Core Revision
GP Diplomas · Core Lens
DipMSK Core Lens
A revision lens for the Diploma in Musculoskeletal Medicine. For each topic: the safety cue you must not miss, the guideline point that anchors the answer, and the exam trap that catches people out.
The five instincts to carry into every question
- Cauda equina syndrome — bilateral leg symptoms, saddle anaesthesia, new bladder or bowel dysfunction, loss of anal tone. Same-day emergency spinal referral; do not wait for outpatient imaging.
- Septic arthritis — a hot, swollen, very painful joint with pain on any movement. Urgent same-day referral for aspiration before antibiotics. A normal temperature does not exclude it.
- Fracture — significant trauma, bony tenderness, inability to weight-bear or use the limb. Remember the fragility fracture in an older patient after trivial force, and the non-accidental injury pattern in a child.
- Malignancy — pain that is unremitting, worse at night, with weight loss, age over 50 with new back pain, or a past history of cancer (breast, prostate, lung, kidney, thyroid). Consider metastatic spinal cord compression.
- Inflammatory back pain — onset under 45, gradual, morning stiffness over 30 minutes, better with movement and worse with rest, waking in the second half of the night, responds to NSAIDs.
The topics, through the lens
The first entry is open as a preview. The other 159 are for members.
Adhesive capsulitis (frozen shoulder)
Safety cueCheck for diabetes — adhesive capsulitis is strongly associated with it, and a new diagnosis may be lurking. Beware assuming "frozen shoulder" in someone with a history of cancer and night pain; global stiffness can also be the presentation of a destructive or infective process.
Guideline pointThe defining sign is loss of passive external rotation. It is a self-limiting condition with painful, stiff and recovering phases; management is analgesia, reassurance about the natural history, exercises, and consideration of intra-articular corticosteroid injection in the painful phase.
Exam trapConfusing it with cuff pathology. Cuff problems restrict active movement with a broadly preserved passive range; a true frozen shoulder restricts both, and external rotation goes first.
The rest of the DipMSK Core Lens is in the DipMSK package
159 more entries across 24 topics, each sorted into the safety cue, the guideline point and the exam trap — written and reviewed by practising UK doctors.
- DipMSK question bank
- Pay once, no subscription
The rest of the DipMSK toolkit
Every part of the DipMSK track, one click away. Work across them rather than through them — the guide explains it, the tools drill the decision, the bank tests it and the Compass tells you what is left.