Welcome to the Ortho Site

Overview

Orthopedics and sports medicine are important topics in family medicine. The curriculum on this page not only covers what you will learn on the individual rotations, but also during your entire residency. The goal is to produce family physicians who can care for the vast array of orthopedic/sports med problems encountered in family medicine. To help make this material more manageable, the content or topics have been broken down, with specific faculty and specialist identified to concentrate on a given topic area.

During each orthopedic month, the resident must complete the following:

  1. Read all assigned readings (listed below) and score a 100% on the associated online quiz:
    1. Ortho R2 Quiz:  https://ucfm.wufoo.com/forms/mm92y1205sbvw7/
    2. Ortho R3 Quiz:  https://ucfm.wufoo.com/forms/m1hagqa918qarn5/
    3. View physical examination videos (posted below).
    4. Complete the practice self-test based upon ITE questions similar to those likely to be encountered on the family medicine boards (provided via email in the first week of your rotation).
    5. Meet with the overseeing family medicine faculty, Dr. Collins, to review key topics and examination skills during the rotation and answer questions on assigned readings. 

Ortho R2 residents are also required to attend (via internet at Dr Rolf's Harrison office) the Sports Medicine Fellowship Lecture series on Mondays, 730am, with Dr Robert Rolf and Beacon Orthopedics.  Sports Med elective residents are also encouraged to attend.  Ortho R3 residents may attend as their schedule permits.  Location:  Beacon Orthopaedics Foundation Classroom, 500 E. Business Way, Sharonville, OH  45241.  This conference may also be attended live via internet (contact Sherry Gammache for information:  sgammache@beaconortho.com). Click HERE for 2012-13 conference schedule.

Please feel free to contact Dr. Collins with questions or concerns. Also please provide us feedback on how to improve the rotation. 

Required Readings & Video Learning Assignments

At the beginning of your rotation, please pick up your textbook (Steinberg, Gerald G et al.  Orthopaedics in Primary Care)(Please return to FMC at the end of your rotation).  During your rotations, please utilize/familiarize yourself with Sarwark/AAOS/AAP, Essentials of Musculoskeletal Care 4, and The Sports Medicine Patient Advisor, located in the FMC Precepting Office (Please do not remove from FMC - sorry!).  Selections from the first two books above, along with a few key articles (linked below), comprise your mandatory reading assignments each rotation.  The Sports Medicine Patient Advisor has excellent one-pagers for patients on almost every orthopedic condition.  Don't forget to complete the online quiz based on your readings (See link above)!

Please read or watch the following during your rotations:

  1. Ortho R2 (Emphasis on back and lower extremity, along with PT/rehab): 
  2. Ortho R3 (Emphasis on C-spine and upper extremity, along with pediatrics): 

Ortho Rotation Toolbox (extras that may be helpful to you):

RADIOLOGY REVIEW:  At the start of your rotations, you may wish to review radiology tutorials on musculoskeletal xray interpretation found here:  http://radiologymasterclass.co.uk/tutorials/tutorials.html.

SHOULDER & KNEE EXAM GUIDE:  Many residents also find this Shoulder and Knee Exam Guide a helpful reference:  One-pager on Shoulder & Knee Exams

MOST BANG FOR BUCK ON SHOULDER EXAM:  See this great little video from JAMA on most important shoulder exam tests for evaluating rotator cuff:  http://jama.jamanetwork.com/multimediaPlayer.aspx?mediaid=5975016# (For full PDF article from JAMA:  The Rational Shoulder Exam, JAMA 2013)

INJECTIONS GUIDE:  From Dr. Holliday's Effective At Every Visit website:  Injections Cheat Sheet

CONCUSSION MANAGEMENT:  SCAT-3 Form

Topic Areas:

Each resident will review the topic areas listed above in the readings list during their rotations.  Overall, the curriculum is designed to cover the following areas by rotation and provider listed (Providers will often address a mix of upper and lower extremity problems):

  1. Ortho R2:
    1. Lower Spine/Back & Hip
    2. Knee
    3. Ankle
    4. Foot
  2. Ortho R3:
    1. Cervical Spine
    2. Shoulder
    3. Elbow
    4. Wrist & Hand
    5. Orthopedic problems in the pediatric patient
  3. Other Ortho Topics (Contact Dr. Collins for additional review/readings):
    1. Splinting and Casting - R1 November Procedures
    2. Joint Injections - Outpatient Noon Conference Series
    3. Other Orthopedic Procedures - Outpatient Noon Conference Series
    4. Radiologic evaluation - Radiology Curriculum  (Dr. Hillary Mount)
Ortho R3Ortho R2
  1. Evaluation of Ankle Pain (Sports Medicine, Dr. Marcheschi)
    1. Charcot's Joint
    2. Fractures
    3. Sprains
    4. Osteroarthritis
  2. Knee (Dr. Scott Jolson, Dr. Sambhu Choudhury)
    1. Complete Exam
    2. Evaluation of knee pain
      1. Osteoarthritis
      2. Menisucs Injury
      3. Anterior knee pain (Chondromalacia patellae)
      4. Ligamentous Injuries/Tears (Anterior and Posterior Cruciate Ligaments)
      5. Bursitis (Pre-patellar and superficial infrapatellar (housemaid knee), anserine bursitis
      6. Tendonitis (patellar, iliotibial band)
      7. Bakers Cyst
    3. Pediatric Knee Pain
      1. Osgood Schlatter
    4. Knee Injection and Aspiration
  3. Shoulder (Dr. Scott Jolson, Dr. Sambhu Choudhury)
    1. Complete Exam
    2. Evaluation of Shoulder Pain
      1. Osteoarthritis
      2. Impingement Syndromes
      3. Rotator Cuff Syndromes
      4. Rotator Cuff Tears
      5. Bicep Tendonitis and Tears
      6. Acromioclavicular ligamentous injuries (sprains, subluxation, dislocation)
      7. Dislocation of the shoulder
      8. Frozen Shoulder (Adhesive Capsulitis)
    3. Injections
  4. Fractures
    1. Initial management
    2. Salter Harris fractures
    3. Buckle fractures
    4. Ottowa rules
    5. Jones fracture (Dr. Todd Adams)
    6. Vertebral Fractures (Dr.Daniel Funk)
    7. Clavicular Fractures (Dr. Scott Jolson)
  5. Leg (Dr. Edward Marcheschi)
    1. Complete Exam
    2. Evaluation of leg pain
      1. Shin Splints
      2. Stress Fracture of the tibia and fibular
      3. Tenosynovitis of the anterior long tendons of the foot
      4. Compartment syndrome
  6. In-Toeing Alignment Problems (Pediatric Rotations)
    1. Gait Evaluation and Alignment Exam
    2. Following conditions:
      1. Metatarsus adductus
      2. Femoral Anteversion
      3. Tibial Torsion
  1. Podiatry (Dr. Todd Adams)
    1. Evalaution of foot pain
      1. Plantar fasciitis
      2. Heel Spurs
      3. Mortons Neuroma
      4. Stress Fracture
      5. Achilles Tendonitis
      6. Hallux Valgus
    2. Routine Nail Care (Dr. Todd Adams)
      1. Onychocryptosis (ingrown toenail)
      2. Routine Care
    3. Deformities of the toes (Dr. Todd Adams)
      1. Hammertoes
      2. Mallet Toes
  2. Knee (Dr. Scott Jolson, Dr. Sambhu Choudhury)
    1. Complete Exam
    2. Evaluation of knee pain
      1. Osteoarthritis
      2. Menisucs Injury
      3. Anterior knee pain (Chondromalacia patellae)
      4. Ligamentous Injuries/Tears (Anterior and Posterior Cruciate Ligaments)
      5. Bursitis (Pre-patellar and superficial infrapatellar (housemaid knee), anserine bursitis
      6. Tendonitis (patellar, iliotibial band)
      7. Bakers Cyst
    3. Pediatric Knee Pain
      1. Osgood Schlatter
    4. Knee Injection and Aspiration
  3. Shoulder (Dr. Rob Rolf, Scott Jolson, Dr Sambhu Choudhury)
    1. Complete Exam
    2. Evaluation of Shoulder Pain
      1. Osteoarthritis
      2. Impingement Syndromes
      3. Rotator Cuff Syndromes
      4. Rotator Cuff Tears
      5. Bicep Tendonitis and Tears
      6. Acromioclavicular ligamentous injuries (sprains, subluxation, dislocation)
      7. Dislocation of the shoulder
      8. Frozen Shoulder (Adhesive Capsulitis)
    3. Injections
  4. Hip (Dr. Sambhu Choudhury)
    1. Complete Examination
    2. Evalatuion of Hip Pain
      1. OA
      2. Avascular Necrosis of the Hip
      3. Bursitis (Trochanteric and tibial band syndrome)
      4. Fracture
    3. Pediatric Hip Pain
      1. Slipped Capital Femoral Epiphysis
      2. Legg-Calve-Perthes
      3. Developmental Dysplasia of the hips
  5. Procedures
    1. Casting and splinting (CCHMC Casting Clinic, Peds ED)
    2. Knee and Shoulder Injection (Dr. Scott Jolson, Dr. Sambhu Choudhury)
    3. Olecranon Aspiration (Other)
    4. Reduction of subluxation of the head of the radius (nursemaid's elbow) (Peds ED)
    5. Steroid injection of Trochanteric bursa (Dr. Sambhu Choudhury)
    6. Incision and drainage of Paronychia (UH ED)
  6. Spine (Dr. Daniel Funk)
  7. Rheumatic Conditions

Schedule

All schedules are subject to change.  Please obtain a detailed and updated schedule by contacting Judy Flick in the residency office prior to the start of your rotation.

Ortho R2

  • MONDAY AM:  Dr Robert Rolf (Beacon Orthopedics; 6480 Harrison Ave; 354-7777 (Shelly Bingle))
  • MONDAY PM:  FMC/Procedures if available (EXCEPTIONS (CONFIRM ON SCHEDULE): 1st MONDAY, 1-130pm, Ortho Orientation, Ste331; FINAL MONDAY, 1-2pm, Lower Extremity Review, Precepting Rm)
  • TUESDAY AM-PM:  Dr Sambhu Choudhury (Western Ridge Office; 6949 Good Samaritan Way; 246-7009, 404-3549 (Cell), 658-1891 (Amanda Perkins))
  • WEDNESDAY AM:  Dr Sambhu Choudhury (Clifton Office, Group Health Assoc wing, 6th Fl)
  • WEDNESDAY PM:  Dr Fred Kahn (TCH Spine)
  • THURSDAY AM:  Dr Todd Adams (Podiatry Assoc of Cinti, 8404 Beechmont Ave, 474-4450 (Laura Telford))
  • THURSDAY PM:  TCH/UC Family Medicine Conferences
  • FRIDAY AM:  Dr Angel Velazquez (Beacon Ortho & Sports Med Summit Clinic, 500 E Business Way, Sharonville (Contact: Megan Peter, PA 354-3700))
  • FRIDAY PM:  FMC 

Ortho R3

  • MONDAY AM:  Dr. Ed Marcheschi (Cincinnati Sports Club, 2nd Floor; 3950 Red Bank Road 45227; 564-3835)
  • MONDAY PM:  FMC or Underserved Site/Procedures if available
  • TUESDAY AM:  FMC/Refugee Clinic (See Refugee Clinic web page); EXCEPTION: TCH Physical Therapy (1st Tues only: w/ Steve Sallada; call him @ 379-6542 before to confirm)
  • TUESDAY PM:  Dr. Scott Jolson (Christ Hosp Ortho Assoc, Jewish Hosp; 8250 Kenwood Crossing Way, Ste 100, 221-5500x44604 (Karen)) (EXCEPTION: 4th MONDAY, 1-2pm, Upper Extremity Review, Precepting Rm)
  • WEDNESDAY AM:  Dr. Ed Marcheschi (Same location as MON AM)
  • WEDNESDAY PM:  FMC or Underserved Site
  • THURSDAY AM:  Dr. Tom Kiefhaber (Hand Surgeon, alternating sites, call 961-4263x1429 or 961-4360 (Sally))
  • THURSDAY PM:  TCH/UC Family Medicine Conferences or MKV
  • FRIDAY AM:  FMC or Underserved Site
  • FRIDAY PM:  Dr. Scott Jolson (Same location as TUES PM)