24 May 2022 15:00 — 16:00 (1 hour)

Agenda

This is what we are going to discuss in this meeting

• Introduction to the new MSK Chairperson
• Lumps & Bumps
• SOP for emergency assessment of Cauda Equina syndrome
• Plain Film Protocols

Minutes

Attendance

James Barren, Neal Larkman, Lisa Field, Charlotte Davies, Katy Liddle, Conrad Nel, Scott Raine, Pankaj Nagtode, Amy Richards, Anthony Smith, Jonathan McConnell, Debra Punshon, Jo Housley

Actions

1. Circulate updated Sarcoma Pathway [completed]
2. Circulate assessment document for Cauda Equina [completed]
3. Calls for Expression of Interest for the Chairperson role [completed]
4. Establish the Neuro SIGs approach to cauda equina [new for PMs/Helen]

Key Discussion Points

• Neal introduced James Barren as the new MSK chairperson. Neal would be there to support for the next couple of meetings.

Lumps and Bumps

• All Trusts struggling with backlog and the number of referrals. Trusts are currently using BMUS guidance and agreed that a criteria of 1cm and above would be a good baseline.
• Radiologists currently make the decision to image, and if x-ray is required before MR.
• Sarcoma pathway created with support from the cancer alliance had previously been circulated. Confirmation required from Phil Robinson as to whether this was now a live document. This document would be re-circulated to MSK SIG members.
• Opportunity to use BMUS and cancer alliance protocols - would be brought back to the next meeting.

Cauda Equina

• Currently no consistent approach amongst Trusts - some Trusts have 24 hour MR cover; depending on the severity and duration of symptoms patients are scanned from ED overnight, or patients are scanned first thing in a morning. Other Trusts have a dedicated virtual clinic first thing in the morning.
• The group agreed that having a consistent approach to CE and communication between ED and radiology would be a good place to start, with the possibility of virtual morning slots as a minumum.
• It was agreed that a discussion with the Neuro SIG was required to establish what their approach to CE was.

Plain Film Protocols

• There was discussion if a good focus could be standardising plain film protocols to incorporate with the launch of the shared reporting solution. Some of the other special interest groups were currently focusing on MRI and CT protocols.
• From looking at national surveys of NHS Trusts, it shows huge variation in lumbar spine, pelvis, knee and foot. There is also radiation implications if scans had to be duplicated due to difference in protocols and reporting.
• There was potential to focus on specific examinations - to be discussed further.