Rheumatology

Abstract

Musculoskeletal pain is a frequent presenting complaint to primary care physicians. The majority of these patients have a localized disorder from overuse, trauma, or degenerative disease. A smaller number of patients present with more generalized musculoskeletal pain and a multitude of complaints that may represent a wide spectrum of illnesses varying from any of the connective tissue diseases to articular manifestations of nonrheumatologic diseases. Although the extent of evaluation of these patients will differ, a similar approach designed to answer several simple questions can be used in both settings. As one does the history and physical examination, the following questions should be answered: (1) Is the problem localized or generalized? (2) Is it structural or inflammatory? (3) What structure or structures are involved? (4) Are there systemic symptoms or extraarticular manifestations?