty of Medicine, DME Day 20 th Day 21 st 55 Benign neoplasm of bone usually found unpredictable, because no specific symtoms before it give complication like compression to the surrounding tissues or a fracture. Conversely bone cancers always give similar signs as another diseases like osteomyelitis or fracture of bone, and bone cancers always be found with bad condition. The management of bone tumors particularly for malignant tumors, early diagnosis is very imfortant for further treatment. The modality of management is defending on the gradation. To know about the stadium, cooperation between orthopaedi, radiology and pathology anatomy are necessary. Vigilance for the bone tumors should be increase because sign of malignant bone tumor always mistakable with another case. Malignant bone tumor usually 75 attack childrents and need radical surgery, extensive, and chemotherapy which uncomfortable, and that are challenge to be an orthopaedic for treating bone tumors. Because of that to be general practitioner to impeach bone tumor will increase early diagnosis and good result in the management. SELF DIRECTING LEARNING Basic knowledge that must be known: 1. Diagnosis od soft tissue tumor 2. Management of soft toissue tumor SCENARIO Case 1 A boy come with lump at the bone of the right thigh close with knee, and below of the left knee. His family doesn’t suffering disease like him, but his farent has lump like him. Learning Task: 1. What the problem with him? 2. What kind of anamnesis which necessary for the patient? 3. What kind of physical examination and pem. Tambahan which necessary for the patient? 4. If the the lump is benign, can you make the classification of bone tumor by Aegerter? 5. Explain, what the meaning with reactive bone lesion, hamartoma ? 6. What are the clinical feature, radiologic, and histopathology of the benign bone tumors Osteoma, Osteochondroma, GCT 7. How the principely of the management of benign bone tumors? Case 2 Seventeen year old boy, two weeks ago his right knee hited a table, and now his knee swollen, redness, warm, and painfull. Learning Task: 1. What x-ray should be performed? 2. What are yourdifferential diagnoses regarding on location where the patient complaint? 3. May the patient suffer of malignant bone tumor? 4. What are the radiologically if true malignant bone tumor? 5. What is the prognosis base on the radiology imaging? 6. Can you explain the tumors which have radiology feature patognomonic? Self Assessment: 1. Learn about the definition of benign and malignant bone tumors 2. Learn the classification of bone tumors 3. Learn about the relation between the location and kind of bone tumors? Udayana University Faculty of Medicine, DME 56 4. Learn about the management of benign bone tumors 5. What the classification of bone tumor by Aegerter? 6. Can be the GCT classify into malignant bone tumor? 7. What kind of radiology appearance for the bone tumor generally? NEOPLASM OF SOFT TISSUE BONE MALIGN AIMS : Establish tentative diagnosis, provide initial management andor refer patient with malign neoplasm of the bone soft tissue LEARNING OUTCOME: Establish tentative diagnosis, provide initial management andor refer patient with malign neoplasm of the bone soft tissue CURRICULUM CONTENTS: Malign neoplasm of the bone soft tissue 1. osteosarcoma 2. chondrosarcoma 3. ewing tumor ABSTRACTS Bone tumor or tumor from bone is rare case that only 0.2 from all tumors. Bone tumors are benign and malignant. Cancers of bone can be primarily from bone itself, or secunderly from another site metastasis. Benign neoplasm of bone usually found unpredictable, because no specific symtoms before it give complication like compression to the surrounding tissues or a fracture. Conversely bone cancers always give similar signs as another diseases like osteomyelitis or fracture of bone, and bone cancers always be found with bad condition. The management of bone tumors particularly for malignant tumors, early diagnosis is very imfortant for further treatment. The modality of management is defending on the gradation. To know about the stadium, cooperation between orthopaedi, radiology and pathology anatomy are necessary. Vigilance for the bone tumors should be increase because sign of malignant bone tumor always mistakable with another case. Malignant bone tumor usually 75 attack childrents and need radical surgery, extensive, and chemotherapy which uncomfortable, and that are challenge to be an orthopaedic for treating bone tumors. Because of that to be general practitioner to impeach bone tumor will increase early diagnosis and good result in the management. SELF DIRECTING LEARNING Basic knowledge that must be known: 1. Diagnosis of malign tissue tumors 2. Management of malign tissue tumors SCENARIO A 10 year old boy complaint about lump around his right knee accompanied with erythema and pain. The lump and pain were beginning 4 months ago. He looks pale and skinny. One week ago, he got slipped and fall, the pain is getting worst. After that, this patient comes to you. Udayana University Faculty of Medicine, DME 57 Learning task: 1. Make a complete history of this patient 2. In physical examination what would you expect to find in this patient? After that, what other you should do? 3. Please explain the radiograph of bone cancer? 4. Please explain about hysthopathologic of bone cancer osteosarcoma, chondrosarcoma, ewing tumor etc 5. What is metastase? How is the pathway of bone cancer metastase? 6. What is the principal of bone cancer treatment? Self assessment: 1. Learn about primary and secondary bone cancer. 2. Learn about management of bone cancer, especially: a. History taking b. Radiographic c. Biopsy d. Treatment: Surgical and adjuvant 3. What is the commonest bone cancer you can find? 4. What is the differences of primary osteosarcoma and secondary osteosarcoma? ULCER AND MANAGEMENTS dr. Eka W, Sp.OT ------ MODULE 22 BONE INFECTIONS dr. Wayan Suryanto Dusak, SpOT AIMS: Establish tentative diagnosis, provide initial management andor refer patient with infection of musculoscletal system LEARNING OUTCOMES: Establish tentative diagnosis, provide initial management andor refer patient with: Osteomyelitis and Septic arthritis CURRICULUM CONTENTS: 1. Osteomyelitis and 2. Septic arthritis Udayana University Faculty of Medicine, DME Day 22 nd 58 ABSTRACTS One of the most serious inflammatory disorders of the musculoskeletal system is acute hematogenous osteomyelitis, a rapidly developing blood – borne bacterial infection of bone and its marrow in children The first and most significant symptom afflicted child experiences is severe and constant pain near the end of the involved long bone. It’s extremely important to appreciate that the early diagnosis of acute hematogenous osteomyelitis must be made on clinical ground alone, because during at least the first week of illness, there is absolutely no concrete radiographic evidence of bone infection Acute hematogenous osteomyelitis represents an extremely serious infection that demands urgents and vigorous treatment. As soon as the clinical diagnosis strongly suspected, the child should be admitted to hospital for intensive treatment. In general, the most effective treatment is bed rest and analgetics, supportive measures immobilization, and antibacterial therapy When pyogenic bacteria are invide a synovial joint, the result is acute septic pyogenic arthritis. The most common source of septic arthritis in children is spreading of pyogenic bacteria from hematogenous osteomyelitis. The general features and general principles treatment of septic arthritis is similar to acute hematogenous osteomyelitis SELF DIRECTING LEARNING Basic knowledge that must be known: 1. Diagnosis of osteomyelitis 2. Management of osteomyelitis SCENARIO Five years old boy, came to the hospital with pain and swelling on his right hip after fell down when he played 3 days ago. The child un willingness to use his limb and within 24 hours appears acutely ill: 1. What you assessment for this patient? 2. What is your diagnosis? 3. How to manage the patient? Learning task: 1. General features of inflammatory process of the musculoskeletal tissue 2. Etiology of AHO and septic arthritis 3. Pathogenesis and clinical features of AHO and SA 4. Treatment AHO and SA 5. Complication of AHO and SA Self Assessment I: 1. Please explain the definition and sign and symptoms of bone infection 2. Please explain the infection route in bone and cartilage 3. Please explain the osteomyelitis classification Self Assessment II: 1. Please explain the radiologic findings of osteomyelitis Udayana University Faculty of Medicine, DME 59 Udayana University Faculty of Medicine, DME 60 MODULE 23 MUSCULOSKELETAL REHABILITATION dr. Tjok Dalem Kurniawan, SpRM AIMS: Describe the Rehabilitation of musculoskeletal LEARNING OUTCOMES: Describe the Rehabilitation of musculoskeletal after injury degenerative disorders CURRICULUM CONTENTS: a. Execerise Therapy b. Deconditioning c. Physical modality d. Prosthesis ABSTRACTS Musculoskeletal disorders are the most frequent type of disabilities, and pain is the most common cause musculoskeletal disability. Musculoskeletal complaint include non specific symptoms such as pain in the neck, back, and extremities, chronic inflammatory or degenerative disorders, and a wide range of sports injuries, traffic and occupation accident. These disorder cause disability, suffering and reduce a person quality of life. Early mobilization in musculoskeletal disorder is needed for preventing immobilization syndrome. Management of rehabilitation for musculoskeletal disorders consist of giving some medicine, physical modality, exercise therapy and sometime need walking aid SELF DIRECTING LEARNING Basic knowledge that must be known:

1. Rehabilitation for musculosceletal disorders SCENARIO