Course Content
🔬 Station 1 — Identification of Tuberculous Osteomyelitis
Learning Outcomes Identify tuberculous osteomyelitis from a provided gross specimen or histopathology image/slide. Identify the key gross and microscopic morphological features supporting the diagnosis. Differentiate the lesion from common pyogenic osteomyelitis when provided with relevant findings.
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Identification of Tuberculous Osteomyelitis
🔬 Station 2 — Identification of Common Bone Tumours
Learning Outcomes Identify the provided bone tumour from a gross specimen, image or histopathology slide. Identify the key morphological features supporting the diagnosis. Differentiate osteosarcoma, osteoclastoma and chondrosarcoma using characteristic morphological findings.
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Identification of Common Bone Tumours
🧪 Station 3 — ASO Test by Latex Agglutination
Learning Outcomes Prepare the specimen and reagents required for the ASO latex agglutination test. Demonstrate the correct steps of the latex agglutination technique. Interpret visible agglutination and report the test as positive or negative.
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ASO Test by Latex Agglutination
🔬 Station 4 — Identification of Squamous Cell Carcinoma and Basal Cell Carcinoma of Skin
Learning Outcomes Identify SCC or BCC from a provided gross specimen/image or histopathology slide. Identify the important morphological features supporting the diagnosis. Differentiate squamous cell carcinoma from basal cell carcinoma on morphological grounds.
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Topic: 🔬 Station 4 — Identification of Squamous Cell Carcinoma and Basal Cell Carcinoma of Skin
💊 Station 5 — Prescription Writing for Gout and Rheumatoid Arthritis
Learning Outcomes Write a complete and rational prescription for a patient with gout or rheumatoid arthritis based on the supplied clinical scenario. Select an appropriate drug, dose, route, frequency and duration. Demonstrate the essential components of safe prescription writing.
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Prescription Writing for Gout and Rheumatoid Arthritis
💊 Station 6 — Prescription Writing for Common Dermatological Disorders
Learning Outcomes Write an appropriate prescription for a supplied case of scabies or psoriasis. Select the appropriate preparation, route, dose/frequency and duration. Include essential patient instructions relevant to safe and effective treatment.
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Prescription Writing for Common Dermatological Disorders
⚖️ Station 7 — Identification of Mechanical Wounds and Causative Weapon
Learning Outcomes Identify the type of mechanical wound from a provided model, image or injury photograph. Recognize abrasion, bruise, laceration, incised wound or stab wound from its characteristic features. Identify the probable causative weapon/mechanism and relevant medico-legal significance.
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Identification of Mechanical Wounds and Causative Weapon
🔫 Station 8 — Examination of Firearm Injury and Identification of Bullet/Ammunition
Learning Outcomes Identify a firearm entry or exit wound from the provided image/model and describe its important features. Interpret features relevant to the probable range or mechanism of firing when demonstrated. Identify a supplied bullet/ammunition specimen and document the important medico-legal findings.
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Examination of Firearm Injury and Identification of Bullet/Ammunition
🩺 Station 9 — Focused Musculoskeletal History and Examination
Learning Outcomes Obtain a focused history relevant to a common musculoskeletal complaint. Perform an appropriate focused general and musculoskeletal examination. Present the relevant positive and negative findings in an organized manner.
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Focused Musculoskeletal History and Examination
🦴 Station 10 — X-Ray Interpretation of Fracture/Dislocation and Initial Limb Management
Learning Outcomes Identify a fracture or dislocation on a provided X-ray. Describe the site, type, displacement and/or angulation of the injury systematically. Demonstrate or describe appropriate immediate immobilization and initial management of the injured limb.
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X-Ray Interpretation of Fracture/Dislocation and Initial Limb Management
AIM OSPE/OSCE Lab — MSK-II Module | 3rd Year MBBS

AIM OSCE / OSPE • MBBS
🔫 Station 8 — Examination of Firearm Injury and Identification of Bullet/Ammunition
Rapid Revision • Identify • Interpret • Document

🎯 Task

CANDIDATE TASK

Examine the supplied firearm-wound image/model and identify whether it represents an entry or exit wound, stating the important features and any findings relevant to the probable range of firing. Identify the supplied bullet/ammunition specimen and state the important medico-legal findings you would document.

⚡ Model Station Answer

Wound identification: A typical entry wound is usually round or oval with inverted margins and an abrasion collar, often with a grease/bullet-wipe collar. An exit wound is usually more irregular with everted margins and normally lacks these collars.

Range features: Soot/blackening, burning or singeing suggest relatively close firing, while powder tattooing indicates deposition of powder particles. Their absence may indicate distant firing, although exact range requires correlation and test firing.

Ammunition: I would identify whether the specimen is a cartridge, cartridge case or projectile and document its dimensions, condition, deformation and any visible rifling impressions without damaging the surface.

Medico-legal handling: The specimen should be handled minimally, preserved separately, labelled, sealed and transferred with an intact chain of custody.

🔎 Stepwise Procedure / Approach

Observe the wound systematically. Note its site, shape, approximate size, margins and surrounding skin changes.

    1. Assess the margins. Look for inversion or eversion and determine whether an abrasion collar or bullet-wipe/grease collar is present.
    2. Look for entry-wound clues. A round or oval defect with an abrasion collar strongly supports an entry wound; soot, burning, singeing or tattooing may provide additional range information.
    3. Look for exit-wound clues. An exit wound is commonly irregular and larger with everted margins and usually lacks soot, tattooing and a bullet-wipe collar.
    4. Interpret probable range cautiously. Note muzzle-related effects, soot/blackening and powder tattooing, but do not assign an exact distance merely from the appearance.
    5. Identify the supplied ammunition evidence. Decide whether it is a complete cartridge, cartridge case, bullet/projectile or other ammunition component and describe its visible features.
    6. Document the projectile carefully. Record dimensions when measured, shape, jacketed or unjacketed appearance, deformation and visible land-and-groove impressions or other identifying marks.
    7. Protect medico-legal evidence. Do not clean, scratch or deliberately mark important projectile surfaces; package specimens separately, label and seal them, and maintain chain of custody.

Exam note: Entry and exit wounds can occasionally be atypical. A supported or “shored” exit wound may show an abrasion resembling an entry wound, so interpretation must use the complete set of findings.

🖼️ Visual Learning

VISUAL 1

Entry vs Exit Wound and Range-of-Fire Clues

 

📝 Important Viva Questions

Q1. What is the most useful feature of a typical firearm entry wound?

Answer: A surrounding abrasion collar is an important feature. A bullet-wipe or grease collar may also be present.
Q2. How does a typical exit wound differ from an entry wound?

Answer: It is usually more irregular, often larger and has everted margins. It normally lacks an abrasion/bullet-wipe collar and range effects such as soot or tattooing.
Q3. What is the difference between blackening and tattooing?

Answer: Blackening is surface deposition of soot and can usually be wiped away. Tattooing is produced by powder particles striking and embedding in or abrading the skin and therefore cannot simply be wiped off.
Q4. Which findings may help estimate the range of firing?

Answer: Muzzle imprint, gas effects, burning, singeing, soot/blackening and powder tattooing are useful range-related findings. Exact distance should not be stated without appropriate test firing and correlation.
Q5. Can an exit wound ever have an abrasion around it?

Answer: Yes. A shored exit wound may develop an abrasion when the skin is supported by a firm surface and can therefore resemble an entry wound.
Q6. What are rifling impressions on a fired bullet?

Answer: They are impressions produced as the bullet passes through a rifled barrel. Their class and microscopic characteristics can assist forensic comparison with a suspected firearm.
Q7. How should a recovered bullet be handled as medico-legal evidence?

Answer: Handle it minimally, avoid cleaning or damaging identifying surfaces, package it separately, label and seal it properly, and maintain chain of custody.
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