Musculoskeletal and Skin Problems
Musculoskeletal and skin problems tests common joint and soft-tissue conditions, back pain red flags, gout, fractures, eczema, psoriasis, acne, skin infections and suspected skin cancer. The exam expects focused examination and conservative management before referral.
Core rules
- Low back pain: screen for red flags such as cauda equina, malignancy, infection, fracture and inflammatory features; most cases need reassurance and activity, not imaging.
- Knee osteoarthritis: diagnose clinically; exercise, weight management and analgesia are core.
- Gout: confirm if possible; treat acute attack with NSAID, colchicine or steroid; review urate-lowering therapy after resolution.
- Eczema: emollients plus topical steroids; psoriasis: topical therapy and assessment of severity; acne: topical retinoid or benzoyl peroxide before oral therapy.
- Skin lesions: use ABCDE and dermoscopy; urgent referral for suspected melanoma.
Worked example
A 55-year-old with knee pain has crepitus, brief morning stiffness and no locking. Diagnose osteoarthritis clinically and offer exercise and weight advice. Reasoning: typical mechanical symptoms and age make imaging unnecessary.
Traps
Missing cauda equina; treating gout without considering infection; overusing oral steroids in eczema; and missing a changing pigmented lesion.