RT Book, Section
A1 Cush, John J.
A2 Loscalzo, Joseph
A2 Fauci, Anthony
A2 Kasper, Dennis
A2 Hauser, Stephen
A2 Longo, Dan
A2 Jameson, J. Larry
SR Print(0)
ID 1190523370
T1 Approach to Articular and Musculoskeletal Disorders
T2 Harrison's Principles of Internal Medicine, 21e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264268504
LK accessmedicine.mhmedical.com/content.aspx?aid=1190523370
RD 2023/06/09
AB Musculoskeletal  complaints  account  for  >315  million  outpatient  visits  per  year  and  >20%  of  all  outpatient  visits  in  the  United  States.  The  Centers  for  Disease  Control  and  Prevention  estimate  that  58.5  million  (or  1  in  4  adults)  of  the  U.S.  population  has  physician-diagnosed  arthritis.  While  many  patients  will  have  self-limited  conditions  requiring  minimal  evaluation,  reassurance,  and  symptomatic  therapy,  specific  musculoskeletal  presentations  or  their  persistence  may  herald  a  more  serious  condition  that  requires  further  evaluation  or  laboratory  testing  to  establish  a  diagnosis.  The  goal  of  the  musculoskeletal  evaluation  is  to  formulate  a  differential  diagnosis  that  leads  to  an  accurate  diagnosis  and  timely  therapy,  while  avoiding  excessive  diagnostic  testing  and  unnecessary  treatment  (Table  370-1).  There  are  several  urgent  conditions  that  must  be  diagnosed  promptly  to  avoid  damage  and  morbidity.  These  “red  flag”  diagnoses  include  septic  arthritis,  acute  crystal-induced  arthritis  (e.g.,  gout),  and  fracture.  Each  may  be  suspected  by  an  acute  onset  and  monarticular  or  focal  musculoskeletal  pain.