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Evaluating rheumatological and musculoskeletal symptoms 

Evaluating rheumatological and musculoskeletal symptoms
Evaluating rheumatological and musculoskeletal symptoms

Gavin Clunie

, Nick Wilkinson

, Elena Nikiphorou

, and Deepak R. Jadon

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date: 15 April 2021

General rheumatological assessment is for musculoskeletal pain, stiffness or swelling, weakness, fever, rashes, and fatigue. This chapter describes both the nature of those symptoms helpful in making a diagnosis and also the subjective elements influenced by exertion, loss of function, anxiety, cultural norms, and other symptoms. In children and adolescents, symptoms are also influenced by developmental stage and may present simply as a limp or loss of limb function. Other referrals are for symptom complexes (such as Raynaud’s disease) or isolated abnormal investigations (such as elevated erythrocyte sedimentation rate or antinuclear antibody). Both paediatric and adult assessment requires the effective use of the (p)GALS screening examination tool described here. The nature of symptoms requiring rheumatological assessment varies according to diagnosis and has a subjective element influenced by exertion, impact, anxiety, cultural norms, and associated symptoms. They include musculoskeletal pain and stiffness, weakness or loss of limb function, fever, and also fatigue. Other referrals require assessment of symptom complexes or isolated abnormal investigations.

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