Epidemiology Estimates of the prevalence of arthritis and other rheumatic diseases demonstrate the enormous impact that these conditions have on the U.S. populace and the health care system in general. Over 21% of U.S. adults report physician-diagnosed arthritis. Osteoarthritis (…
Arthritis, arthralgias, and myalgias can be significant features of several systemic diseases and may be the presenting symptoms for some of these disorders ( Table 254-1 ). Appropriate evaluation of these musculoskeletal symptoms, including selected laboratory tests and radiographs, can…
Definition Fibromyalgia is the term that describes chronic widespread musculoskeletal pain, for which no alternative cause can be identified. If fatigue rather than pain is the presenting complaint, individuals are often diagnosed with chronic fatigue syndrome. , Gastroenterologists often see…
The three most common crystal-induced arthropathies are caused by precipitation of monosodium urate monohydrate, calcium pyrophosphate dihydrate, and basic calcium phosphate and are termed gout, calcium pyrophosphate arthropathy , and basic calcium arthropathy , respectively. Basic calcium crystals are ultramicroscopic…
Infection of Bursae Septic Bursitis Definition Bursae are the satellite structures that form to protect tissues from bony prominences. The superficial bursae, including the olecranon, prepatellar, infrapatellar, and bursae over the first metatarsophalangeal bunions, are more likely to become infected…
Definition Polymyalgia rheumatica and giant cell arteritis, also called temporal arteritis, are companion systemic inflammatory disorders of unknown etiology that is propagated by antigen-driven, cell-mediated immune mechanisms that may be associated with specific genetic markers. These disorders represent a spectrum…
Definition The vasculitides are a heterogeneous group of disorders linked by the common finding of destructive inflammation within blood vessel walls. The most current nomenclature scheme identifies at least 27 different forms of primary vasculitis ( Table 249-1 ). TABLE…
Definition The inflammatory myopathies are a heterogeneous group of acquired disorders in which the immune system is thought to play a major pathogenic role. Though some genetic disorders affecting muscle also have significant involvement of the immune system and are…
Definition Sjögren syndrome is a systemic autoimmune disease with glandular and extraglandular manifestations. Its cardinal glandular features are keratoconjunctivitis sicca, or dry eyes, and xerostomia, or dry mouth, otherwise known as the sicca complex. Sjögren syndrome can be primary or…
Systemic Sclerosis Definition Systemic sclerosis , originally termed scleroderma , is a chronic autoimmune disease of unknown cause associated with considerable morbidity and mortality. The disease shows marked clinical heterogeneity, has protean clinical manifestations, and may follow a stable, indolent,…