Ensuring that all paediatricians and rheumatologists recognise significant rheumatic diseases

In many health-care systems around the world, many generalists (defined here as a clinician who is not an expert in paediatric musculoskeletal [pMSK] medicine) will be the doctor to whom children with MSK problems are most likely to present. The generalist is likely to have a clinical background in family medicine and paediatrics, but may be a specialist in adult orthopaedics, adult rheumatology or emergency care. Therefore, it is critical that the generalist is able to quickly recognise a child with significant rheumatic disease in order to initiate the proper treatment or referral to a specialist. However, most generalists are ill equipped to be able to do so, because of current deficiencies in education and training. The aims of this article are as follows:•Demonstrate the need to improve the generalist's performance of clinical assessment in musculoskeletal medicine•Suggest solutions within medical education and manpower planning in health care•Focus on important areas of pMSK medicine to be learned by the generalist to help identify children with significant rheumatic disease