Evaluation of Common Musculoskeletal Injuries in the Urgent Setting

INTRODUCTION: Musculoskeletal (MSK) complaints comprise approximately 20% of primary care and emergency department visits annually in the United States. At the same time, there is a shortage of MSK specialists specifically trained to evaluate and treat these conditions. Improper management of patients with MSK diagnoses increases morbidity and undesirable outcomes for patients and leads to higher health care costs resulting from extraneous tests and imaging. METHODS: This resource consists of a set of four modules reviewing ankle, hip, shoulder, and wrist injuries and their initial treatment. Each module is a PowerPoint presentation formulated as a self-study guide for the evaluation of common MSK injuries by primary care and emergency medicine providers (initial providers). Each module includes material on physical examination, imaging, and management, including reduction and splinting, as well as indications for referral to an orthopedic specialist. RESULTS: The efficacy of the course for 43 first-year residents in internal medicine, orthopedic surgery, and the emergency department was measured using an external instrument. Pre- and posttest scores improved by 28% for knowledge of the material and by 30% for confidence level with the disposition of these injuries. All participants stated they were moderately to extremely satisfied with the course. DISCUSSION: Completion of this course will result in improved evaluation and management of injuries by initial providers, including—where appropriate—improved communication between these providers and treating surgeons.